Special Considerations in the Management of Autoimmune Hepatitis in COVID-19 Hotspots: A Review

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The ongoing coronavirus disease-2019 (COVID-19) pan-demic has necessitated special considerations in the man-agement of diseases. The way presence of pre-existing dis-eases or treatment for it predisposes to, alters course of, and changes the management of COVID-19, is of relevance and is being extensively studied. Autoimmune hepatitis (AIH) is unique in that it is an autoimmune disease man-dating treatment with immunosuppressive drugs, as well as a liver disease with potential for varying degrees of under-lying fibrosis. The use of immunosuppressive drugs could alter the risk of acquiring COVID-19, the clinical course and severity of COVID-19 and the degree of underlying liver fibrosis could alter the clinical outcomes of patients with COVID-19. In this review, we try to summarize key areas relevant in understanding and improving the clinical care of patients with AIH in the current pandemic. Special con-siderations required in the management of patients with AIH in COVID-19 hotspots have been outlined based on the current evidence.
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