Table 1 Selected AASLD, APASL, and EASL Recommendations for Liver Disease Management During the COVID‐19 Pandemic Recommendations AASLD APASL EASL Limit nosocomial transmission Prioritize patients to limit in‐person care On arrival, screen patients for COVID‐19 symptoms, exposures; if suggestive of COVID‐19, refer care per clinic’s protocol for symptomatic patients Use telemedicine alternatives for routine care Reduce routine laboratory and imaging monitoring Prescribe 90 days of medications Cancel all elective/nonurgent endoscopic procedures and biopsies Limit in‐clinic evaluations for transplant Limit clinical trial activity to essential clinical trials Limit HCWs providing care or on patient rounds HCWs follow recommendations for PPE Use telemedicine alternatives for routine care Minimize number of HCWs caring for patients Minimize number of HCWs on patient rounds Cancel elective, nonurgent endoscopies and liver biopsies HCWs follow recommendations for PPE Limit in‐person care to urgent cases Remodel clinic space for social distancing Use telemedicine for routine care; postpone specialist visits Reduce frequency of laboratory monitoring and obtain locally HCWs follow recommendations for PPE Evaluate and care for patients with COVID‐19 for liver disease Prioritize for COVID‐19 testing: (1) patients with cirrhosis, (2) patients with CLD receiving immunosuppressive medications, and (3) patients with new‐onset encephalopathy or other acute decompensation Regularly monitor liver biochemistries Consider non‐COVID‐19 etiologies for liver disease: (1) exacerbation of preexisting CLD or (2) drug‐induced hepatotoxicity Use acetaminophen 2 g/day as preferred medication Use nonsteroidal anti‐inflammatory drugs as needed Consult the University of Liverpool document to assess possible drug interactions Follow WHO guidelines for COVID‐19 diagnosis Consider NAFLD as a prognostic factor for severe COVID‐19 Screen patients for hepatitis B surface antigen Consider HBV prophylaxis prior to use of anti‐IL‐6, other immunosuppressive therapy Monitor liver function tests of patients with CLD Be alert to possible drug hepatotoxicity Decompensated CLD and ALT >5 times ULD contraindications for remdesivir therapy Prioritize persons with CLD for clinical trials Test for COVID‐19 patients with acute decompensation or acute‐on‐chronic liver and per institution’s practices Persons with NAFLD likely to have comorbidity risk factors for severe COVID‐19 Consider patients with CLD/COVID‐19 for early admission and clinical trial Use acetaminophen (2–3 g/day is generally safe) Limit use of nonsteroidal anti‐inflammatory drugs Test for COVID‐19 patients with acute decompensation or acute‐on‐chronic liver and per institution’s practices Persons with NAFLD likely to have comorbidity risk factors for severe COVID‐19 Consider patients with CLD/COVID‐19 for early admission and clinical trial Use acetaminophen (2–3 g/day is generally safe) Limit use of nonsteroidal anti‐inflammatory drugs Manage hepatitis B; hepatitis C Continue HBV and HCV treatment of patients with COVID‐19 Proceed with HBV and HCV treatment in patients without COVID‐19 as clinically warranted Do not consider HBV treatment in patients with COVID‐19 unless flare is suspected Continue HBV and HCV treatment of patients with COVID‐19 Proceed with HBV and HCV treatment in patients without COVID‐19 as clinically warranted Do not consider HBV treatment in patients with COVID‐19 unless flare is suspected Document discussion with patient regarding CLD diagnosis and management Manage patients with HCC Continue HCC surveillance schedule for high‐risk subjects; 2‐month delay is acceptable Document discussion of risks and benefits of delaying surveillance with patient Proceed with HCC treatments as appropriate Continue therapy for non‐COVID‐19 patients For patients with HCC with COVID‐19, postpone elective transplant and resection surgery, withhold immunotherapy Maintain care per guidelines Admit early if COVID‐19 is diagnosed Consider postponing HCC therapies Manage pretransplant and posttransplant patients Screen donors and recipient for COVID‐19 Do not postpone transplants (an essential medical service, CMS Tier 3b) Notify patients of possible extended waiting times on transplant list Have low threshold for admitting patients on transplant waiting list diagnosed with COVID‐19 For posttransplant patients with moderate COVID‐19, consider reduction of immunosuppression therapy as appropriate Do not reduce immunosuppressive therapy in patients with mild COVID‐19 disease Test donors and recipient for COVID‐19 Limit transplant listing to emergency and urgent cases Look for SARS‐COV‐2 prior to organ procurement; defer donors with evidence of infection Consider specific COVD‐19 consent for patients on transplant waiting list For posttransplant patient with moderate COVID‐19, consider reduction of immunosuppression therapy as appropriate Do not reduce immunosuppressive therapy in patients with mild COVID‐19 disease Maintain care per guidelines Limit transplantation listings to patients with poor short‐term prognosis Vaccinate against pneumonia and flu Avoid reductions in immunosuppressive therapy Do not reduce immunosuppressive therapy in patients with mild COVID‐19 John Wiley & Sons, Ltd This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.