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Covid-19 Advice for Liver Service Patients

Updated advice to all Liver patients attending Royal Liverpool University Hospital

Many of you will have received a letter or text from the Department of Health about your health risk in relation to coronavirus. People who received this were contacted because they were on a database of people who ought to receive the Seasonal Flu vaccine. The advice you received was based purely on that criterion.

The Liver and Gastroenterology Specialists across the UK, and beyond, have worked together to refine the advice, to make it more personal. The advice we are giving you is supported by the British Society for Gastroenterology (, and the British Association for the Study of the Liver ( Please do look at their websites to verify our message.

For the moment we think that it will be better for you not to go for extra tests or hospital visits to avoid you getting the virus. 

In the meantime please follow the government advice to wash your hands frequently, Stay at home and

  • Only go outside for food, health reasons or essential work
  • Stay 2 metres (6ft) away from other people
  • Wash your hands as soon as you get home

You can keep up to date by listening to news on radio or television or if you have internet at

In addition to the government guidelines we would advise the following groups of patients to take additional measures to go into self isolation for 12 weeks.

Patients with liver disease and

  • Aged over 70 years old
  • Pregnant
  • Other existing illnesses including diabetes, lung disease or heart disease
  • All Liver transplant recipients
  • All patients taking immunosuppression drugs for autoimmune hepatitis
  • Patients with cirrhosis and one or more of: 
    1. Ascites – Fluid in the tummy
    2. Encephalopathy – Confusion episodes treated with lactulose
    3. Jaundice – Yellowness of the eyes and skin

Please be aware this guidance may change and we advise that you consult the British Association for the Study of the Liver or The British Society of Gastroenterology website for up to date advice during this evolving outbreak.

If you develop new symptoms related to your liver disease or have any queries or questions related to your liver excluding coronavirus, we will endeavor to respond as soon as possible.

During the outbreak, most patients will be reviewed 'virtually'. Your specialist will review your notes. If no action is required (you were due a routine checkup for example), we will write to you, so don’t be alarmed if you haven’t received a call on the day of your appointment. If we feel it is important to do so we may call you around the time of your existing outpatient appointment - you should not attend the clinic in person.  If we decide that we need to meet in the clinic, we will make specific arrangements. If investigations (like blood tests or scans) are required you will be informed of the best way these can be carried out.

In addition to the above advice:

  • If you are unwell, please do not attend Accident and Emergency (A&E) unless it is an absolute emergency and there is a threat to your life or an accident has occurred.
  • Please contact 0151 7062805 or email if you have any urgent queries or symptoms felt to be related to your liver disease, or if you have tested positive for Coronavirus (COVID-19), as your first contact.
  • Be aware that our Liver nurses are overwhelmed currently and are having to prioritise calls with the most urgent being answered first.
  • If you are on immunosuppression such as steroids (usually prednisolone), immunomodulators (Azathioprine, Mercaptopurine, Methotrexate, Tacrolimus, Mycophenolate or Cyclosporin) do not stop taking these unless you become unwell and are instructed to do so as it is essential your liver disease remains under control as much as possible.
  • Please ensure you have enough oral medications to last for at least a few months if that is possible – do appreciate GPs, pharmacies and primary care services are also overwhelmed.

We want to thank you in advance for your cooperation at this very difficult time and can assure you we will do the very best we can for you given the situation the NHS is in.  We apologise that the Liver service may not be exactly what you are used too but please bear with us and we will do our very best to take care of everyone during this difficult time.

This international crisis has galvanized the entire healthcare and scientific community to find joint solutions to fighting this virus – not just in Liver patients, but the entire world population.  If there is one good thing that can come out of this crisis, it is that everyone is working together.  This should give you all great hope.

Finally, please all take very good care of yourselves and your families at this difficult time. Please do keep our team in your thoughts and prayers too.  We hope we can all get through this together.


Urgent Contact Details

By Email:

By Phone: 0151 706 2805