COVID-19: advice for people with liver disease

Posted on: 6th February 2023

COVID-19 information is still changing regularly. The information on this page was correct at the time of publication. For up to date information, check the NHS website here.


Am I at higher risk from COVID-19?

Some people with a liver condition will be at a higher risk from COVID-19. You may have had a letter from your GP or specialist to tell you that you are higher risk.

If you have not had a letter, or if you have only recently found out that you have a liver condition, it can be hard to work out if you are at higher risk.

There is no clear list of conditions that make you high risk. Even people with the same medical condition can have different levels of risk. So, if you are not sure if you are at higher risk, you will need to talk to your doctor. GPs and hospitals have been given guidance on how to decide if someone is higher risk or not.


Higher risk liver condtions
As a guide, health care professionals have told the British Liver Trust that people with a liver condition are likely to be higher risk if:

  • You have liver cirrhosis and decompensation. This means you have had any of these complications in last 12 months:
    • Ascites,
    • hepatic encephalopathy
    • hepatocellular carcinoma
    • variceal bleed
    • fluid retention
  • You have had a liver transplant
  • You are on the liver transplant waiting list
  • You have long term (chronic) liver disease AND you are taking immunosuppressant medicine
  • Your GP or hospital specialist has assessed your medical condition and decided that you are at higher risk

You can also see the NHS list of people thought to be at higher risk, on the NHS website here:

If you are at higher risk, you may be entitled to booster vaccines, free tests and earlier treatment. So it is worth talking to your doctor and finding out.

Keeping yourself safe from COVID-19

The ending of restrictions can be worrying if you have a serious health condition.

Vaccines have reduced the spread of COVID-19 and how badly it affects most people. But some people are still at higher risk of becoming very unwell if they get COVID-19.

The NHS has advice on things that can help keep you safe if you are at higher risk:

  • Get vaccinated against COVID-19 Read more here
  • Continue to wear a face covering in shops, on public transport and when it's hard to stay away from other people (particularly indoors or in crowded places)
  • Continue to stay at least 2 meters away from people (particularly indoors or in crowded places)
  • Try to work from home if you can, or talk to your employer about how they can help reduce your risk at work
  • Wash your hands with soap and water or use hand sanitiser regularly throughout the day
  • Limit the number of people you meet inside and avoid crowded places
  • Meet people outside if possible
  • Open doors and windows to let in fresh air if meeting people inside
  • Think about asking people to wear a face covering if meeting them inside
  • Think about asking people to take a rapid lateral flow test if meeting them inside


You can find this information on the NHS website here


Looking after your mental health

It’s normal to be anxious if you or a loved one are living with a health condition. Protecting your mental health is just as important as your physical health. Here are some things that could help:

  • Stay connected.

We often feel alone at difficult times. Try and keep in regular contact with people you know will support you.

  • Connect with people on social media.

But avoid reading or commenting on things that increase your stress or worries.

You can join our online community to talk to other people in a similar situation:

  • Think about the things you can control.

If it feels like there are a lot of things you cannot control, try to focus on something that you can. You could try to eat a healthy balanced diet, take regular exercise, or get into a routine to improve your sleep.

  • Avoid information overload.

Only look at reliable sources of information that are updated regularly. Safe sources of information include: the NHS, and

  • If you are feeling isolated or lonely and need someone to talk to, you can contact a helpline:

Samaritans:116 123 (for anyone at any time for any reason)

Mind: 0300 123 3393

FAQs for people with a liver condition who are immunosuppressed

No, the risk is about the same.

A study found that people with autoimmune hepatitis, and people with other liver conditions have the same level of risk from COVID-19.

The study compared two groups:

  • People with both COVID-19 and autoimmune hepatitis
  • People with both COVID-19 and a different liver condition

The results showed that people in both groups had the same risk of needing to stay in hospital, having to stay in an intensive care unit (ICU), or dying.

Most of the people with autoimmune hepatitis who took part in the study were taking immunosuppressant medicines.

The work was carried out by researchers at Oxford university hospitals.

Most people with a liver condition are not severely immunosuppressed.

You may be severely immunosuppressed if:

  • You are taking immunosuppressant medicines including:
    • Immunosuppressive or immunomodulating biological therapy
    • High dose steroids, taken for more than a month
    • Steroid sparing agents
  • You have a history of haematological malignancy

A haematological malignancy is a cancer that started in your blood, bone marrow, or immune cells.

You should be told if a medicine will make you severely immunosuppressed before you start taking it. If you are unsure, always talk to your GP or specialist.

The COVID-19 vaccines used in the UK are safe for people who are immunosuppressed.

Vaccines have been shown to significantly reduce your risk of becoming very unwell or dying from COVID-19 if you have had a transplant or are waiting for one.

A study is underway to look at how well the vaccines work for people who are immunosuppressed. Including those with liver conditions.

People in this study were given vaccines. The researchers then looked at how well their immune systems responded. This included looking at how many antibodies they produced against the COVID-19 virus.

The study reported its first results in August 2021. It found that, in people with a chronic liver condition, about 6 in 10 had a similar number of antibodies to someone with no health conditions.

We don’t yet understand how many antibodies you need to reduce your risk from COVID-19. So, people who didn't have as many antibodies could still be getting some protection.

Professor Iain McInnes, one of the lead investigators, said:

“We would continue to encourage all people and especially those patients within these clinically at-risk groups to make sure they receive their vaccine doses if they haven’t done so already.”

Find out more about the COVID-19 vaccines and how to get them here:

Your specialist will talk with you about any vaccinations you need, including COVID-19. They can recommend you have the vaccine straight away, rather than wait for a campaign. Read more about COVID-19 vaccines.


Find out more about COVID-19 vaccinations for people with a liver condition.

COVID-19 treatments for people most at risk

If you are at higher risk from COVID-19, you can get free tests and treatment. Read more here.