Coronavirus (COVID-19) and Transplant Patients
Coronavirus (COVID-19) is spread mainly from person to person. Older adults and people with suppressed immune systems or other chronic medical conditions seem to be at higher risk for more serious reactions. Because of this increased risk for transplant, kidney, liver, and other patients, it is especially important for our community to take preventative actions to protect ourselves. The Center for Disease and Control (CDC) recommends these actions to reduce your exposure:
Stock up on supplies
Take every day precautions (see below) to keep space between yourself and others
When you go out in public, keep away from others who are sick; limit close contact
Wash your hands often
Avoid crowds as much as possible
During a Coronavirus outbreak in your area, stay home as much as possible.
It's important that everyone follow these preventative measures recommended by the Centers for Disease Control (CDC):
Stay home if you feel sick or have any symptoms such as fever, cough, sore throat, body aches, headache, chills. IMPORTANT NOTE: If you are on dialysis, you should NOT miss your treatments. Contact your clinic if you feel sick or have any concerns.
Avoid others who are sick. Limiting face-to-face contact with others as much as possible.
Cover coughs and sneezes with a tissue, then throw it in the trash can. If you don't have a tissue, cough or sneeze into your upper sleeve, not your hands.
Wash hands often with soap and water for at least 20 seconds; especially after going to the bathroom, before eating, and after blowing your nose, coughing or sneezing. If you don't have soap and water, use hand sanitizer with 60%-95% alcohol.
Clean things that get touched a lot, like door handles, very often.
Avoid touching your face, especially your nose and mouth.
Wear a face mask if your healthcare team or someone from the public health office says you should.
Transplant Recipients in the Workplace
Transplant recipients have been strongly advised to telework/work from home or take leave, for at least 30 days when the situation will be reassessed. This is also suggested for family members so they do not expose the transplant recipient.
If the transplant recipient or family member feels that they MUST stay physically in the workplace (which is discouraged), please advocate for maximal social distancing. This includes doing all meetings as virtual meetings or calls, doing excellent and frequent hand hygiene, and avoiding use of public transportation to get to the workplace.
If there is an isolated office space that you can use for the duration, that is safer than a room full of cubicles. Disposable masks are not all that protective, although they will cut down on some droplet transmission. It is recommended that disposable masks be used by transplant recipients in any public places and the workplace, as well as hospital waiting rooms, but that the best option right now is to be out of the workplace and sheltering at home for at least 30 days.
Consult with your physician about your current options. If your physician feels like you need to be working remotely or taking a leave of absence, they can write you a letter to share with your employer based on your specific situation. Here is an example of what your physician could include but it will need to be adjusted based on your specific situation. This is just a starting point.
If you are experiencing symptoms and feel you need to be seen by your doctor, call your healthcare provider before your appointment. Tell your health provider that you are concerned about being exposed to COVID-19. Some offices also offer TeleHealth, which could help you avoid any unnecessary contact.
If you are a dialysis patient, it is important that you do NOT miss your treatments. If you feel sick, please be sure to tell a member of your healthcare team. The National Kidney Foundation has up-to-date information on clinic closings and emergency resources. The CDC and American Society of Nephrology have also provided guidance to dialysis centers to help them identify and handle suspected cases of COVID-19 and to minimize exposure to other patients. If you're concerned, here are some questions you can ask the staff at your center:
- Can I wait in my car instead of in the waiting room?
- What should I do if I have any flu-like symptoms?
- Can you provide a mask for me to wear during my treatment?
- What procedures do you have in place if you suspect a patient at the center may have COVID-19?
- How will you inform patients of any emergency information?
- Where will I receive dialysis if I get sick?
Check out this 3-Day Emergency Diet Plan. It does not take the place of dialysis but can reduce the waste that builds up in your blood in an emergency were you unable to get your treatment.
Listen to what COVID-19 means to kidney patients by watching this presentation by Alan Kliger, MD, with the American Society of Nephrology (ASN) and Shannon Novosad, MD with the Centers for Disease Control and Prevention (CDC),
Guidance for post-transplant patients
If you are a post-transplant patient, due to your need for immunosuppressive drugs, you may be at a higher risk for becoming seriously ill from COVID-19. If you feel sick, please be sure to tell a member of your healthcare team. If you're concerned, here are some questions you can ask the staff at your center:
- What should I do about having medications on hand?
- If I am feeling sick, should I contact my primary care doctor?
- If I am feeling sick, should I contact the transplant center?
- Should I wear a face mask when I need to have labs?
Guidance for pediatric patients
So far, it is not well understood whether pediatric kidney disease patients are at a higher risk for more serious illness, but pediatric nephrologists recommend following the advice from the CDC that has been issued for the elderly, especially if they are receiving immunosuppressive drugs. If your child's school is still open, consult with your nephrologist about keeping them home.
While taking the precautions listed above, it is also important to have a plan in the case that you do get sick with COVID-19:
- Talk with family and caregivers
- Establish how you will stay in touch if you need to be isolated
- Know important contacts:
- Dialysis facility
- Medical providers
- Care providers
- Determine who can provide care to you if your caregiver gets sick
If you feel sick or think you might have been exposed:
- Call your dialysis or transplant center and primary care providers to let them know your symptoms.
- This will help them appropriately prepare for your treatment or appointments.
- Know when to get emergency help by looking for the following symptoms:
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- New confusion or inability to arouse/drowsiness
- Blueish lips or face
Stress associated with the outbreak of COVID-19 is normal and may be different for each individual. Stress may include:
- Fear about your own health or about the health of someone you care about
- Difficulty sleeping or changes in sleep patterns
- Changes in eating patterns
- Difficulty concentrating
- Chronic health problems can worsen
- Increased use of alcohol, tobacco, or other drugs
Things you can do:
- Give yourself a break from news and social media
- Take care of yourself
- Deep breathing or meditation
- Eat healthy, well-balanced meals
- Get plenty of sleep
- Find time to relax and unwind
- Find time to do things you enjoy
- Connect with others and discuss how you are feeling
Learn more about helping children manage their stress and anxiety here.
Kidney-friendly shelf-stable items for your pantry
If there is a virus outbreak in your area and you need to decrease your risk of getting sick, it's important that you have shelf-stable food (foods that last a long time without spoiling, such as canned foods) in your home. It's important to prepare now by stocking up 2-3 weeks' worth of healthy, kidney friendly foods, fresh water, and medicines. This will help reduce your risk of infection by allowing you to avoid crowded spaces like grocery stores and pharmacies.