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CORONAVIRUS DISEASE (COVID-19): FAQ for transplant candidates and recipients

Updated: May 26, 2020

Information from the American Society of Transplantation

**Updated on March 16, 2020**


Information regarding COVID-19 is changing rapidly. This document will be updated as able with new information. Please contact your transplant center with specific concerns. A PDF version of this information can be found here.


Background:

Coronaviruses are common viruses that usually cause a simple cold. When new strains of viruses emerge, they can cause more severe diseases, as seen with the recent novel coronavirus disease called Coronavirus disease 2019 (COVID-19). This coronavirus is called the Severe Acute Respiratory Syndrome 2 virus (SARS-CoV-2). This new virus and disease were the cause of the outbreak in Wuhan, China, starting in December 2019 and now has spread to many parts of the world.


COVID-19 Symptoms:

  • Fever

  • Cough

  • Shortness of breath

  • Other flu-like symptoms

  • Some transplant recipients may develop pneumonia.


Currently, there are no antivirals or vaccines effective against this virus, although studies to develop these are ongoing.


Many transplant recipients and their families have questions regarding COVID-19. The information and questions below are designed to help give answers with currently available information, as well as links to national and international websites for regularly updated information.


Frequently Asked Questions

Q: Are transplant recipients at higher risk for the virus?

A: We do not have specific information on whether COVID-19 infection will be more severe in transplant recipients compared to healthy people; however, other viruses often cause more severe disease in people whose immune system is low, such as transplant recipients. For this reason, it is important to take precautions to prevent infection.

Infection occurs mostly through close, direct contact with someone who is carrying the virus.

People are thought to be most contagious when they have symptoms, BUT some people may carry the virus even if they are not showing symptoms or only mildly ill.It may be possible to catch the virus from a surface that an infected person touched if they touched their nose or mouth without washing their hands before placing them on the surface (like door handles, tabletops, etc.).The chances of being infected depend on whether there are infected individuals surrounding the transplant recipient.


Q: Are there any travel restrictions for transplant recipients?

A: COVID-19 has now been declared a pandemic, which means it is found in most areas of the world. Please visit the CDC website for information regarding the number of infections across the globe. For the most up-to-date travel advisories, please visit the U.S. Department of State website.


We currently recommend that transplant recipients:

  • Follow public health recommendations for social distancing.

  • Stay home as much as possible and put distance between you and other people if you must be out.

  • Do not travel to areas with high amounts of the circulating virus.

  • Should try to avoid crowds, especially if you live in an area where COVID-19 is being seen.


The level of risk varies by country and area, and it is changing quickly.

It is best to postpone nonessential travel, particularly to countries where access to medical care may be limited. We also highly suggest that transplant recipients’ immediate household contacts should postpone non-essential travel to areas that are considered high risk. All travel plans should be discussed with your transplant provider before your travel.

Travel restriction recommendations are likely to change over time. Check frequently for updated recommendations:

Centers for Disease Control and Prevention (CDC)World Health Organization (WHO)In Canada


Q: My family member just returned from an area with high COVID-19 activity. What should I do?

A: It is best to avoid contact for 14 days with individuals who returned from an area where they could have been exposed to COVID-19. If the individual remains healthy after 14 days, contact can be resumed.

If avoiding contact is not possible, it is recommended to:

  • Practice frequent handwashing or hand sanitizer use.

  • All household members should avoid touching their eyes, mouths, and noses.

  • Try to limit your contact with the family member.

  • Maintain as much separation as possible.

  • Cough and sneeze etiquette should be practiced (see figure below).




Q: Should transplant recipients wear a mask or avoid public places?

A: The benefit of wearing masks in public is controversial even for transplant recipients. It is unknown if wearing a mask will help prevent infection. Most surgical masks are not tight-fitting, and aerosols can get through. However, they may prevent you from touching your nose and mouth. Transplant recipients should avoid overcrowded situations.


If you have a fever and are coughing and sneezing, you should:

  • Tell your transplant center

  • Put on a mask when you go out in public, to the hospital, or a transplant clinic.

Overall, if you choose to use a mask to prevent any spread of infection, it is recommended to choose a surgical mask (DO N