COVID-19 (Coronavirus) Information for Transplant Recipients

• Fever
• Cough
• Shortness of breath
• Other flu-like symptoms

Most people with COVID-19 have only mild, flu-like and respiratory symptoms which can be managed at home. However, some patients may develop severe pneumonia and breathing problems that require hospitalization. Those with a weak immune system are particularly at risk.

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

The complete clinical picture of COVID-19 is not fully understood. While information so far suggests that most COVID-19 illness is mild, serious illness occurs in some cases. Older people and people with certain underlying health conditions like heart disease, lung disease, diabetes, for example, seem to be at greater risk of serious illness. Transplant recipients taking immunosuppressive medications are also at risk of more severe illness. A severe illness can result in death.

The virus is thought to spread mainly from person-to-person; Between people who are in close contact with one another (within about 6 feet), through respiratory droplets produced when an infected person coughs or sneezes. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

Given their immunosuppression, transplant patients are felt to be at higher risk for developing COVID infection and having more severe COVID infection, putting them at a higher risk for spreading infection to people around them. It is important to know that COVID-19 may be much more severe than the typical “flu” and severe infections have a greater risk of being fatal.

You may have heard about two kinds of facemasks. N95 masks are special masks used in industry and the construction trades, as well as by health care workers in an infectious environment. During this outbreak, the President and national authorities have asked for all N95 masks to be reserved for healthcare workers. The more common facemask is the surgical mask you’re used to seeing in healthcare environments, but even these are currently in limited supply.

The CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19. However, if you are a transplant recipient or a person with a weak immune system you should be wearing a face mask when likely to be around sick people, in crowded spaces or entering a healthcare facility. Otherwise, facemasks should be used by people who are suspected of exposure to the virus and those who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for people who are taking care of someone in close settings (at home or in a health care facility).

• Avoid close contact with people who are sick.
• Avoid busy places and large crowds.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Cover your cough or sneeze with a bent elbow or tissue and then throw the tissue in the trash.
• Wash your 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 soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol.
• Clean and disinfect high-touch objects and surfaces using a household cleaning spray or wipe.
• Practice “social distancing.” If you must go out, stay at least six feet from others.
• Stay home when you are sick.
• If you work, try to work from home as much as you can.

If you have fever, cough and difficulty breathing, seek medical advice early. Call your transplant coordinator anytime, 24/7 or Henry Ford’s Coronavirus hotline Monday – Friday 8 a.m. – 5 p.m. and 8 a.m. to 2 p.m., Saturday at (313) 874-1055.

It is best to postpone nonessential travel. Recommendations regarding international travel are changing regularly. For up-to-the-minute information, see the U.S. Department of State website. Transplant recipients’ immediate household contacts should also postpone non-essential travel. All plans should be discussed with your transplant coordinator before you travel. If it is critical that you travel, follow all the recommended precautions. More travel advice is available from the Centers for Disease Control.

There are many different causes for fever, cough, shortness of breath, and flu-like symptoms.

If you have not traveled to high-risk areas in the last two weeks and you have not been in contact with someone who has COVID-19 (for example someone who has recently returned from a country or area with high COVID-19 activity and is ill), it is unlikely you have COVID-19. However, you need to call your transplant coordinator or physician to be evaluated for possible testing, for further instructions and to monitor your progress.

Currently, in North America, influenza and several other respiratory viruses are circulating as well. If you have a cough or fever and access to a mask, use a surgical mask (not an N95 mask) when in public to avoid the spread of infection to anyone else.

If your symptoms are mild, do not come to the hospital or any health care facility without first talking to your transplant coordinator. If you have only mild symptoms we may not want you to come to the clinic, so talk with your transplant coordinator FIRST before coming to any hospital or clinic.

If a close contact is diagnosed with or suspected of having COVID-19, you should avoid all further contact with them. You should let your transplant coordinator know you have been in contact with someone diagnosed with COVID-19. Then monitor your health and contact your transplant coordinator if you develop fever, cough or shortness of breath.

The risk of acquiring COVID-19 from organ donation is low. Donors are being screened for COVID-19 symptoms and exposure history. They are also being tested for the virus in Michigan and most other states. Living donor transplants are being postponed at Henry Ford, and at most centers around the country. This is likely to continue until it is safe for living donors and recipients continue with their procedures.

Living donors are additionally being asked to not travel for at least 14 days before donation and to watch for symptoms. Information regarding recent travel and possible exposure is also asked about deceased donors to help determine if they are safe candidates for organ and tissue donation.

When living donor procedures resume, donors and recipients may be tested for the virus using nasopharyngeal swabs.