In the current state of knowledge, there is a theoretical risk that patients with kidney disease, dialysis patients or transplant patients, once infected with the coronavirus, will develop more severe forms of the disease, leading to more complications and death.
Although no data exist at this stage on the consequences of coronavirus in these patients, this risk, which is explained by their fragility and weakened immune defenses, is well documented for most infectious diseases.
For example, transplant patients infected with influenza have a higher risk of developing complications, and a higher risk of dying from influenza.
In the context where the virus seems to be spreading in France, many of you have expressed your questions and dismay, especially since there are still no official recommendations for patients with kidney disease, dialysis patients or transplant patients. The SFNDT published on 9/03 a document intended for nephrologists, but it deals only with the organization of care by dialysis and transplantation.
For all these reasons, it seems useful to us to offer some advice, largely inspired by the recommendations published in other countries.
The objective is to protect oneself as much as possible from the virus, to avoid catching it, or failing that, to delay contamination as long as possible.
Indeed, saving time means avoiding overloading our health care system at a time when it is likely to be under stress. It also means allowing knowledge about the disease to improve and effective treatments to be developed.
✅ Apply all the precautions recommended for the general population.
✅ Stay at home as much as possible, opting for teleworking if possible.
✅ If teleworking is not possible and if you fear that your professional activity may expose you to the virus, in the absence of a right of withdrawal provided for to date for people at risk of developing serious forms, discuss with your nephrologist the advisability of a work stoppage as a precautionary measure.
✅ Avoid public places, crowds, public transport, restaurants, theatres, cinemas, etc.
✅ Avoid contact with potentially contagious people: you can be contagious without having any symptoms.
✅ If one of your relatives living under the same roof as you is infected, it may be useful to temporarily consider separate accommodation.
✅ Avoid going to hospital unless it is strictly necessary, prefer teleconsultations or a simple telephone conversation with your doctor as much as possible.
✅ If you still have to go to a confined area where you might come across contagious people, for example a dialysis center or hospital, wear a mask if possible and keep a safe distance of at least one meter from other people.
✅Des masks are usually available in pharmacies for frail people on prescription. But to date we have little certainty about this device and contradictory testimonials about it.
✅ If you have symptoms that make you fear you may have caught the coronavirus (cough, fever, difficulty breathing, etc.) contact your nephrologist or the nephrology service that is treating you without delay.
Corona Kidney Failure: A symptom in some patients of the virus.
Coronaviruses, in general, occur worldwide and are mainly transmitted via droplet infection. According to the World Health Organization, coronaviruses are a large family of respiratory viruses that can cause diseases ranging from common colds to Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS).
Those who are ill primarily show infections of the respiratory tract. The incubation period is seven days on average. This means that one week can pass between infection and the outbreak of an infectious disease. According to the Robert Koch Institute, the incubation period for the new coronavirus, on the other hand, is assumed to last up to 14 days.
According to the WHO, symptoms of the current (novel) disease are fever (over 38 degrees), cough and/or shortness of breath. The Robert-Koch-Institute also lists colds, as with a mild cold. The WHO also lists the occurrence of breathing difficulties. “In serious cases, an infection can cause pneumonia, severe acute respiratory syndrome, kidney failure, and even death,” says the World Health Organization.
Updated March 7, 2020
949 confirmed cases and 16 deaths in France.
While no specific official recommendation for people with kidney disease has yet been issued in France, several other countries are proposing and developing them.
✅ The nephrology service of the University Hospitals of Geneva has published a new development. While it renews the “usual” recommendations (washing hands, avoiding handshakes, avoiding contact with sick people or busy places, etc.), it also advises transplant patients :
to avoid public places, meetings, transport at peak times, to opt for teleworking if possible
avoid going to hospitals and prefer teleconsultations. Otherwise, she said that the Geneva hospital keeps masks available for patients who go there.
✅ After the learned societies of nephrology and transplantation, it is the turn of the American government, via the CDC, to publish recommendations for people at risk. People with kidney disease are explicitly mentioned as being at risk.
The advice is very demanding since it is suggested, among other things, to stay at home and to build up a sufficient supply of medicines, food and basic necessities for a few weeks.
Similar recommendations are proposed by the American Kidney Foundation.
✅ The ONT, the Spanish equivalent of the Biomedicine Agency, has published recommendations for transplant patients, established with learned societies, in the form of computer graphics.
Update of 5 March 2020
There are few specific novelties for renal failure patients in France, which now has 423 confirmed cases and 7 deaths.
On the other hand, some information is coming to us from other countries:
✅The nephrology service of the University Hospitals of Geneva proposes on its blog an article “Coronavirus and renal failure patients: what about it?”.
“(…) We recommend that you do not come into contact with a person who has a fever, coughing or acute respiratory symptoms. If you have to be in confined spaces and you have fears, you can put on a mask (…) (type FFP2). Frequent hand washing is an easy extra precaution.
However, it is not necessary to wear a mask in the open air or in a public place if you do not have close and prolonged contact with someone who shows the above-mentioned signs.
We remind you that we speak of close and prolonged contact when it is less than 2 meters away and lasts more than 15 minutes.”
The United States
✅The American Learned Society of Nephrology has published recommendations for managing possible contamination of dialysis patients.
✅The American learned society of transplantation has published a document on coronavirus in transplant patients. It recommends that these patients “be cautious” with high-traffic areas and states that it is not certain that wearing a surgical mask will protect them from the virus.
Updated March 1, 2020
✅Pour At present, no specific instructions have been sent to patient associations and the “official” information is not specific to people at risk of developing a serious form of Covid-19 disease.
✅France Assos Santé has published this information note on the virus, preventive gestures and reflexes to adopt in case of doubt.
We will regularly update this page according to new information available.
✅ Santé Publique France offers an information page updated daily at 7pm with data on viruses in France and around the world.