Abstract
Rationale & ObjectiveStudies published from countries with a high prevalence of COVID-19 have found increased incidence and a more severe disease course of coronavirus disease 2019 (COVID-19) in kidney transplant recipients than in the general population. We investigated how the first wave of the COVID-19 pandemic affected the everyday life of kidney transplant recipients in a country with a low infection burden.Study DesignProspective case-control study.Setting & ParticipantsAll adult kidney transplant recipients in Norway with a functioning graft and listed in the public phone registry (n = 3,060) and a group of randomly recruited individuals >18 years from the general population (n = 20,000) were invited to participate in the study by an SMS text message. In parallel, all kidney transplant recipients in Norway were invited to measure severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG from mid-June to October 2020.PredictorsThe participants were asked to fill out a questionnaire focused on everyday life, travel history, exposure to known COVID-19 cases, and demographics.Analytical ApproachGroups were compared with independent tests using 2-sided 0.05 significance levels.ResultsA total of 1,007 kidney transplant recipients and 4,409 controls answered the questionnaire. The kidney transplant recipients reported being more concerned about SARS-CoV-2 infection (27%) than the control group (7%; P value < 0.001); ie, they behaved more carefully in their everyday life (not going to the grocery store, 5.9% vs 0.9%, P < 0.001; keeping at least 1 meter distance, 16.6% vs 5.8%, P < 0.001). Of the kidney transplant responders, 81% had a SARS-CoV-2 IgG taken; all were negative.LimitationsMortality data is not reliable because of the low number of SARS-CoV-2 infected kidney transplant recipients in Norway. The relatively low questionnaire response rate for kidney transplant recipients is not optimal.ConclusionsThe questionnaire shows that kidney transplant recipients have behaved more carefully compared with the general population with less social interaction and a very high degree of adherence to governmental advice.
Highlights
Coronavirus disease 2019 (COVID-19) rapidly spread worldwide and was declared a pandemic by the World Health Organization (WHO) in March 20201
The need for life-long immunosuppression is a challenge for fighting viral infections and may pose a specific risk for a more severe course of COVID-19 in kidney transplant recipients
Studies published from countries with a high prevalence of COVID19 support this theory as they found increased incidence and a more severe disease course of COVID-19 in kidney transplant recipients than in the general population 7-9
Summary
Mortality data is not reliable due to the low number of SARS-CoV-2 infected kidney transplant recipients in Norway. Conclusions: The questionnaire shows that kidney transplant recipients have behaved more carefully compared to the general population with less social interaction and a very high degree of adherence to governmental advice. Journal Pre-proof Plain-language summary: Studies from countries with a high incidence of COVID-19 disease have shown increased incidence and a more severe disease course of COVID-19 in kidney transplant recipients than in the general population. All kidney transplant recipients in Norway were invited to measure SARS-CoV2 IgG. We found that kidney transplant recipients have behaved more carefully compared to the general population. The kidney transplant recipients have not had an increased incidence of COVID-19 compared to the general population, in contrast to previous findings in countries with a high prevalence of COVID-19
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