Coronavirus (COVID-19) Q&A for heart and lung-transplant recipients

The coronavirus (COVID-19) outbreak is a rapidly developing situation in the UK. At Harefield Hospital we have taken steps to reduce non-emergency clinic appointments for patients who are well and will offer telephone appointments as an alternative option for patients who require medical advice. 

We are receiving an increased number of calls from patients and will attempt to answer some of the common questions below.

Public Health England has issued guidance on social distancing for everyone in the UK. This covers a list of those who fall into the high-risk group identified as people who are at increased risk of severe illness from coronavirus. The list includes those with clinical conditions, including people who have received an organ transplant. Read the guidance in full.

Last updated 12th March 2020.

What can I do to keep myself safe?
Am I at increased risk?
What should I do if I feel unwell?
What should I do if I think I have been in contact with someone with COVID-19?
Should I self-isolate or work from home?
What should I do if I have a holiday planned?
If someone at my child's school gets it should I keep my child off as well?
Will I still be able to access my medicines / do I need to stockpile?
How you can help

What can I do to keep myself safe? 

Patients who have undergone transplant should follow national guidance as below in order to help prevent spread of the virus:

  1. Always carry tissues with you and use them to catch your cough or sneeze. Then bin the tissue, and wash your hands, or use a sanitiser gel
  2. Wash your hands often with soap and water, especially after using public transport. Use a sanitiser gel if soap and water are not available
  3. Avoid touching your eyes, nose and mouth with unwashed hands
  4. Avoid close contact with people who are unwell
  5. Social distancing measures such as avoiding face-to-face contacts, conducting business by phone or online, avoiding public places and reducing unnecessary travel are likely to reduce your risk of acquiring COVID-19 as well as reducing risk of ongoing transmission.

You should share this advice with friends and family. You can access the latest updates from the NHS website.

Am I at increased risk?

There is no specific data on the relative risk of COVID-19 in patients who have had a cardiothoracic transplant. Patients with chronic heart or lung disease are known to be at increased risk of developing severe illness. It seems reasonable to consider that all patients who have had a transplant will be at increased risk of severe infection especially if they have established graft damage that has occurred since transplant. Patients requiring oxygen or NIV will most likely be at highest risk.

There is no evidence that wearing a face mask will protect patients from acquiring COVID-19, but if they have a cough then wearing the mask may protect others, so this is a reasonable approach if you have symptoms.

What should I do if I feel unwell?

It is extremely important that you do not go directly to your transplant centre unless specifically advised to do so by a member of the transplant team.

The symptoms of COVID-19 are the same as many other problems in patients who have had a transplant which makes it difficult to decide the best course of action. You should monitor your symptoms closely, i.e. increased vigilance with spirometry is highly desirable if you have had a lung transplant or monitor for respiratory of cardiac symptoms if you have had a cardiac transplant. If you develop fever, cough or difficulty breathing you should call the transplant team on 01895 823737. If you are well (i.e. with no drop-in spirometry) it is likely we will ask you to call NHS 111 for access to local COVID-19 testing. If you are unwell you may be asked to attend the transplant unit.. If you are advised to come to the hospital, please stay in your car and call the on-call transplant doctor/nurse in charge to advise them that you have arrived. Do not enter the hospital without doing so. If there is clinical concern based on your history, a member of staff will come to meet you with protective clothing for you to wear and will direct you to the most appropriate place immediately.

Please continue to follow advice regarding social distancing and handwashing stringently.

What should I do if I think I have been in contact with someone with COVID-19?

If you have been in contact with someone who has a confirmed case of COVID-19, you should self-isolate, and let your clinical team know so that they can monitor you closely. If you start having symptoms call 111 and let your transplant team know.

Should I self-isolate or work from home?

Social distancing is highly advisable. You should follow PHE advice on self-isolation. As a transplant team we encourage you to work from home, if possible.

What should I do if I have a holiday planned? 

The current situation with regards COVID-19 is evolving rapidly. Specific advice with regard to risk can be found on the Foreign and Commonwealth Office website.

Deciding to travel in this current climate is difficult and highly personal. Given the potential for exposure to large numbers of people it would seem sensible to avoid all but essential travel. If travel is essential, please take out appropriate travel insurance and see first point: “What can I do to keep myself safe?

If someone at my child's school gets it should I keep my child off as well?

Patients should follow the national advice with respect to school and work attendance. If a lung transplant recipient or their family are concerned about the risks associated with catching COVID-19 infection, they should discuss these with their transplant team. For people that have significant and established graft disease, it is difficult to quantify the risk and other measures may be appropriate if agreed with your transplant team. For children that are well it is important that they are not unnecessarily kept off school.

Will I still be able to access my medicines/do I need to stockpile? 

We are working closely with our NHS partners e.g. Healthcare at Home, to make sure we continue to have enough supplies of medicines for our patients. If you are currently receiving medicines such as anti-rejection medication from Healthcare at Home, this will continue, however, at this time we are unable to enrol any new patients. The main change people may experience is that drivers may not ask for signature and may stay a safe distance away from patients by setting parcel down and then walking away and watching for recipient to pick up parcel. No medicines will be left unattended.

How you can help 

As usual, make sure you have enough ‘buffer stock’ by keeping at least two to four weeks’ worth of your medicines at all times (as advised by your clinical team), and requesting repeat prescriptions or homecare deliveries well in advance of this supply running out. That will give your pharmacy or homecare provider enough time to deal with any shortages should they arise.

It’s important to note that this is standard practice for our patients and not new advice.

If you are experiencing any difficulty getting hold of a supply of your medicines, or if you have any concerns about their availability, please let the pharmacy team know as soon as, please contact the team at Harefield Hospital: transplantpharmacy@rbht.nhs.uk


Further information about coronavirus is available on the NHS website and gov.uk/coronavirus

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