Forum: Growing concern over rising Covid-19 infection in transplant patients

With the surge in Covid-19 infections in Singapore over the last few months, we as transplant and infectious diseases professionals are increasingly concerned about the growing number of Covid-19 infections among our transplant patients.

Unvaccinated transplant patients have a higher risk of getting serious Covid-19 infections than vaccinated patients (as is the case in the general population).

Unfortunately, unlike the general population, Covid-19 infection in kidney transplant patients is associated with worsening kidney function, longer intensive care unit stay and mechanical ventilation, and even death due to Covid-19-related complications, especially if the infected transplant patient is not treated early after infection.

Immunosuppressive medicines that prevent transplant rejection also impair the transplant patient's ability to fight Covid-19 infection.

We appeal to transplant recipients to do the following:

  • Get Covid-19 vaccination. At the National University Centre for Organ Transplantation (Nucot) at the National University Hospital, we have vaccinated more than 96 per cent of our kidney transplant patients. We monitored these patients carefully after their vaccination, and found that the side effects of vaccination are low and manageable.
  • Get their third dose two months after their second dose. Do not delay this third dose, as protection from Covid-19 infection after two doses of vaccination is lower in transplant patients than in the general population.
    Contact the transplant centre for a third dose vaccination memo before proceeding for vaccination.
  • Contact the transplant centre immediately if they test positive for Covid-19 or if they have close contact with a Covid-19-infected patient. Early diagnosis and treatment of Covid-19 infection in transplant patients can reduce Covid-19-related complications, including death. While home recovery is advised for the general population, it is not the desired approach for transplant patients.

Transplant patients should continue to practise safe management measures, minimise all mask-off activities, limit socialisation and avoid crowds.

Household contacts of transplant patients should also practise safe management measures and minimise their own risks of getting Covid-19 infection, including being vaccinated for Covid-19, so that they can reduce the risks of transmitting the infection to their loved ones.

Vathsala Anantharaman (Professor)

Co-Director, National University Centre for Organ Transplantation

National University Hospital

This letter was co-signed by five doctors from Nucot and the Division of Infectious Diseases, National University Hospital.