Awareness and concerns about novel coronavirus disease 2019 (COVID-19) among parents of pediatric liver transplant recipients.

OBJECTIVES: Pediatric transplant recipients may be at increased risk of developing serious infections due to COVID-19. We undertook a web-based survey among parents of post-liver transplant pediatric patients to assess knowledge and concerns regarding COVID-19 pandemic and impact of social media on them. METHODS: This cross-sectional online survey was conducted between March 21 and March 26, 2020. A 19-item questionnaire was sent to 172 parents of post-liver transplant children. RESULTS: 106 (62%) of parents responded. Median time since transplant was 31 (12-52) months. The majority of parents had good understanding regarding symptomatology and routes of transmission. Only 27% were aware of feco-oral transmission, and 34% knew about gastrointestinal symptoms of COVID-19. 100% of parents understood concept of social distancing, and 70% knew that asymptomatic individuals can transmit the virus. Television followed by newspapers was the main source of their information, though over 40% claim to regularly receive information through social media. 87% would consult their doctor if the child had flu-like symptoms rather than modify immunosuppression or try alternative medications. Parental concerns mainly revolved around early recognition of symptoms, queries on unconventional treatments circulating over social media, and supply of medications during the lockdown period. CONCLUSIONS: The majority of parents had basic understanding of COVID-19 pandemic. Social media appeared to be an important source of information. Results from this survey helped us in modifying patient care protocols to ensure continuity of care while maintaining social distancing.

Awareness and Concerns Among Adult Liver Transplant Recipients in the Current Pandemic Caused by Novel Coronavirus (COVID-19): Strategies to Safeguard a High-risk Population.

BACKGROUND: The coronavirus disease 2019 (COVID-19) virus is spreading rapidly, and there are obvious concerns for the immunocompromised patient population including transplant recipients. Creating awareness and understanding patient concerns will play an important role in protecting this vulnerable group in developing timely and appropriate healthcare interventions. METHODS: A cross-sectional online survey was conducted between 23rd March 2020 and 1st April 2020 among 154 liver transplant recipients, transplanted between October 2018 and February 2020. An 18-point questionnaire explored their knowledge of COVID-19, awareness of recipient's high-risk status, interventions to minimize cross-infections, and concerns of this patient group regarding the pandemic. RESULTS: There were 112 (73%) respondents, with median age of 53 years (81% males). There was no difference in demographics between those who responded (n = 112) and those who did not respond to the survey (n = 42). Most of the recipients were aware of the main symptoms of COVID-19, such as fever (92%), breathlessness (86%), and dry cough (87%), but less than half were aware of diarrhea (39%) as a symptom. Awareness about spread from asymptomatic individuals was limited (26%). Majority (95%) understood their high-risk status, but worryingly, 23% of the respondents felt that there was no risk in visiting the hospital for routine clinic visit and blood tests. Concerns were raised by the recipients mostly regarding the uncertainties of COVID-19 infection and its treatment options, the quality of information on social messaging platforms, and lack of access to routine tests/immunosuppression levels because of lockdown/social distancing. CONCLUSIONS: Our liver transplant recipients have a reasonable awareness regarding COVID-19. Problems in accessing the healthcare system during prolonged periods of lockdown was a major concern. It is important for each transplant unit to educate, support, and remain accessible to this vulnerable patient cohort as the pandemic continues to progress worldwide.