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

Social Media and the Adolescent Transplant Recipient

INTRODUCTION

Social media is interwoven into adolescents' daily lives. Many adolescents utilize digital technology in their healthcare journeys, as do their caregivers. Health systems increasingly seek ways to leverage these new tools toward supporting and caring for patients. These approaches may be of particular importance of adolescents, as well as healthcare systems, in providing care for chronic and serious illness including transplant patients.

METHODS

This review article will begin with an overview of adolescent social media use. We will then consider ways in which social media may impact adolescents' healthcare experience including identity development and adherence.

RESULTS

Caregivers may leverage social media for information seeking. Families may use social media to seek social support, as well as potential donors. For healthcare systems, social media may enhance research efforts as well as information delivery.

DISCUSSION

Future directions include studies examining how social media can support adolescent transplant patients. incorporation of youth voice into these studies may enhance application of findings to clinical practice.

Coping With COVID-19: Perspectives of Caregivers of Children and Young People With Chronic Kidney Disease

BACKGROUND

Caregivers of children and young people with chronic kidney disease (CKD) face challenging circumstances on a daily basis; however, the difficulties they experienced during the COVID-19 pandemic, as well as potentially positive experiences, are not yet fully understood. The aim of this study was to explore the pandemic-related experiences of these caregivers.

METHODS

Twelve caregivers were recruited from a hospital-based pediatric renal program; eight families were posttransplant. Caregivers participated in virtual semistructured interviews conducted between March 2021 and November 2022. They provided responses to open-ended questions concerning how the pandemic affected their child with CKD, their family, and themselves. Interviews were transcribed and coded using thematic analysis.

RESULTS

Four main themes were identified: (1) Family Life, which included disruptions in routine, reduced social supports, and changes in the quality of family relationships; (2) Mental Health and Coping, which included increased anxiety and positive coping strategies; (3) Work and School Life, which included changes to work and school; and (4) Health and Health Care Systems, which included virtual health care and public health restrictions.

CONCLUSIONS

Despite facing profound challenges, caregivers identified both positive and negative aspects of their pandemic experiences. Their coping strategies highlighted individual and family resilience characteristics. Implications for health care providers, including future pandemic planning, support for the transition from in-person to virtual care, and strategies to better address barriers to resources for families of children with chronic kidney disease were discussed.

A Narrative Review COVID-19 in Solid-Organ Transplantation: Real-World Evidence From India

Worldwide, India ranks number 2 and 3 for COVID-19 burden and absolute transplant numbers, respectively. Here, we summarized our single and multicenter Indian studies on solid-organ transplant during the COVID-19 pandemic. During the pandemic, solid-organ transplants declined 40% to 50%. The mortality rate in COVID-19-positive kidney transplant recipients (11.6%) was lower in India compared with the developed world during the first wave and lower compared with maintenance hemodialysis patients (13% to 38%) but significantly higher compared with the nonimmunosuppressed general population (1% to 3%) in India. We contributed to National Organ and Tissue Transplant Organization transplant-related guidelines to increase safety and access to solid-organ transplant. We reported the safety and feasibility of remdesivir (n = 57) and convalescent plasma therapy (n = 10) in kidney transplant recipients. We reported 100% patient and graft survival without any complications related to COVID-19 in a large cohort of kidney transplant recipients who recovered from COVID-19 (n = 372) and a large cohort of kidney transplant recipients of living donors (n = 31) who recovered from COVID-19 without any change in induction and maintenance immunosuppression. COVID-19 disease severity and mortality in the second episode (reoccurring infection) was higher (46%) compared with the first episode (11.6%). There was 4.4% incidence of COVID-19-associated mucormycosis in kidney transplant recipients with mortality of 46% in the second wave. We reported COVID-19 vaccine safety with suboptimal efficacy in kidney transplant recipients and dialysis patients compared with the general population. Our report suggested that transplant with carefully selected COVID-19-recovered donors and patients may be feasible and safe, at least over the short term. Continued research is needed on vaccine efficacy, booster doses, and long-term follow up sequelae.

Treatment adherence and behavior of pediatric liver transplant recipients during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has affected medical care worldwide. Thus, we aimed to assess the impact of the COVID-19 pandemic on pediatric LT recipients.

METHODS

A cross-sectional study based on a structured internet or telephone survey was conducted among pediatric LT recipients. Survey results were compared with results of a survey conducted among pediatric patients with IBD.

RESULTS

Seventy-six pediatric LT patients participated in the study. Of them, 58 (76.3%) reported fear of severe COVID-19 infection due to LT or LT-associated medications. Half of the patients reported needing emotional support. Most patients (51, 67.1%) reported strictly following official guidance, while more stringent protective measures were taken by 64 (84.2%) patients. None of the patients discontinued their medications due to COVID-19. Compared to pediatric patients with IBD, a higher proportion of pediatric LT recipients reported fears of contracting severe COVID-19 infection due to their illness or medications (45, 59.2% vs. 110, 45.1%).

CONCLUSION

Among pediatric LT recipients a higher proportion reported fear of severe COVID-19 infection, implemented additional protective measures and expressed a need for emotional support, compared to patients with IBD. Medical teams should provide adequate information and offer a support system for this vulnerable population.

Impact of COVID-19 on Families of Pediatric Solid Organ Transplant Recipients

OBJECTIVE

The COVID-19 pandemic and lockdown measures have had a clear psychological impact on families, and specifically those with children with chronic illnesses have reported greater overloads and exhaustion. The objective of this study was to evaluate the exposure, impact and experience of the pandemic on families of pediatric solid organ transplant (SOT) recipients compared to families of healthy children and adolescents.

METHODS

We recruited 96 families, 48 with a pediatric SOT recipient and 48 healthy controls, matched by child age and gender. A primary caregiver from each family responded to an online sociodemographic questionnaire and the COVID-19 Exposure and Family Impact Survey (CEFIS), which explores the exposure, impact and experience of the pandemic and lockdown on families.

RESULTS

Exposure to the pandemic was greater in families of healthy children and adolescents. The impact was mostly negative in both groups: caregivers reported increased anxiety (76%) and mood disturbances (71.9%) and hindered quality of sleep (64.6%) and health habits (58.3%). On the positive side, family relationships improved. Qualitatively, the SOT group positively perceived isolation and established hygienic measures as protective and destigmatizing, although they reported fear of virus transmission to their child.

CONCLUSIONS

The psychological impact of the pandemic has been similar in both groups, although families of transplant recipients have protected themselves more, probably because they are used to prevention measures and they see contagion as a graver risk. Additionally, SOT recipients' families presented some idiosyncratic elements, especially a decrease in their perception of stigma associated with the medical condition.

A qualitative study on parents' concerns about adult children with intellectual disabilities amid the COVID-19 pandemic in South Korea

BACKGROUND

This study aimed to understand parents' concerns about their adult child with intellectual disabilities due to the restriction of community-based services amid the COVID-19 pandemic in South Korea.

METHODS

In-depth interviews were conducted face-to-face or by telephone with 19 parents of adult children with intellectual disabilities who had to stop using community-based services.

RESULTS

Participants worried that their adult child was not aware of the seriousness of COVID-19, was more susceptible to the COVID-19 virus, could not recognize self-infection and could have fatal consequences of getting infected with COVID-19. They expected challenges in their adult child's life (losing a daily routine, being isolated, regression in skills, becoming bored, lacking physical activities and increased behavioural challenges) but also experienced adjustments and hopes.

CONCLUSION

The study demonstrated parents' worry about their adult child becoming infected with COVID-19, highlighting the urgent need for community-based services to address psychosocial challenges during the pandemic.

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.