COVID-19 and your kidneys

Updated 18 July 2022

Epidemiology:

The current increase in infections Australia is driven by the surge of Omicron BA.4 and BA.5 subvariant. BA.4 and BA.5 are associated with increased immune escape, and we are likely to see rates of reinfection rise among those who have previously been infected with an earlier COVID-19 variant and those who are up to date with their vaccinations. Vaccination continues to be the most important protection against severe illness.
Given reinfections may occur as early as 28 days after recovery from a previous COVID-19 infection, the AHPPC advises that the reinfection period be reduced from 12 weeks to 28 days. People who test positive to COVID-19 more than 28 days after ending isolation due to previous infection should be reported and managed as new cases.

Vaccination:

The updated recommendations are: ATAGI updated recommendations for a winter dose of COVID-19 vaccine | Australian Government Department of Health and Aged Care 7th July 2022
• Adults aged 50 to 64 years are now recommended to receive a winter booster dose of a COVID-19 vaccine.
• Adults aged 30 to 49 years can receive a winter booster dose of a COVID-19 vaccine, however the benefit for people in this age group is less certain.
• The interval recommended between a recent SARS-CoV-2 infection or the first booster dose and a winter booster dose is now 3 months.

ATAGI emphasises that people previously eligible for a winter booster dose remain at higher risk of severe disease and death from COVID-19 and should receive a winter booster dose as soon as possible. They include:
• All adults aged 65 years or older
• Residents of aged care or disability care facilities
• Aboriginal and Torres Strait Islander people aged 50 years or older
• People who are severely immunocompromised (this will be their fifth dose)
• People aged 16 years or older with a medical condition that increases the risk of severe COVID-19 illness
• People aged 16 years or older with disability, significant or complex health needs, or multiple comorbidities which increase the risk of a poor outcome.
• ATAGI emphasises that individuals who have previously been infected with SARS-CoV-2, irrespective of which variant it may have been, should continue to receive recommended vaccine doses, after an interval of 3 months, as prior infection alone will not provide sufficient protection against severe disease.

ATAGI also encourages people to be vaccinated against Influenza. Influenza vaccine can be co-administered with the additional booster dose of COVID-19 vaccine. However, if a person is not yet eligible for their additional booster dose, influenza vaccine could be given ahead of the additional booster dose.

Additional measures:

• Wearing a mask outside your home when in crowded, indoor environments including on public transport. This is important to protect yourself and others.
• Ensuring indoor spaces are well ventilated
• Staying home if you have any COVID-19 symptoms, no matter how mild, and get tested
• If you have any symptoms, are at higher risk of severe illness and have a negative Rapid Antigen Test (RAT) result, seek a PCR test to confirm whether or not you have COVID-19 so you can access oral treatments for COVID-19 if eligible.
• Not attending high-risk settings such as health care (unless seeking treatment), aged care and disability settings or correctional facilities if you have any symptoms of COVID-19, no matter how mild
• Employers should review their occupational health and safety risks and mitigations, and their business continuity plans. They should consider the feasibility of some employees working from home and support employees to take leave when sick.
• Practising good respiratory and hand hygiene
• Staying up to date with jurisdictional public health requirements and information

Testing:

RATs are a convenient diagnostic tool to detect COVID-19 virus fragments in nasal secretions or saliva. There are three key concepts to understanding how accurate RATs are: sensitivity (true positive result), specificity (true negative) and pre-test probability (the likelihood a person has COVID-19 infection based on their clinical symptoms, exposure history and/or the background community rate of infection).
• So, if you have symptoms and RAT positive -> COVID-19.
• No symptoms and RAT positive -> need a PCR to confirm.
• Close contact of positive case and RAT negative -> course of action depends on pre-test probability which includes vaccination status; presence of other conditions; medications. Err on caution -> PCR to confirm.

What to do if you acquire COVID-19:

If you get a positive test result, you must isolate straight away. PUT TOGETHER A ‘COVID PLAN’ – WHAT TO DO IF IN ISOLATION.
If you test positive on RAT -> notify your state or territory health department: What do you if you get COVID-19 | Australian Government Department of Health.

Treatments:
Treatments are available, which if administered early can change the course of the disease. The following are considered for non-hospitalised people with mild to moderate COVID-19 who are at risk of progressing to severe disease. Speak to your GP, nephrologist or kidney unit as soon as possible.
Outpatient treatments include:
• Inhaled corticosteroids (budesonide)
• Antiviral therapy (Paxlovid, Molnupiravir)

Kidney Health Australia is part of the Australian and New Zealand Society of Nephrology COVID-19 National Working Group which continues to respond to the COVID - 19 Crisis to ensure the needs and concerns of patients are being heard, and that the information as it relates to people with kidney disease is up to date and backed by the clinical community.

COVID -19 Vaccine

It is best advised that you speak with your treating doctor about the COVID-19 vaccine and what will be best for your health.

With information changing rapidly in regards to vaccine availaibility and eligibility, we recommend you regularly check the Australian Government website for up-to-date information about the rollout, including timelines.

To read more about the need for vaccination for people with kidney disease, read the joint statement from the ANZSN COVID-19 Working Group here.

Even with vaccination, physical distancing, mask wearing masks and safe hand hygiene continue to be very important measures to protect from COVID - 19.

Other useful links

Health Professional Webinars

We're hosting regular webinars for health professionals to help inform them on how to care for kidney patients during the COVID-19 crisis. Learn more.

Want more information?

There is a large amount of unverified information circulating on social media. It is important that you seek information on coronavirus from trusted sources.

Australian Government

Visit the Australian Government’s Coronavirus Information Page. This page is regularly updated with the latest information.

If you have questions about coronavirus please call the Australian Government’s Coronavirus Health Information Line on 1800 020 080. The helpline operates 24 hours a day, seven days a week.

World Health Organisation

The WHO has a large range of global resources and information visit the World Health Organisation Advice for the Public Page.

National COVID-19 Clinical Evidence Taskforce

Health professionals can get up-to-date information and best practice care advice on the COVID-19 Evidence website.

Transplant Australia

Transplant Australia have resources, videos and updates on staying safe with your transplant visit their website.

Health Direct Australia