Psychological responses to the Covid-19 pandemic in renal transplant recipients

Zgoura, Panagiota; Seibert, Felix S.; Waldecker, Christoph; Doevelaar, Adrian; Bauer, Frederic; Rohn, Benjamin; Schenker, Peter; Wunsch, Andreas; Viebahn, Richard; Babel, Nina; Westhoff, Timm H.

Background Renal transplant recipients are at increased risk for an adverse course of Covid-19, most likely due to immunosuppression and the high level of cardiovascular comorbidity. Many transplant reci-pients are aware of these facts. The psychological effects of this knowledge, however, remain elusive. Methods Cross-sectional study on 62 renal transplant recipients. 50 cardiovascular outpatients without immunosuppression and 55 healthy subjects served as control. We performed a focused psychological assessment during the pandemic (April 2020) and compared the data to a moment six months before. Additionally, an intergroup analysis was performed for the data during the pandemic. The analysis was performed by means of a questionnaire derived from KPD-38. We extracted five questions focusing on the parameters "life satisfaction" and perceived "action competence". Life satisfaction score ranged from 2 to 8, the score for action competence from 5 to 20. Results Both life satisfaction and perceived action competence were significantly lower during the pandemic than six months before in all the three groups (p<0.005 each). During the pandemic median levels of life satisfaction did not significantly differ between the three groups (transplant recipients 6, IQR 4-7; cardiovascular patients 5, IQR 4-6; healthy controls 6, IQR 5-7; Kruskall Wallis p>0.05). In contrast, the perceived action competence was higher in healthy subjects (15, IQR 12-17) than in both renal transplant recipients (13, IQR 10-15) and cardiovascular patients (13, IQR 8-14, Kruskall Wallis p=0.0003). Conclusion The Covid-19 pandemic has negative effects on life satisfaction and perceived action competence in renal transplant recipients, cardiovascular patients without immunosuppression and healthy subjects. The effects on life satisfaction in transplant recipients did not differ from non-immunocompromised patients or healthy controls. In contrast, the feeling of reduced action competence exceeded healthy controls, most likely due to a subjective need for stricter social distancing to avoid infection.