“The fragile patients continue to suffer the triple penalty of the disease, the deprivation of relational life and the threat of a virus”

Tribune. We, hospital doctors, transplant doctors, nephrologists, infectious disease specialists, hepatologists and virologists, want to testify with the fragile patients we treat: a few days ago, transplant and dialysis patients, renal failure, immunocompromised patients addressed the President of the Republic to alert him to their very great vulnerability and ask him to protect them, while the Covid-19 epidemic continues and we are at the dawn of the fourth wave.

There are 100,000 patients on dialysis and kidney transplants, to which are added tens of thousands of patients transplanted from other vital organs and people immunocompromised by other diseases and their treatments; 250,000 patients in total.

We share the concerns of our patients and support their request. In our centers, up to 15% of patients infected with the SARS-CoV2 virus died as a result of Covid, in 2020 but also in 2021. Many patients have significant sequelae of long hospitalization, very often necessary, in particular in intensive care.

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Despite progress in the prevention and management of this infection, and despite a large-scale vaccination campaign, the number of contaminations in this population remains high, such as the use of hospitalization in critical care and, unfortunately, the death.

Painful medical stories

Due to a weakened immune system to accept the transplant, the vaccine response is reduced. Dialysis can also damage the body’s defenses, and dialysis patients have paid a heavy price for this disease. By recommending a third dose in immunocompromised patients, France has been a pioneer. This extra dose has been shown to be safe and effective.

Unfortunately, it remains insufficient for some of them. Those will be able to see their immunity against this virus reinforced by a fourth dose, provided that the access to this one becomes simple and fast.

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But some will remain unprotected or insufficiently protected. Very recent American data from the Johns Hopkins Center (Baltimore, Maryland) shows that a transplant patient who has received two doses of vaccine has an 82 times greater risk of contracting SARS-CoV-2 than in the general population, while that of the general population. being hospitalized or dying from it is multiplied by 485.

Our patients, whom we have sometimes followed for decades, have long, complex and painful medical histories. Yet they have families, work and have a legitimate desire to regain their social life.

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