Impact of COVID-19 on access to chronic kidney replacement therapy in the public sector of Western Cape Province, South Africa

To the Editor: Since the start of the lockdown in South Africa (SA) on 27 March 2020, a decision was made to temporarily suspend living and deceased kidney donor transplant programmes in Western Cape Province because of concerns regarding the unknown consequences that COVID-19 might have in this vulnerable, immunocompromised population. In addition, the management of deceased potential donors was also stopped so that emergency departments and intensive care units could prioritise COVID- 19 patients. This decision was justified, as subsequent studies reported poor outcomes for both the kidney allograft and patient survival following COVID-19 infection, with reported mortality rates ranging from 20% to 28%, greater than that reported for the general population.[1-3]