SARS-CoV-2 infection can lead to an increase in tacrolimus levels in renal transplant patients: a cohort study

Chalklin, Christopher G., Koimtzis, Georgios, Khalid, Usman, Carrington-Windo, Eliot, Elker, Doruk and Asderakis, Argiris 2022. SARS-CoV-2 infection can lead to an increase in tacrolimus levels in renal transplant patients: a cohort study. Transplant International 35 , 10127. 10.3389/ti.2022.10127

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Abstract

The aim of this study is to evaluate the effect of SARS-CoV-2 infection on serum tacrolimus levels. Tacrolimus levels of 34 transplant patients diagnosed with SARS-CoV-2 in 2020 were compared with their pre-infection values and those of a control group with alternative infections. 20 out of 34 (59%) had high levels. At diagnosis, median tacrolimus level in the SARS-CoV-2 cohort was 9.6 μg/L (2.7–23) compared to 7.9 μg/L in the control group (p = 0.07, 95% CI for difference −0.3–5.8). The ratio of post-infection to pre-infection tacrolimus values was higher in the SARS-CoV-2 group (1.7) compared to the control group (1.25, p = 0.018, 95% CI for difference 0.08–0.89). The acute kidney injury rate was 65% (13 of 20) in SARS-CoV-2 patients with a level >8 μg/dl, compared to 29% (4 of 14) in those with lower levels (p = 0.037). Median length of stay was 10 days among SARS-CoV-2 infected patients with high tacrolimus levels compared to 0 days in the rest (p = 0.04). Four patients with high levels died compared to 2 in the control group. Clinicians should be aware of this potential effect on tacrolimus levels and take appropriate measures.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Medicine
Additional Information:	This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
Publisher:	Frontiers Media
ISSN:	1432-2277
Date of First Compliant Deposit:	12 May 2022
Date of Acceptance:	16 February 2022
Last Modified:	05 May 2023 02:51
URI:	https://orca.cardiff.ac.uk/id/eprint/149738

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