Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, United Kingdom.
College of Medicine, Infection and Immunity, Cardiff University, Cardiff, United Kingdom.
Transpl Int. 2022 Mar 21;35:10127. doi: 10.3389/ti.2022.10127. eCollection 2022.
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 ( = 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, = 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 ( = 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 ( = 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.
本研究旨在评估 SARS-CoV-2 感染对血清他克莫司水平的影响。比较了 2020 年诊断为 SARS-CoV-2 的 34 名移植患者的他克莫司水平与其感染前的值和替代感染的对照组的值。34 名患者中有 20 名（59%）出现高水平。在 SARS-CoV-2 组中，诊断时他克莫司水平中位数为 9.6μg/L（2.7-23），而对照组为 7.9μg/L（ = 0.07，95%CI 差值为-0.3-5.8）。与对照组相比，SARS-CoV-2 组感染后与感染前他克莫司比值更高（1.7 比 1.25， = 0.018，95%CI 差值为 0.08-0.89）。血清肌酐升高的急性肾损伤发生率在 SARS-CoV-2 患者中为 65%（20 例中有 13 例），而在水平 <8μg/dl 的患者中为 29%（14 例中有 4 例）（ = 0.037）。SARS-CoV-2 感染患者中高水平他克莫司水平的中位住院时间为 10 天，而其余患者为 0 天（ = 0.04）。与对照组相比，4 名高水平患者死亡，而对照组有 2 名。临床医生应注意到这对他克莫司水平的潜在影响，并采取适当措施。
