Effect of Paxlovid on Tacrolimus Concentration in Perioperative Kidney Transplant Patients Infected With COVID-19: A Case Report

Paxlovid, as a new drug, received emergency approval for the treatment of COVID-19 in China; there is very little experience with kidney transplantation patients taking tacrolimus with perioperative COVID-19 infection. We discontinued tacrolimus on the day of using Paxlovid, and we chose to frequently monitor the concentration of tacrolimus and creatinine early in the course of treatment by enzyme multiplied immunoassay technique (EMIT) and liquid chromatographymass spectrometry (LC-MS/MS). The results show varying degrees of elevation of creatinine levels in 3 patients, and EMIT may overestimate the true concentration of tacrolimus metabolites compared with LC-MS/MS. All the data comply with the Helsinki Congress and the Declaration of Istanbul.