Coronavirus disease 2019 and transplantation: The combination of lopinavir/ritonavir and hydroxychloroquine is responsible for excessive tacrolimus trough level and unfavorable outcome

Abstract

The ongoing outbreak of coronavirus disease 2019 (COVID‐19) first reported in Wuhan has been declared global public health emergency and a pandemic by the World Health Organization. Faced with this novel coronavirus, scientists have been trying to use drugs that have not been validated by rigorous clinical trials, such as lopinavir/ritonavir (LPV/r) and hydroxychloroquine (HCQ). These drugs may be used tentatively for general population with COVID‐19, but for solid organ transplant (SOT) recipients with long‐term immunosuppressive therapy and drug‐related metabolic diseases, antiviral drugs should be chosen with particular care. Notably, the elderly SOT patients commonly suffer from liver and kidney dysfunction of varying degrees, resulting in worse drug metabolism.