Clozapine, neutropenia and Covid-19: should clinicians be concerned? 3 months report.
Brain Behav Immun Health
; 13: 100212, 2021 May.
Article
in English
| MEDLINE | ID: covidwho-1051476
ABSTRACT
BACKGROUND:
Clozapine is among the most effective antipsychotics used for treatment resistant schizophrenia. Adverse reactions to clozapine include neutropenia. In March 2020, at the start of the Coronavirus -19 pandemic, clinicians raised concerns regarding continuation of antipsychotic treatment, and specifically of clozapine, in patients with coronavirus disease. We aimed here at providing a short report focusing on the association between neutropenia and clozapine in a case series of psychiatric inpatients diagnosed with COVID-19. PATIENTS &METHODS:
We retrospectively inspected data of 10 patients on clozapine, admitted to Highgate Mental Health Centre, Camden & Islington NHS Foundation Trust, between March and July 2020; selection was based on their COVID-19 positive PCR test. We used a linear regression model to estimate whether there was a significant drop in the neutrophil count during SARS-CoV-2 infection.The analysis was done in R using a linear regression to the origin.RESULTS:
Data were collected on 10 patients, of which 7 were males. During COVID-19 infection, neutrophils' count (ANC) was 4.13 â× â109/l (SD â= â2.70) which constituted a significant drop from a baseline value of 5.2 â× â109/l (SD â= â2.24). The mean relative reduction in ANC was -0.2729 (SD â= â0.1666). The beta value of 0.8377 obtained with the linear regression showed that ANC values during SARS-CoV-2 infection were 83.77% of the baseline ANC showing that within the two time points there was a decrease of 16.23%. The linear regression had a pvalue â= â8.96 â× â10-8 and an adjusted R2 of 95.94% which shows that the variability of the data is very well explained by the model. We also compared baseline ANC with ANC values approximately a month after resolution of the infection and results indicate that ANC values return to a 95% of baseline.CONCLUSIONS:
Clinicians should bear in mind that a significant drop in neutrophils' count may occur in patients taking clozapine and affected from a SARS-CoV-2 infectionand that this drop is only transitory.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Language:
English
Journal:
Brain Behav Immun Health
Year:
2021
Document Type:
Article
Affiliation country:
J.bbih.2021.100212
Similar
MEDLINE
...
LILACS
LIS