Τίτλος:
Clozapine, neutropenia and Covid-19: should clinicians be concerned? 3 months report.
Περίληψη:
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 × 10(9)/l (SD = 2.70) which constituted a significant drop from a baseline value of 5.2 × 10(9)/l (SD = 2.24). The mean relative reduction in ANC was -0.2729 (SD = 0.1666). 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 = 8.96 × 10(-8) and an adjusted R(2) 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.
Συγγραφείς:
Bonaccorso, Stefania
Ricciardi, Angelo
Ouabbou, Sophie
Theleritis, Christos
Ross-Michaelides, Arabella
Metastasio, Antonio
Stewart, Neil
Mohammed, Marwa
Schifano, Fabrizio
Περιοδικό:
Brain, behavior, & immunity - health
Λέξεις-κλειδιά:
COVID-19, SARS-CoV-2, Coronavirus, Neutrophils, Neutropenia, Schizophrenia, Psychosis, Absolute Neutrophil Count (ANC), Agranulocytosis, Clozapine, Lymphopenia, Neutrophilia
DOI:
10.1016/j.bbih.2021.100212
