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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Brain+Behav+Immun+Health 2021 ; 13 (ä): 100212 Nephropedia Template TP
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Clozapine, neutropenia and Covid-19: should clinicians be concerned? 3 months report #MMPMID33527097
Bonaccorso S; Ricciardi A; Ouabbou S; Theleritis C; Ross-Michaelides A; Metastasio A; Stewart N; Mohammed M; Schifano F
Brain Behav Immun Health 2021[May]; 13 (ä): 100212 PMID33527097show ga
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 ?x ?10(9)/l (SD ?= ?2.70) which constituted a significant drop from a baseline value of 5.2 ?x ?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 ?x ?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.