Clozapine prescribing in COVID-19 positive medical inpatients: a case series

Clozapine prescribing in COVID-19 positive medical inpatients: a case series

Blog Article

There is both uncertainty regarding the safety of clozapine in COVID-19 patients owing to limited published data and a lack of consensus on continuing clozapine in patients with severe respiratory infections.COVID-19 is known to induce an acute immune response which can affect haematological parameters associated with clozapine 2.5/3.5/6.5mm monitoring, and systemic infection may reduce clozapine clearance.Clozapine, which has been associated with worse outcomes in some pneumonias, may in theory worsen outcomes in COVID-19.

Despite these concerns, there are some data to indicate it is safe to continue clozapine in COVID-19 infection.In this retrospective case series, we describe our experiences of clozapine prescribing and disease progression of eight SARS-CoV-2 positive patients on medical wards in a major London teaching hospital.In four cases clozapine was stopped during the hospital admission.

A COVID-19 pneumonia developed in four patients: three of these required intensive care unit admission for an average of 34 days.At the time of writing, three patients had died (two directly from COVID-19 pneumonia), two remained in general hospital wards, two were recovering in the community and one had been transferred to an inpatient psychiatric hospital.Follow-up length varied but in each case was not more than 104 days.

Delirium was the most common adverse neuropsychiatric event, and in one case a relapse of psychosis occurred after cessation of clozapine.This retrospective case series illustrates the safe use of clozapine during COVID-19 infection.Our experiences suggest that consideration should be made to continuing clozapine even REPAIR RESCURE SHAMPOO in those most unwell with COVID-19.

We also identify areas which require larger scale hypothesis-testing research.