Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom.
Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
Eur Neuropsychopharmacol. 2022 Mar;56:92-99. doi: 10.1016/j.euroneuro.2022.01.007. Epub 2022 Jan 24.
Clozapine, an antipsychotic, is associated with increased susceptibility to infection with COVID-19, compared to other antipsychotics. Here, we investigate associations between clozapine treatment and increased risk of adverse outcomes of COVID-19, namely COVID-related hospitalisation, intensive care treatment, and death, amongst patients taking antipsychotics with schizophrenia-spectrum disorders. Using the clinical records of South London and Maudsley NHS Foundation Trust, we identified 157 individuals who had an ICD-10 diagnosis of schizophrenia-spectrum disorders, were taking antipsychotics (clozapine or other antipsychotics) at the time of COVID-19 pandemic in the UK and had a laboratory-confirmed COVID-19 infection. The following health outcomes were measured: COVID-related hospitalisation, COVID-related intensive care treatment and death. We tested associations between clozapine treatment and each outcome using logistic regression models, adjusting for gender, age, ethnicity, neighbourhood deprivation, obesity, smoking status, diabetes, asthma, bronchitis and hypertension using propensity scores. Of the 157 individuals who developed COVID-19 while on antipsychotics (clozapine or other antipsychotics), there were 28% COVID-related hospitalisations, 8% COVID-related intensive care treatments and 8% deaths of any cause during the 28 days follow-up period. amongst those taking clozapine, there were 25% COVID-related hospitalisations, 7% COVID-related intensive care treatments and 7% deaths. In both unadjusted and adjusted analyses, we found no significant association between clozapine and any of the outcomes. Thus, we found no evidence that patients with clozapine treatment at time of COVID-19 infection had increased risk of hospitalisation, intensive care treatment or death, compared to non-clozapine antipsychotic-treated patients. However, further research should be considered in larger samples to confirm this.
氯氮平是一种抗精神病药，与其他抗精神病药相比，它会增加感染 COVID-19 的易感性。在这里，我们研究了氯氮平治疗与 COVID-19 不良结局（即 COVID 相关住院、重症监护治疗和死亡）之间的关系，这些结局发生在接受抗精神病药治疗的精神分裂症谱系障碍患者中。我们使用伦敦南部和莫兹利国民保健信托基金会的临床记录，确定了 157 名患有精神分裂症谱系障碍的 ICD-10 诊断患者，他们在英国 COVID-19 大流行期间正在服用抗精神病药（氯氮平或其他抗精神病药），并且有实验室确认的 COVID-19 感染。以下是测量的健康结果：COVID 相关住院、COVID 相关重症监护治疗和死亡。我们使用逻辑回归模型测试了氯氮平治疗与每种结果之间的关联，调整了性别、年龄、种族、社区贫困、肥胖、吸烟状况、糖尿病、哮喘、支气管炎和高血压，使用倾向评分。在 157 名因服用抗精神病药（氯氮平或其他抗精神病药）而感染 COVID-19 的患者中，有 28%的 COVID 相关住院治疗、8%的 COVID 相关重症监护治疗和 28 天随访期间任何原因的 8%的死亡。在服用氯氮平的患者中，有 25%的 COVID 相关住院治疗、7%的 COVID 相关重症监护治疗和 7%的死亡。在未经调整和调整分析中，我们都没有发现氯氮平与任何结果之间存在显著关联。因此，我们没有发现证据表明 COVID-19 感染时接受氯氮平治疗的患者与非氯氮平抗精神病药治疗的患者相比，住院、重症监护治疗或死亡的风险增加。然而，应该在更大的样本中进一步研究以证实这一点。
