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新冠感染精神分裂症患者 C 反应蛋白与抗精神病药物水平的关系。

Relationship between C-reactive protein and antipsychotics levels in schizophrenic patients infected with COVID-19.

机构信息

Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China.

Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China.

出版信息

J Psychiatr Res. 2024 Feb;170:297-301. doi: 10.1016/j.jpsychires.2024.01.002. Epub 2024 Jan 3.

DOI:10.1016/j.jpsychires.2024.01.002
PMID:38185075
Abstract

In the context of the COVID-19, inflammation emerges as a prominent characteristic. C-reactive protein (CRP) serves as a commonly employed marker for the evaluation of inflammation. This study aimed to examine the correlation between CRP levels and antipsychotic drug concentrations in patients diagnosed with SCZ during the COVID-19 pandemic. A total of 186 SCZ patients were included in this study, which utilized electronic medical records. The collected data encompassed SCZ diagnoses based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria, respiratory symptoms, and treatments. Laboratory assessments involved the measurement of CRP levels and monitoring of blood drug concentrations. The most prevalent symptoms observed in the patient cohort were fever (59.14%), cough (52.15%), fatigue (45.7%), sore throat (46.24%), runny nose (28.49%), and stuffy nose (25.27%). The levels of CRP during the infection period were significantly higher compared to both the prophase and anaphase of infection (all p < 0.001). The serum levels of clozapine, olanzapine, aripiprazole, quetiapine, and risperidone were elevated during the infection period (all p < 0.001). During the anaphase of infection, patients exhibited higher serum levels of clozapine, olanzapine, and risperidone (all p < 0.001) compared to the infection period, but there was no significant change in serum levels of aripiprazole and quetiapine. Multiple regression analysis revealed a statistically significant positive correlation (P < 0.0001) between CRP and clozapine concentration. In light of the COVID-19 pandemic, it is crucial to adjust the dosage based on drug serum concentration to prevent intoxication or adverse drug reactions.

摘要

在 COVID-19 的背景下,炎症成为一个突出的特征。C 反应蛋白(CRP)是评估炎症的常用标志物。本研究旨在探讨 COVID-19 大流行期间诊断为精神分裂症(SCZ)患者的 CRP 水平与抗精神病药物浓度之间的相关性。这项研究共纳入了 186 名 SCZ 患者,他们的电子病历数据被收集。收集的数据包括基于《精神障碍诊断与统计手册》第四版(DSM-IV)标准的 SCZ 诊断、呼吸道症状和治疗。实验室评估包括 CRP 水平的测量和血液药物浓度的监测。在患者队列中观察到的最常见症状是发热(59.14%)、咳嗽(52.15%)、疲劳(45.7%)、喉咙痛(46.24%)、流鼻涕(28.49%)和鼻塞(25.27%)。感染期间的 CRP 水平明显高于感染前和感染期(均 P < 0.001)。感染期间血清氯氮平、奥氮平、阿立哌唑、喹硫平、利培酮水平升高(均 P < 0.001)。在感染后期,与感染期相比,患者的血清氯氮平、奥氮平和利培酮水平升高(均 P < 0.001),而阿立哌唑和喹硫平的血清水平没有明显变化。多元回归分析显示 CRP 与氯氮平浓度之间存在统计学上显著的正相关(P < 0.0001)。鉴于 COVID-19 大流行,根据药物血清浓度调整剂量以防止中毒或药物不良反应至关重要。

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