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Clozapine and the Risk of Severe COVID-19: A Retrospective Cohort Study

Published online by Cambridge University Press:  27 August 2024

I. Yaich ,
A. Touiti ,
C. Ben Said  and
N. Bram
I. Yaich*
Affiliation:
1Forensic Psychiatry Departement, Razi Hospital, La Manouba 2Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia
A. Touiti
Affiliation:
1Forensic Psychiatry Departement, Razi Hospital, La Manouba 2Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia
C. Ben Said
Affiliation:
1Forensic Psychiatry Departement, Razi Hospital, La Manouba 2Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia
N. Bram
Affiliation:
1Forensic Psychiatry Departement, Razi Hospital, La Manouba 2Faculty of Medecine of Tunis, Tunis El Manar University, Tunis, Tunisia
*
*Corresponding author.

Abstract

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Introduction

Clozapine is the standard treatment for managing treatment-resistant schizophrenia (TRS). However, concerns arise due to potential hematologic side effects, such as agranulocytosis, especially during the COVID-19 pandemic.

Objectives

This study aims to investigate the association between clozapine treatment and an increased risk of severe COVID-19 infection in patients with TRS.

Methods

A retrospective study reviewed clinical records of forensic patients with TRS from 2020 to 2022 at Razi Hospital’s forensic psychiatry department in Tunisia. Twenty-five patients, including 18 on clozapine treatment, were included.

Results

All patients were male, with an average age of 39.7 years. Twenty-three patients received at least one vaccine dose. Twenty-two patients contracted COVID-19. Among those treated with clozapine, two required intensive care unit admission and oxygen therapy without intubation. Clozapine treatment remained uninterrupted, with no dose escalation during infection episodes. Lymphopenia was the most commonly reported hematologic abnormality.

Conclusions

While there may be an association between clozapine use and an increased risk of COVID-19 infection, no clear correlation with infection severity and antipsychotic treatment was established in this study. Further research is needed to explore this potential association comprehensively.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 67 , Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry , April 2024 , pp. S265
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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