ArticleActa psychiatrica Scandinavica2022
Clozapine treatment and risk of severe COVID-19 infection.
Article in Acta psychiatrica Scandinavica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clozapine Therapy and COVID-19: A Systematic Review of the Prevalence Rates, Health Outcomes, Hematological Markers, and Patient Perspectives.Schizophrenia bulletin · 2023Pooled it
- Psychotropic drug repurposing for COVID-19: A Systematic Review and Meta-Analysis.European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology · 2023Pooled it
- COVID-19 disease outcomes in patients receiving clozapine versus other antipsychotics: a national study in Qatar.Frontiers in psychiatry · 2025Article
- Aripiprazole as protector against COVID-19 mortality.Scientific reports · 2024Article
- Infections associated with clozapine: a pharmacovigilance study using VigiBaseFrontiers in pharmacology · 2023Article
- COVID-19 Vaccines and the Virus: Impact on Drug Metabolism and Pharmacokinetics.Drug metabolism and disposition: the biological fate of chemicals · 2023Review
- The Impacts of Clozapine Use on the Risk and Outcomes of COVID-19 Disease in Patients with Schizophrenia.Noro psikiyatri arsivi · 2023Article
- Clozapine and COVID-19 Vaccination: Effects on blood levels and leukocytes. An observational cohort study.Acta psychiatrica Scandinavica · 2022Observational
- Clozapine treatment and risk of severe COVID-19 infection.Acta psychiatrica Scandinavica · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate whether patients with clozapine treatment are at an increased risk of a more severe COVID-19 infection as compared with patients on other antipsychotic drugs.
methodsIn this register-based cohort study, all residents (age 18 or older) in the Stockholm Region with a psychotic disorder diagnosis and antipsychotic treatment were included (N = 8 233) and followed from 1 March 2020 to 14 January 2021. The exposure was defined as clozapine treatment and the outcome measures (indicating a more severe COVID-19 infection) were: inpatient care, care within intensive care unit or death due to COVID-19 infection. Differences in outcome rates between exposed (n = 966) and unexposed (other antipsychotics; n = 7 267) were examined using Cox proportional hazards models and expressed as hazard ratios (HR) with 95% confidence intervals (CI).
resultsNo statistically significant differences in outcome rates were found between the two groups of patients after adjusting for age, sex and residence in retirement homes. The adjusted HR for the exposed compared to the unexposed was 0.96 (95% CI: 0.54, 1.70) for inpatient care; 1.69 (0.48, 5.93) for care in intensive care unit (ICU); and 0.86 (0.26, 2.80) for death. Regarding inpatient care, additional adjusting for country of birth, living in socioeconomically vulnerable areas, number of care visits during the previous year, and comorbid medical illnesses did not alter the results.
conclusionsOur results may add support to the present guidelines, recommending sustained clozapine treatment during the current COVID-19 pandemic with careful monitoring and readiness to alter drug doses as needed.
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