{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:39:51Z","timestamp":1772159991443,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T00:00:00Z","timestamp":1635465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate whether patients with clozapine treatment are at an increased risk of a more severe COVID\u201019 infection as compared with patients on other antipsychotic drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this register\u2010based cohort study, all residents (age 18 or older) in the Stockholm Region with a psychotic disorder diagnosis and antipsychotic treatment were included (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a08\u00a0233) and followed from 1\u00a0March 2020 to 14\u00a0January 2021. The exposure was defined as clozapine treatment and the outcome measures (indicating a more severe COVID\u201019 infection) were: inpatient care, care within intensive care unit or death due to COVID\u201019 infection. Differences in outcome rates between exposed (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0966) and unexposed (other antipsychotics;\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a07\u00a0267) were examined using Cox proportional hazards models and expressed as hazard ratios (HR) with 95% confidence intervals (CI).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results may add support to the present guidelines, recommending sustained clozapine treatment during the current COVID\u201019 pandemic with careful monitoring and readiness to alter drug doses as needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13379","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T05:38:40Z","timestamp":1634881120000},"page":"79-85","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clozapine treatment and risk of severe COVID\u201019 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Sweden"},{"name":"Centre for Epidemiology and Community Medicine Stockholm County Council Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Dalman","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet Stockholm Sweden"},{"name":"Centre for Epidemiology and Community Medicine Stockholm County Council Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/PGPM.S115741"},{"issue":"2","key":"e_1_2_9_3_1","first-page":"303","article-title":"Clozapine treatment and offending: a within\u2010subject study of patients with psychotic disorders in Sweden","volume":"46","author":"Bhavsar V","year":"2020","journal-title":"Schizophr 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