{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:04:04Z","timestamp":1787321044537,"version":"build-2736575974"},"reference-count":26,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T00:00:00Z","timestamp":1595808000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec id=\"S0007125020001518_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clozapine, an antipsychotic with unique efficacy in treatment-resistant psychosis, is associated with increased susceptibility to infection, including pneumonia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125020001518_sec_a2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate associations between clozapine treatment and increased risk of COVID-19 infection in patients with schizophrenia-spectrum disorders who are receiving antipsychotic medications in a geographically defined population in London, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125020001518_sec_a3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Using information from South London and Maudsley NHS Foundation Trust (SLAM) clinical records, via the Clinical Record Interactive Search system, we identified 6309 individuals who had an ICD-10 diagnosis of schizophrenia-spectrum disorders and were taking antipsychotics at the time of the COVID-19 pandemic onset in the UK. People who were on clozapine treatment were compared with those on any other antipsychotic treatment for risk of contracting COVID-19 between 1 March and 18 May 2020. We tested associations between clozapine treatment and COVID-19 infection, adjusting for gender, age, ethnicity, body mass index (BMI), smoking status and SLAM service use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125020001518_sec_a4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 6309 participants, 102 tested positive for COVID-19. Individuals who were on clozapine had increased risk of COVID-19 infection compared with those who were on other antipsychotic medication (unadjusted hazard ratio HR =\n                      <jats:sans-serif>2<\/jats:sans-serif>\n                      .62, 95% CI 1.73\u20133.96), which was attenuated after adjusting for potential confounders, including clinical contact (adjusted HR = 1.76, 95% CI 1.14\u20132.72).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125020001518_sec_a5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings provide support for the hypothesis that clozapine treatment is associated with an increased risk of COVID-19 infection. Further research will be needed in other samples to confirm this association. Potential clinical implications are discussed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2020.151","type":"journal-article","created":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T03:42:06Z","timestamp":1595821326000},"page":"368-374","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":58,"title":["Clozapine treatment and risk of COVID-19 infection: retrospective cohort study"],"prefix":"10.1192","volume":"219","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9925-7866","authenticated-orcid":false,"given":"Risha","family":"Govind","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8876-4595","authenticated-orcid":false,"given":"Daniela","family":"Fonseca de Freitas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8872-3614","authenticated-orcid":false,"given":"Megan","family":"Pritchard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4453-244X","authenticated-orcid":false,"given":"Richard D.","family":"Hayes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6754-1018","authenticated-orcid":false,"given":"James H.","family":"MacCabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2020,7,27]]},"reference":[{"key":"S0007125020001518_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2018.04.009"},{"key":"S0007125020001518_ref9","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2012-202480"},{"key":"S0007125020001518_ref20","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2018.152"},{"key":"S0007125020001518_ref13","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1136\/eb-2013-101441","article-title":"Current use of second-generation antipsychotics may increase risk of pneumonia in people with schizophrenia","volume":"16","author":"Haddad","year":"2013","journal-title":"Evid Based Ment Health"},{"key":"S0007125020001518_ref3","doi-asserted-by":"publisher","DOI":"10.1177\/0269881118817387"},{"key":"S0007125020001518_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbz093"},{"key":"S0007125020001518_ref4","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2017.16091097"},{"key":"S0007125020001518_ref2","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1111\/acps.12989","article-title":"Clozapine and all-cause mortality in treatment-resistant schizophrenia: a historical cohort study","volume":"139","author":"Cho","year":"2018","journal-title":"Acta Psychiatr Scand"},{"key":"S0007125020001518_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(15)00152-2"},{"key":"S0007125020001518_ref25","unstructured":"25 White, C , Nafilyan, V . Coronavirus (COVID-19) Related Deaths by Ethnic Group, England and Wales: 2 March 2020 to 10 April 2020 . Office for National Statistics, 2020 (https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/deaths\/articles\/coronavirusrelateddeathsbyethnicgroupenglandandwales\/2march2020to10april2020)."},{"key":"S0007125020001518_ref5","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbu120"},{"key":"S0007125020001518_ref15","doi-asserted-by":"publisher","DOI":"10.1097\/YIC.0000000000000162"},{"key":"S0007125020001518_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2012.12.007"},{"key":"S0007125020001518_ref10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-021187"},{"key":"S0007125020001518_ref14","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbr202"},{"key":"S0007125020001518_ref26","article-title":"Safe and informed prescribing of psychotropic medication during the COVID-19 pandemic","author":"Luykx","journal-title":"Br J Psychiatry"},{"key":"S0007125020001518_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2018.07.001"},{"key":"S0007125020001518_ref6","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.117.202606"},{"key":"S0007125020001518_ref17","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20384"},{"key":"S0007125020001518_ref22","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-9-51"},{"key":"S0007125020001518_ref23","unstructured":"23 CRIS NLP Applications Library. CRIS Natural Language Processing v1.1. National Institute for Health Research Biomedical Research Centre, 2020 (https:\/\/www.maudsleybrc.nihr.ac.uk\/facilities\/clinical-record-interactive-search-cris\/cris-natural-language-processing\/)."},{"key":"S0007125020001518_ref1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.115.177261"},{"key":"S0007125020001518_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sby052"},{"key":"S0007125020001518_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.03.005"},{"key":"S0007125020001518_ref21","doi-asserted-by":"publisher","DOI":"10.1503\/jpn.200061"},{"key":"S0007125020001518_ref19","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291719000369"}],"container-title":["The British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125020001518","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T18:01:49Z","timestamp":1696442509000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125020001518\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,27]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["S0007125020001518"],"URL":"https:\/\/doi.org\/10.1192\/bjp.2020.151","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2020.06.17.20133595","asserted-by":"object"}]},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,27]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2020. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}