scholarly journals COVID-19 infection causes a reduction in neutrophil counts in patients taking clozapine

2021 ◽  
Vol 46 (2) ◽  
Author(s):  
Siobhan Gee ◽  
David Taylor
Keyword(s):  
Acute Phase ◽  
Plasma Levels ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
White Cell ◽  
Clozapine Treatment ◽  
Cell Counts ◽  
Baseline Levels

Background: Monitoring of white cell counts during clozapine treatment leads to cessation of therapy if levels fall below predetermined values. Reductions in white cell counts, driven by lower levels of lymphocytes, have been observed with coronavirus disease 2019 (COVID-19). Neutropenia during COVID-19 has not been reported. We present data for 56 patients who were taking clozapine and had COVID-19. Methods: We included patients who were taking clozapine at the time they tested positive for COVID-19. We compared absolute neutrophil counts, lymphocyte counts and white cell counts between baseline and the first week of infection, and baseline and the second week of infection. Results: We observed reductions in absolute neutrophil counts (p = 0.005), lymphocyte counts (p = 0.003) and white cell counts (p < 0.001) between baseline and the first 7 days of COVID-19. All cell counts had returned to baseline levels by days 8 to 14. Six patients experienced neutropenia (absolute neutrophil counts < 2.0 × 109/L) and of those, 4 underwent mandatory cessation of clozapine. For 3 patients, clozapine treatment had been established for more than 6 months with no previous neutropenia, neutrophil levels returned to baseline within 2 weeks and no further neutropenia was observed on restarting treatment. Limitations: This was a retrospective chart review; larger cohorts are required. Clozapine plasma levels were largely not measured by clinicians. Conclusion: These data strongly suggest that mild neutropenia in the acute phase of COVID-19 in patients who are well established on clozapine is more likely to be a consequence of the virus than of clozapine treatment.

Reducing restraint with clozapine in involuntarily admitted patients with schizophrenia

2017 ◽  
Vol 41 (S1) ◽  
pp. S563-S563
Author(s):  
P. Ifteni ◽  
A. Teodorescu
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Retrospective Data ◽  
Multivariate Models ◽  
Clozapine Treatment ◽  
Restraint Use ◽  
Second Generation Antipsychotics ◽  
Entire World ◽  
Competing Interest ◽  
Aggressive Effect

IntroductionIn the entire world, restraint and seclusion are common interventions in psychiatric in-patient settings due to aggressive behavior.ObjectivesOur objective was to test for the immediate anti-aggressive property of clozapine compared to other antipsychotic treatments in an enriched cohort with high rates of restraint during early hospitalization.MethodsWe present a retrospective chart review in all involuntary admissions with schizophrenia during 2011–2014 in Psychiatry and Neurology Hospital, Brasov, Romania. Timing and number of restraints in addition to clinical, demographic and treatment characteristics were extracted. Based on our earlier observation of clinical efficacy of early, fast titration of clozapine, we tested the hypothesis that clozapine treatment was associated with reduced use of restraint, and with longer restraint-free periods.ResultsIn 115 patients with schizophrenia (age = 39.7 ± 11.1 years; male = 59%) involuntarily admitted due to externalized (74.78%) or self-directed violence (25.22%), restraint was used in 89.6%; with a median duration of 3 hours until restraint past admission. Antipsychotics used immediately after hospitalization included haloperidol (70.4%), clozapine (11.3%), olanzapine (10.4%) and other second-generation antipsychotics (7.9%). Comparison of restraint characteristics favored immediate clozapine use with highly reduced rates of restraint (38.5% vs.95.6%. P < 0.001) and significantly extended hours until restraint ([118 h,24 h, 426 h] vs.[3 h,0.25 h, 48 h]; median; 25th, 75th percentile; P < 0.001) relative to the remaining cohort. These effects remained highly significant after controlling for potential moderators of restraint use in multivariate models.ConclusionsThese retrospective data suggest an early anti-aggressive effect of clozapine during the immediate use of clozapine in highly problematic patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Clinical Analysis of 60 Patients with Hepatocellular Cancer Treated in Korean Medicine Hospital; A Retrospective Chart Review

2020 ◽  
Vol 41 (3) ◽  
pp. 447-456
Author(s):  
Mi-jung Yoon ◽  
Na-kyung Cho ◽  
Hong-sic Choi ◽  
Seung-mo Kim ◽  
Sang-chan Kim ◽  
...  
Keyword(s):  
Chart Review ◽  
Hepatocellular Cancer ◽  
Retrospective Chart Review ◽  
Clinical Analysis ◽  
Korean Medicine

Physical Medicine Rehabilitation Consults and 30 Day Readmissions: A Retrospective Chart Review

2014 ◽  
Vol 95 (10) ◽  
pp. e93-e94
Author(s):  
Aziza Azadali Kamani ◽  
Earl L. Smith ◽  
Jeffrey Fine ◽  
Lawrence M. Reich
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Physical Medicine

scholarly journals Cardiovascular Health in Individuals with Exceptional Longevity Residing in Arkansas

2021 ◽  
Vol 7 ◽  
pp. 233372142110189
Author(s):  
Brandi M. Mize ◽  
Brandon Duke ◽  
Amanda K. Pangle ◽  
Jeanne Y. Wei ◽  
Gohar Azhar
Keyword(s):  
Heart Failure ◽  
Chart Review ◽  
Cardiovascular Health ◽  
Ldl Cholesterol ◽  
Retrospective Chart Review ◽  
Hdl Cholesterol ◽  
Study Cohort ◽  
Old Patients ◽  
Genetic Components ◽  
Blood Pressures

Cardiovascular disease is a common comorbidity associated with an aging population. However, there is a unique group of individuals whose age-defying qualities are still being investigated. This retrospective chart review analyzed various cardiac and metabolic health parameters to characterize the prevalence of heart failure and metabolic derangements in individuals aged 90 years old or older in central Arkansas. Only 236 of the 291 patients in our study cohort had blood pressures recorded. Of these, 50% had systolic blood pressures ≥140 mmHg. Additionally, 77% had pulse pressures ≥50 mmHg. Of the 96 patients with BNP data, 44% had values ≥300 pg/mL. There was a slight positive correlation between aging and HDL cholesterol, while there was a negative correlation between aging and both total cholesterol and LDL cholesterol. A majority of our patients had both elevated systolic blood pressures and elevated pulse pressures. A majority also had high BNP values, indicative of some degree of heart failure. Additionally, atrial fibrillation was a common arrhythmia identified on EKG. However, these oldest of the old patients had fewer documented metabolic derangements. These findings lay important groundwork for further investigation into lifestyle and genetic components that allow them to live exceptionally long with such comorbidities.

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