Clozapine and COVID-19

Abstract

In the absence of an antibody test for COVID-194 we rely on reverse-transcriptase polymerase chain reaction COVID-19 testing, which does not have 100% sensitivity in the initial phase of infection, so a single negative test does not exclude infection. The combination of flu-like symptoms, chest pain and shortness of breath will, as community prevalence of COVID-19 increases, be much more likely to be because of COVID-19 than clozapine-induced myocarditis, except perhaps within the first 60 days of treatment.7 However, such a presentation will still need investigation and cessation of clozapine may on occasion be required as well as urgent general medical assistance. In summary; COVID-19 presents us with extreme difficulties regards clozapine initiation, the risks of COVID-19 are insufficient to justify stopping clozapine, an action which presents its own serious problems, precautions must be taken now to help protect our high-risk patients as COVID-19 infection may jeopardise both their physical and mental health.