Balancing Immunity in a Setting of Covid-19

Abstract

Only precautionary measures are practical at the moment in controlling the COVID-19 pandemic and one such measure is balancing self-immunity. The recent findings about the durability of COVID-19 antibodies in the infected people has put some concerns about the prospects of long-term immunisation methods. In such circumstances, one way of protecting from COVID-19 is by enhancing one's own immune mechanisms. Unfortunately, there is less discussion about this serous issue. Elderly patients are at a higher risk of getting infected with SARS-CoV-2 and should be mindful of balancing the immunity. Adherents of Integrated medicine seem to have more awareness of different facets of immunity and they go beyond the conventional methods. Immunological research is in a standstill. This paper is an attempt to evaluate balancing immunity through all the known practices done in different disciplines of medicine.

Clozapine Metabolism is Associated With Absolute Neutrophil Count in Individuals With Treatment-Resistant Schizophrenia

“…However, the main associations we found across our successive tests suggest that clozapine might have sustained effects on ANC even in individuals without obvious hematological adverse effects. This is consistent with the rationale for the current practice of continued hematological monitoring of people being prescribed clozapine, and supports that additional measures to lower their risk of infections might indeed be warranted even in long term clozapine users ( Siskind et al, 2020 ), for example ensuring their timely access to the annual influenza vaccine ( Pandarakalam, 2020 ).…”

“…It is important to better understand the link between clozapine doses, clozapine metabolism and neutrophil counts for several reasons. First, because it would allow for the evaluation of the effectiveness of interventions aimed at lessening the potential detrimental impacts of clozapine on the immune system, such as those proposed in response to the COVID-19 pandemic ( Pandarakalam, 2020 ; Siskind et al, 2020 ). Additionally, in line with recent research on underrepresented populations ( Legge et al, 2019 ), improved comprehension of the biology behind potential adverse effects could help with the refinement of current dosing and titration protocols, therefore increasing the number of TRS patients who can be safely prescribed the medication and benefit from its therapeutic effects.…”

Clozapine, neutropenia and Covid-19: should clinicians be concerned? 3 months report

“…It may be too speculative to claim that clozapine might act as a modulating factor against severe outcome of COVID-19, by reducing the ratio neutrophils/lymphocytes at the time of the SARS-Cov-2 infection. However, there is evidence that clozapine has immunosuppressant and pro-inflammatory effects at high doses ( Clark et al, 2018 ) and there are suggestions that clozapine may also work on immunomodulation rather than neuromodulation only ( Pandarakalam, 2020 ; Røge et al, 2012). Notably, fluvoxamine (Lenze al., 2020), chlorpromazine ( Plaze et al, 2020 ), valproic acid ( Singh and Singh, 2020 ; Bhargava et al, 2020) and lithium ( Murru et al, 2020 ) have recently been repurposed as potential immunomodulators in COVID-19 treatment.…”

“…Clozapine remains significantly underutilized, in part due to frequent blood tests requiring regular absolute neutrophil count (ANC) monitoring ( Nichols et al, 2020 ). Adverse reactions to clozapine include neutropenia (2.7% of patients) which can prefigure an impending life-threatening agranulocytosis, (0.4% of patients) ( Atkin et al, 1996 ; Gee and Taylor , 2020; Pandarakalam, 2020 ). Clozapine treatment is also associated with diabetes, obesity, pulmonary disease ( Gee et al, 2020 ; Dragoi et al, 2020 ) and a reported increased risk of COVID-19 infection ( Govind et al, 2020 ).…”