COVID-19 infection in 50 patients receiving lithium

Objectives
The aim of the study was a naturalistic observation of the occurrence and course of COVID-19 infection in fifty patients treated with lithium from March 2020 to March 2021 and not receiving the vaccination against COVID-19 during this period.

Materials and methods
The study group included 23 men and 27 women aged 23–71 (mean 45) receiving lithium for 1–45 (mean 7) years. Bipolar disorder (BD) was diagnosed in 46 patients, including BD type 1 in 19 patients and BD type 2 in 26 patients, and recurrent depression in one patient. The patients were treated with lithium to prevent manic and depressive recurrences, of which six underwent lithium monotherapy. Four patients with schizophrenia receiving clozapine were administered with lithium to treat and prevent neutropenia.

Results
In the study group, 37 patients (74%), including five patients receiving lithium monotherapy, did not develop the infection. The infection was mild in 8 patients and moderately severe in two. Two patients developed lithium intoxication. One patient died of COVID-19 related pneumonia.

Conclusions
The observations made on the study group show that COVID-19 infection occurred in one-fourth of lithium-treated patients. In the majority of the subjects, the infection was benign. The results also suggest that COVID-19 infection and related circumstances may be a risk factor for lithium intoxication.