An educational case series of Parkinson's disease during the COVID-19 pandemic

Monaco, Maria Rita Lo; Colacicco, Giovanni; Marotta, Jessica; Bentivoglio, Anna Rita

doi:10.1016/j.neurol.2020.07.007

Cited by 3 publications

(7 citation statements)

References 4 publications

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“…20,24 Mortality rates for PD patients with COVID-19 who were hospitalized ranged from 5.7% to 100%. [10][11][12][13][14][15][16][17][19][20][21][22][23]25…”

Section: Resultsmentioning

confidence: 99%

“…Of the 355 studies identified during the first round of screening, 16 studies comprising, 7 (43.8%) were case reports and case series, 4 (25%) case-control studies, 2 (12.5%) cross-sectional, 2 (12.5%) cohort, and 1 (6.25%) retrospective study were added (Figure 3). [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] In total, a synthesis of 1290 PD patients with COVID-19 and the characteristics of all included studies are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

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The Influence of Coronavirus Disease-2019 (COVID-19) On Parkinson’s Disease: An Updated Systematic Review

Jaiswal

Alquraish

Sarfraz

et al. 2021

J Prim Care Community Health

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Background COVID-19 has affected global communities with multiple neurological complications in addition to other critical medical issues. COVID-19 binds to the host’s angiotensin-converting enzyme 2 (ACE2) receptors, which are expressed in the neurons and glial cells, acting as an entry port to the central nervous system (CNS). ACE2 receptors are abundantly expressed on dopamine neurons, which may worsen the prognosis of motor symptoms in Parkinson’s disease (PD). SARS-CoV-2 may lead to an indirect response via immune-mediated cytokine storms and propagate through the CNS leading to damage. In this systematic review, we aim to provide thorough analyses of associations between COVID-19 and neurological outcomes for patients with PD. Methods Using PRISMA statement 2020, a systematic review was conducted to isolate confirmed COVID-19 patients and analyze the PD-associated neurological outcomes using the following databases: PubMed, Science Direct, Google Scholar, and Cochrane databases. The following keywords were used “COVID19, SARS-CoV-2, Parkinson’s disease, Pandemic, Mortality.” A modified Delphi process was employed. Results Of the 355 studies located during the initial round of screening, 16 were included in the final synthesis. Of PD patients who tested positive for SARS-CoV-2, worsening motor symptoms and other viral-associated symptoms were reported. These symptoms included bradykinesia, tremors, gait disturbances, delirium and dementia, and severe spasms of arms and legs. Encephalopathy was presented in 2 of the included studies. Increased mortality rates were identified for hospitalized patients due to COVID-19 and PD as compared to other patient groups. Conclusion Patients with PD may experience substantial worsening of symptoms due to COVID 19. Given the novelty of neurological-viral associations, clinical studies in the future ought to explore the disease severity and neurological outcomes in COVID-19 positive patients with PD as compared to non-PD patients, in addition to understanding the role of ACE2 in increased vulnerability to contracting the infection and as a treatment modality.

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“…20,24 Mortality rates for PD patients with COVID-19 who were hospitalized ranged from 5.7% to 100%. [10][11][12][13][14][15][16][17][19][20][21][22][23]25…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Influence of Coronavirus Disease-2019 (COVID-19) On Parkinson’s Disease: An Updated Systematic Review

Jaiswal

Alquraish

Sarfraz

et al. 2021

J Prim Care Community Health

View full text Add to dashboard Cite

show abstract

“…Of the 16 articles, 7 (43.8%) were case reports and case series,4 (25%) case-control studies, 2 (12.5%) cross-sectional, 2 (12.5%) cohort and 1(6.25%) retrospective study (Figure 3) [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. All Together describing a total of 1290 Parkinson's patients with COVID-19.…”

Section: Resultsmentioning

confidence: 99%

“…All Together describing a total of 1290 Parkinson's patients with COVID-19. Male gender was predominant in 10 studies [6][7][8][9][10][11][12][13][14][15] and female gender was predominant in 6 studies [14] [16-20]. Of the patients whose data was available, Average mean age was 76.9 and average disease duration was 11 years.…”

Section: Resultsmentioning

confidence: 99%

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The Influence of Coronavirus Disease-2019 (COVID-19) On Parkinson’s Disease: An Updated Systematic Review

Jaiswal

Alquraish

Nagpal

et al. 2021

Preprint

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Background: The novel Coronavirus (COVID 19) infection has affected the population with various medical issues including the underlying neurological comorbidities such as Parkinson disease. COVID 19 is found to bind with the host angiotensin-converting enzyme 2 (ACE2) receptors for viral entry. ACE2 receptors are normally expressed in various body surfaces as well as in the neurons and glial cells where they act as an entry port to SARS-CoV-2 infection to invade the central nervous system (CNS). ACE2 are also highly expressed in dopamine neurons which might worsen the outcome in terms of motor symptoms in PD with the treatment course. It may lead to an indirect response via immune-mediated cytokine storms and propagate through CNS leading to damage. Parkinsons disease has also been noticed due to certain post viral infections apart from COVID-19 such as, HSV, Influenza virus A, Measles virus, Cytomegalovirus and Mumps (Olsen et al, 2018). We aim to provide a thorough review on neurological outcomes and impact of COVID-19 in Parkinson disease. Methods: A systematic review was conducted to analyze the impact of COVID 19 in patients with Parkinson disease (> 21 yo). Systematic literature search was done using PubMed, Science Direct, Google Scholar and Cochrane databases. PRISMA guidelines were followed summarized in Fig. 3 for study acquisition. Results: Of the Parkinsons patients that were tested positive for SARS-CoV 2, worsening of motor symptoms were reported along with other COVID 19 symptoms (Fig. 4 and 5). These symptoms include bradykinesia, tremors, gait disturbances, delirium and dementia and severe spasms of arms and legs. Encephalopathy was also one of the main symptoms presented in two of the studies. Increased mortality rates were identified for those who were hospitalized due to COVID-19 and PD when compared to other patients. Conclusion: Parkinsons disease may experience substantial worsening of motor and non motor symptoms during COVID 19. Due to the novelty of the virus, studies were reported from recent years and further extensive studies are needed to explore more about the disease severity and neurological outcomes when compared to other non-PD patients. Authors identify this as a limitation for this paper. Additional studies are needed to understand the role of ACE2 in increasing vulnerability to viruses and role of ACE inhibitors as treatment modality.

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COVID-19 and Parkinson’s Disease: What Do We Know So Far?

Artusi

Romagnolo

Ledda

et al. 2021

JPD

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Background: Many studies on Parkinson’s disease (PD) patients affected by Coronavirus-disease-2019 (COVID-19) were recently published. However, the small sample size of infected patients enrolled in most studies did not allow to draw robust conclusions on the COVID-19 impact in PD. Objective: We aimed to assess whether the prevalence and outcome of COVID-19 in PD patients are different from those observed in the general population. Methods: We conducted a systematic review of studies reporting data on PD patients with a diagnosis of COVID-19 (PD-COVID+). We extracted prevalence, clinical-demographic data, outcome, and mortality. We also analyzed risk or protective factors based on comparisons between PD-COVID+ and control populations with PD without COVID-19 or without PD with COVID-19. Results: We included 16 studies reporting on a total of 11,325 PD patients, 1,061 with a confirmed diagnosis of COVID-19. The median infection prevalence ranged from 0.6% to 8.5%. PD-COVID+ patients had a median age of 74 and a disease duration of 9.4 years. Pooling all PD-COVID+ patients from included studies, 28.6% required hospitalization, 37.1% required levodopa dose increasing, and 18.9% died. The case fatality was higher in PD-COVID+ patients than the general population, with longer PD duration as a possible risk factor for worse outcome. Amantadine and vitamin D were proposed as potential protective factors. Conclusion: Available studies indicate a higher case fatality in PD patients affected by COVID-19 than the general population. Conversely, current literature does not definitively clarify whether PD patients are more susceptible to get infected. The potential protective role of vitamin D and amantadine is intriguing but deserves further investigation.

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An educational case series of Parkinson's disease during the COVID-19 pandemic

Cited by 3 publications

References 4 publications

The Influence of Coronavirus Disease-2019 (COVID-19) On Parkinson’s Disease: An Updated Systematic Review

The Influence of Coronavirus Disease-2019 (COVID-19) On Parkinson’s Disease: An Updated Systematic Review

The Influence of Coronavirus Disease-2019 (COVID-19) On Parkinson’s Disease: An Updated Systematic Review

COVID-19 and Parkinson’s Disease: What Do We Know So Far?

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