Impact of the COVID-19 Pandemic on Patients with Parkinson’s Disease from the Perspective of Treating Physicians—A Nationwide Cross-Sectional Study

Abstract

The COVID-19 pandemic has posed challenges to maintaining medical care for patients with Parkinson’s disease (PD). The Parkinson’s Disease during the COVID-19 Pandemic (ParCoPa) survey was conducted as an online, nationwide, cross-sectional survey from December 2020 to March 2021 and aimed to assess the impact of the pandemic on the medical care of PD patients from the physicians’ perspective. Invitations containing a randomly generated registration code were mailed to healthcare professionals from sixty-seven specialty centers in Germany. Confounders for the worsening of subjective treatment quality, perceived health risk due to the profession, and adequate protective measures against SARS-CoV-2 were assessed using logistic regression analysis. Of all forty physicians who responded, 87.5% reported a worsening of motor and nonmotor symptoms in their patients, 97.5% experienced cancellation of appointments, and difficulties in organizing advanced and supplementary therapies were reported by over 95%. Participants offered alternative consultation options, mostly in the form of telephone (77.5%) or online (64.1%) consultations, but telephone consultations were the most accepted by patients (“broadly accepted”, 40.0%). We identified pandemic-related deficits in providing care for patients with PD and areas of improvement to ensure continued care for this vulnerable patient population.

SARS-CoV-2 and neurodegenerative diseases: what we know and what we don’t

“…This is in line with cross-sectional data from more than 5000 patients with PD that revealed worsening of motor (43%) and especially non-motor (52%) symptoms since pandemic onset (Brown et al 2020 ). Home confinement and other disease control measures aiming at reduction of contacts are likely to contribute to a diminished physical activity in PD patients (Leavy et al 2021 ) and foster the discontinuation of medical treatments, such as multimodal complex treatment or levodopa/carbidopa intestinal gel (LCIG) set-ups (Richter et al 2021 ; Wolff et al 2022 ). Disruptions were furthermore observed to impact clinical trials, due to difficulties in recruitment, initiation and monitoring (Lorusso et al 2020 ) which will impact the development of future therapeutic options.…”

“…In particular, patients with pre-existing neurodegenerative or chronic neurological diseases are at special risk for this development. Patients with dementia, AD, PD, and multiple sclerosis have been found to suffer from worsening of pre-existing symptoms and de-novo development of neuropsychiatric symptoms, e.g., anxiety and cognitive decline (Lara et al 2020 ; Boutoleau-Bretonniere et al 2020 ; Wei et al 2022 ; Salari et al 2020 ; Shalash et al 2020 ; Wolff et al 2022 ; Haji Akhoundi et al 2020 ). This long-lasting impact of an infection with SARS-CoV-2 has resulted in the need for an implementation of a medical care structure for these patients (Gemelli Against 2020 ).…”

Challenges in Parkinson’s Disease Care—In Light of the COVID-19 Pandemic

“…13 A total of 77.5% of respondents said that they offered phone counseling to patients during the pandemic and that this option was "broadly accepted" by patients. 13 Research on home-monitoring systems to help evaluate movement disorders remotely is also being actively conducted. 14 In our survey, 93.4% of participants responded that they were in favor of introducing telemedicine for parkinsonian disorders.…”

“…Meanwhile, telemedicine is emerging as an alternative to these geographic disparities, especially in regard to the management of chronic diseases during pandemics. In a survey of clinicians at centers specializing in PD across Germany, 97.5% said they had experienced cancellations of patient visits during the COVID-19 pandemic [ 13 ]. A total of 77.5% of respondents said that they offered phone counseling to patients during the pandemic and that this option was “broadly accepted” by patients [ 13 ].…”

SARS-CoV-2, COVID-19 and Neurodegeneration

“…Fründt et al studied the impact of the COVID-19 pandemic on the health care situation of people with Parkinson’s disease in Germany in the Care4PD study [ 1 ]. In a nationwide cross-sectional survey (ParCoPa), Wolff et al examined the impact of the COVID-19 pandemic on Parkinson’s disease patient population from the perspective of the treating physicians in Germany [ 2 ]. In a study from Poland, Krzyston et al performed an online survey to analyze the secondary impact of the COVID-19 pandemic on Parkinson´s patients with a focus on the level of activity, quality of life and PD-related symptoms [ 3 ].…”