Morbidity and severity of COVID-19 in patients with Parkinson's disease treated with amantadine - A multicenter, retrospective, observational study

Przytuła, Filip; Kasprzak, Jakub; Dulski, Jarosław; Koziorowski, Dariusz; Kwaśniak-Butowska, Magdalena; Sołtan, Witold; Roszmann, Anna; Śmiłowska, Katarzyna; Schinwelski, Michał; Sławek, Jarosław

doi:10.1016/j.parkreldis.2022.105238

Cited by 4 publications

(5 citation statements)

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“…In recent decades, it was mainly used in PD due to its potential to increase dopamine and block NMDA receptors. It was initially suggested that it might be beneficial in COVID [35,36]; however, a recent study on a large group of 552 patients did not confirm this observation [37]. Although there was no sufficient information available in the literature to analyse the impact of amantadine use on post-COVID parkinsonism, a causal relationship would be interesting to explore.…”

Section: Discussionmentioning

confidence: 99%

“…Angiotensin-converting enzyme-2 (ACE-2) is the main cell entry receptor for SARS-CoV-2 [2,38,39]. The receptor is expressed in glia and neurons, particularly in the brainstem, cerebral cortex, hypothalamus, substantia nigra, and basal ganglia [2,37,38]. High expression of the ACE2 receptor in the dopaminergic neurons may explain the predilection of SARS--CoV-2 to affect these brain regions [38].…”

Section: Discussionmentioning

confidence: 99%

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Incidence and characteristics of post-COVID-19 parkinsonism and dyskinesia related to COVID-19 vaccines

Dulski

Sławek

2023

Neurol Neurochir Pol.

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Background. Coronavirus disease 2019 (COVID-19) is an infectious disease mainly affecting the respiratory system; however, a significant prevalence of neurological symptoms has been noted. Objectives.To investigate the incidence and characteristics of post-COVID-19 parkinsonism and to study dyskinesia related to COVID-19 vaccines. Material and methods.The MEDLINE, PubMed, Scopus, and Web of Science databases were searched for all manuscripts relevant to post-COVID-19 parkinsonism and dyskinesia related to COVID-19 vaccines. Subsequently, we extracted and analysed data from the manuscripts in a structured manner.Results. We found 24 patients with post-COVID-19 parkinsonism, with a mean onset age of 58 years after a mean of 30 days from the COVID-19 onset. Akinetic-rigid (n = 11) and mixed (n = 6) subtypes were the most common. Asymmetry was present in 13/15 patients. Brain MRI was unremarkable in 11/19, whereas dopaminergic system imaging was abnormal in 8/8 patients. Responsiveness to dopaminergic treatment was observed in 12/15 patients. Four patients improved after immunomodulatory therapy. Comorbidities were present in 9/24, encephalopathy symptoms in 11/24, and loss of smell in 9/13 patients. Most patients (n = 14) suffered serious COVID-19related complications and three were treated with haloperidol. Parkinsonism improved (n = 5) or resolved (n = 4) during the follow-up.Five patients, with a mean age of 52, developed dyskinesia at a mean of 25 hours after receiving the COVID-19 mRNA vaccines. One patient had a history of neuropsychiatric symptoms and developed functional dyskinesia of the tongue. Four patients had a previous history of Parkinson's Disease (PD) with a mean duration of 10 years and developed dyskinesia and dystonia, which resolved (n = 2) or improved (n = 2) during the follow-up. Conclusions.Post-COVID-19 parkinsonism is a very rare complication, and it is likely that this is an umbrella syndrome that includes many different etiologies. Dyskinesia due to COVID-19 vaccines is exceedingly rare and probably has the same pathophysiological basis as in other conditions with exacerbation of PD symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Incidence and characteristics of post-COVID-19 parkinsonism and dyskinesia related to COVID-19 vaccines

Dulski

Sławek

2023

Neurol Neurochir Pol.

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“…A recent systematic review and meta-analysis found that PD patients were at a higher risk of contracting SARS-CoV-2 (OR = 1.65 (1.34–2.04), especially if they were cognitively impaired [ 32 ]. An observational, retrospective, multicenter study ( n = 552) showed that the incidence of COVID-19 was significantly higher among PD patients who were younger than 50 and had shorter durations of disease or had less-advanced PD [ 33 ]. Three systematic reviews and meta-analyses also explored this hypothesis, highlighting obesity, subjacent pulmonary disease, diabetes mellitus and immune compromise as potential risk factors for the PD population, while another systematic review found outstanding differences in the prevalence of COVID-19 depending on the geographical location of the assessed PD cohort [ 34 , 35 , 36 , 37 ].…”

Section: Is Covid-19 More Common Among Parkinson’s Disease Patients?mentioning

confidence: 99%

“…An observational, retrospective multicenter study ( n = 552) investigated the incidence and severity of COVID-19 infection in PD patients who were chronically prescribed amantadine compared to those who were not. No statistically significant differences were found between the two groups of patients, leading the authors to conclude that amantadine did not impair the risk of developing COVID-19 or the severity of the infection [ 33 ].…”

Section: Are There Any Treatment Options For Parkinson’s Patients Wit...mentioning

confidence: 99%

SARS-CoV-2 and Parkinson’s Disease: A Review of Where We Are Now

Boura,

Qamar,

Daddoveri

et al. 2023

Biomedicines

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Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has been discussed in the context of Parkinson’s disease (PD) over the last three years. Now that we are entering the long-term phase of this pandemic, we are intrigued to look back and see how and why the community of patients with PD was impacted and what knowledge we have collected so far. The relationship between COVID-19 and PD is likely multifactorial in nature. Similar to other systemic infections, a probable worsening of PD symptoms secondary to COVID-19, either transient or persistent (long COVID), has been demonstrated, while the COVID-19-related mortality of PD patients may be increased compared to the general population. These observations could be attributed to direct or indirect damage from SARS-CoV-2 in the central nervous system (CNS) or could result from general infection-related parameters (e.g., hospitalization or drugs) and the sequelae of the COVID-19 pandemic (e.g., quarantine). A growing number of cases of new-onset parkinsonism or PD following SARS-CoV-2 infection have been reported, either closely (post-infectious) or remotely (para-infectious) after a COVID-19 diagnosis, although such a link remains hypothetical. The pathophysiological substrate of these phenomena remains elusive; however, research studies, particularly pathology studies, have suggested various COVID-19-induced degenerative changes with potential associations with PD/parkinsonism. We review the literature to date for answers considering the relationship between SARS-CoV-2 infection and PD/parkinsonism, examining pathophysiology, clinical manifestations, vaccination, and future directions.

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“…How ever, the lat est ev i dence from clin i cal stud ies have not dem on strated any pre ven tive ben e fits of this med i ca tion. F. Przytuùa et al re cently pub lished the results of an ob ser va tional, ret ro spec tive, multicenter co hort study of five hun dred and fifty-two (n=552) id io pathic PD pa tients and con cluded that amantadine does not af fect either the se ver ity or the risk of de vel op ing COVID-19 [17].…”

Section: Treat Ment Guidancementioning

confidence: 99%

Psychosis as an Isolated Manifestation of COVID-19 in Non-Demented Patients with Parkinson's Disease: Clinical Cases and Literature Review

Lokominaitė,

Kaladytė Lokominienė

2023

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Psychotic disorders in patients with Parkinson's disease are usually associated with poor cognitive performance, comorbidities, and changes in treatment regime. Despite the recognition of cognitive deficit as a major risk factor for psychosis in Parkinson's disease, psychotic events have been reported in patients without dementia. SARS-CoV-2 is now recognized as a harmful invader of the nervous system, and defining its consequences still requires multidirectional research. Patients with Parkinson's disease may develop psychosis during COVID-19 infection. According to our observation, psychotic disorder seems to be an isolated manifestation of SARS-CoV-2 infection in Parkinson's disease. In this article, we present two clinical cases of non-demented patients with Parkinson's disease who underwent full vaccination against SARS-CoV-2. The patients were on stable antiparkinsonian medication, had no previous psychiatric disturbances, and developed psychosis as a consequence of COVID-19 without any other clinical signs of infection; no recurrent psychotic disorders were registered during the one-year follow-up. The discussion on diagnostic difficulties and treatment options includes a review of the literature. We recommend to perform reverse transcription polymerase chain reaction (RT-PCR) swab testing for SARS-CoV-2 in patients with Parkinson's disease who develop acute psychosis.

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Morbidity and severity of COVID-19 in patients with Parkinson's disease treated with amantadine - A multicenter, retrospective, observational study

Cited by 4 publications

References 22 publications

Incidence and characteristics of post-COVID-19 parkinsonism and dyskinesia related to COVID-19 vaccines

Incidence and characteristics of post-COVID-19 parkinsonism and dyskinesia related to COVID-19 vaccines

SARS-CoV-2 and Parkinson’s Disease: A Review of Where We Are Now

Psychosis as an Isolated Manifestation of COVID-19 in Non-Demented Patients with Parkinson's Disease: Clinical Cases and Literature Review

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