Potential impact and challenges associated with Parkinson’s disease patient care amidst the COVID-19 global pandemic

Abstract

Background: COVID-19 has made itself known to health care providers and families across the world in a matter of months. While primarily a respiratory disorder, it has also been shown to cause neurological symptoms, which can be a concern for Parkinson's disease (PD) patients. Although PD is not as common as other conditions such as cardiovascular diseases, it affects millions of patients around the world whose care has been affected by the global pandemic. Objectives: The aim of this review is to provide insight into the direct and indirect associations between COVID-19 and PD patient care. Results: Potential direct effects of COVID-19 include possible neurodegeneration, concerns of symptom selfmanagement with over-the-counter (OTC) products and ICU challenges that can arise in PD patients. In addition, a subset of PD patients may be at higher risk of severe COVID-19 infection. The indirect effects of the pandemic are associated with the social distancing measures and disruptions in health care systems and PD clinical trials, which may negatively affect PD patients' mental wellbeing and create barriers in controlling their PD symptoms. On a more positive note, telemedical care is quickly emerging as a primary communication tool for virtual patient care. However, further research should be conducted to examine the applicability of telemedicine across the entire PD population, such as those with more severe symptoms living in less developed areas. With all the uncertainty during this time, it is hopeful to hear many promising COVID-19 treatments being researched, one of them being a PD drug therapy, amantadine. Conclusion: Hopefully, we can consider this pandemic an opportunity to strengthen the PD community and learn more about the impact of the SARS-COV-2 virus. This review provides an overview of the interaction between COVID-19 and PD patients and future investigational retrospective studies are suggested to validate the observations.

Effects of the COVID-19 Pandemic on Parkinson’s Disease: a Single-Centered Qualitative Study

“…Some elective surgical procedures like deep brain stimulation (DBS) have been delayed, leaving some PD patients facing barriers in achieving optimal care until further notice. 20 Only one participant in this study was waiting for his DBS appointment, which has been cancelled for the time being, while many other participants expressed a short-term understanding of the delay in clinical care but foresee progressive PD problems if the clinical visitations do not resume soon.…”

Alzheimer’s and Parkinson’s Diseases Predict Different COVID-19 Outcomes: A UK Biobank Study

“…Although data are thus far limited, it is conceivable that PD patients may be at elevated risk of severe respiratory complications following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or even unfavourable outcomes. In addition, it has been suggested that other indirect factors of the pandemic, including increased stress, self-isolation, and anxiety, as well as prolonged immobility, may further exacerbate the outcome of PD patients affected by COVID-19 [ 20 , 21 ]. Currently, there is insufficient evidence to show that a pre-existing diagnosis of PD increases the risk of COVID-19 or mortality, and contradictory results have been reported from small samples of COVID-19 patients.…”

Impactos globais da infecção por COVID-19 em pacientes com a doença de Parkinson: uma revisão integrativa

“…Os sintomas motores da DP podem ser acentuados por agravo de qualquer doença acometida pelo paciente, como por exemplo, as virais respiratórias no caso da COVID-19. Os pacientes quando acometidos por uma doença viral, podem notar agravo nos sintomas de bradicinesia, de rigidez ou ter e/ou piorar quadros de alucinações, podendo ou não estes estarem associados à sintomatologia do quadro clínico da infecção pelo vírus (Elbeddini et al, 2020).…”

“…Embora todos sejam suscetíveis à infecção, pacientes idosos apresentam mais chances de sintomas graves e morte. O perfil do paciente com DP comporta idosos comumente portadores de outras comorbidades como doenças cardiovasculares, doenças mentais, o que agrava a classificação nos grupos de alto risco relacionados à COVID-19 (Elbeddini et al, 2020).…”