To describe researchers’ observations on a population of patients with PD and COVID-19 admitted to the COVID-19 hospital
Cross-sectional
Mean = 9 yrs
N = 12 (6 M, 6 F) and AgeM = 73 yrs
(i) UPDRS
During hospitalization: 8th March to 30th May 2020
(i) Most of the PD patients had a long disease duration and multiple comorbidities even though SARS-CoV-2 manifestations were mild, and none required intensive care (ii) Despite lung conditions, most of PD patients had mild symptoms: 7 patients were clinically asymptomatic (58.3%); 3 patients had fever, cough, and myalgia (25%) and 2 patients had dyspnea (16%) that needed high-flow oxygen therapy
Slight complications of PD were seen. All patients were discharged during 30 days. No mortality occurred during hospitalization. The findings show that SARS-CoV-2 infection has a good prognosis in patients with PD
To describe the demographic characteristics, presentation, management, and outcome of 36 patients at Movement Disorders Center with positive COVID-19, with the intent of exploring factors that may influence the clinical course in this patient population
Cross-sectional
Mean = 13.06 yrs
N = 36 (23 M, 13 F), AgeM = 74.5 yrs, PD = 22, Atypical parkinsonism = 7, and Other diagnosis = 7
(i) Telephone interview and medical record
During pandemic: 8th March to 6th June 2020
(i) 27 (75%) exhibited alteration in mental status (ii) 15 (42%) had abnormalities of movement (iii) In 61% and 31%, respectively, these were the presenting symptoms of the disease (iv) 67% required hospitalization (v) mortality rate 36%
These data suggest that hospitalization and mortality rates in patients with movement disorders after COVID-19 are higher than in the general population. Patients with movement disorders frequently presented with altered mental status, generalized weakness, or worsening mobility but not anosmia
(i) Retrospective data collection with little sample size
First, to evaluate if PD patients are more susceptible than non-PD to take COVID-19 infection Second, to detect if the infection course is worse in PD-COVID-19+ patients versus non-PD
Cohort
Mean = 6.7 yrs
N = 18 PD = 13 (8 M, 5 F), AgeM = 68.1 yrs, non-PD = 5 (4 M, 1 F), and AgeM = 57.8 yrs
(i) Hoehn and Yahr scale
During pandemic: 15th February to 26th March 2020
(i) 50% (n = 5) were completely asymptomatic (ii) 40% (n = 4) showed mild symptoms of the infection such as intermittent fever, myalgia, pharyngitis (iii) No significative differences were found between the PD-COVID-19+ and PD-COVID-19- negative patients (iv) PD could be not considered as a risk factor for SARS-CoV-2 infection
PD was not identified as a primary risk factor for SARS-CoV-2 infection. Even if COVID-19 worsens motor and non-motor symptoms in PD’s patients and increases the risk of death
(i) Few cohort and control patients’ number (ii) Neuroimaging evaluation was avoided in order to reduce the risk of cross infection
To report on people with PD who had suspected or confirmed COVID-19 to understand how COVID-19 manifested in PD patients
Cross-sectional
Mean = 7.8 yrs
N = 46 (29 M,17 F) and AgeM = 67.9
(i) Data collected from two study protocols: CUIMC registry cohort, PF survey cohort and (ii) survey includes question from coronavirus tracking survey, questions for neurological manifestations of COVID-19, UPDRS
During pandemic: CUIMC Registry cohort: 2nd April to 16th Sept 2020; PF survey cohort: 24th June to 9th July 2020
(i) many experienced worsening of pre-existing motor or non-motor: Bradykinesia, rigidity, balance, UPDRS-walking, UPDRS-mentation, UPDRS-motivation/initiative, UPDRS-handwriting, UPDRS-speech, UPDRS- dressing, UPDRS-turning in bed, UPDRS-thought disorder, anxiety, UPDRS-tremor, sleep- insomnia, UPDRS-hygiene, UPDRS-swallowing, UPDRS-cutting food, UPDRS-freezing, Constipation, pain, Urinary Dystonia, UPDRS-falling, UPDRS-depression,
Symptoms of COVID-19 in PD were similar to the general population. Motor symptoms (such as bradykinesia in 54%, stiffness in 49% and balance disorders in 44% of patients) and non-motor symptoms (eg, motivational problems in 58%, and mental disorders in 48% of patients) worsened during COVID-19 disease. Several motor and non-motor symptoms also appeared for the first time. A small number of participants reported improvement in PD symptoms during COVID-19 disease, including tremor, stiffness, balance disorders, handwriting, speech, shutdown time, insomnia, and anxiety
Depending on e-mail questionnaires likely biases us towards milder COVID-19 cases in patients (i) No PCR or serology test was performed to confirm the diagnosis and the patient was contacted by telephone
To evaluate clinical and demographic variables that may be associated with COVID-19 in patients with PD and those that may influence mortality and morbidity
Case control
Mean = 8.7 yrs
N = 211 PD + COVID-19 = 39(23 M, 16 F), AgeM = 75.5 yrs PD + NoCOVID-19 = 172(101 M, 71 F), and AgeM = 73.9 yrs
(i) Electronic medical record includes demographic, clinical features, advanced therapies, comorbidities, and institutionalization
During pandemic: 1st March to 31th July 2020
(i) the frequency of common comorbidities was similar between COVID-19+ and COVID-19− groups, with the exception of dementia, that was significantly more frequent in the group of cases (36% and 14%, (). Only institutionalization remained significantly associated with COVID-19 + group ()
The results showed that PD did not affect the severity of COVID-19. Epidemiological factors and fragility are also important causes of COVID-19 mortality in PD
(i) its retrospective nature and a relatively small sample size (ii) do not use any fragility scale, which was critical to diagnosing an increased risk of severe illness or death
To determine the clinical manifestations, and outcomes of PD patients with severe COVID-19 and to further explore the risk factors associated with in-hospital mortality of PD patients in the early stage of the epidemic
Cohort
Mean = 8.6 yrs
N = 296, COVID-19 + PD = (3 M, 7 F), AgeMedian = 70 yrs, COVID-19 + NOPD = 286 (147 M, 139 F), and AgeM = 66 yrs
(i) EMR: clinical signs and symptoms, medical history, laboratory findings, treatment used, and outcomes
Admitted at hospital: 28th January to 29th February 2020
(i) the proportion of PD patients with cough and anorexia was significantly higher than that of patients without PD (65.38%, n = 187 and 19.23%, n = 55, respectively) () (ii) No significant differences in lengths of hospital stay and duration of disease between patients with and without PD ()
Older people with a longer duration of PD and a later stage of PD are more severe if they get COVID-19. Also, the severity of COVID-19 and the presence of complications can greatly affect the prognosis of PD patients with severe COVID-19
(i) Small number of PD patients (ii) low proportion of COVID-19 patients with PD (iii) evaluation was not performed for a long time
Researchers identified the risk factors that increase the risk of death in patients with Parkinson’s disease who are infected by SARS-CoV-2
Cohort
Mean = 5 yrs
N = 87, EG = 53 (31 M, 22 F), AgeM = 78.7 yrs, CG = 34 (19 M, 19 F), and AgeM = 78.5 yrs
(i) Clinical examinations
Assessment during COVID-19
PD patients with SARS-CoV-2 infection had a higher mortality rate (35.8%) compared to PD patients without the infection (5.9%, ); there was a statistically significanthigher mortality rate in patients older than 70 years with COVID-19 than in 60–70 years old PD patients ()
Mortality rate due to SARS-CoV-2 infection did not increase with age control in PD patients. However, some unalterable factors (advanced disease and age over 70 years) and alterable factors (reduction of PD drugs) put them at increased risk of mortality
(i) sample size of PD patients with and without COVID-19
Researchers aimed to determine clinical characteristics and outcomes in hospitalized PD individuals infected with COVID-19
Cohort
Mean = 6 yrs
N = 25, EG = 25 (19 M, 6 F), and AgeM = 82 yrs
(i) Clinical examinations
Assessment during COVID-19
The most common comorbidities were hypertension (72%) and mild cognitive impairment or dementia (48%). A total of 44% and 12% of individuals presented with altered mental status and falls, respectively. Mortality rate was 32% compared to 26% for age-matched controls ()
People with PD who are hospitalized for COVID-19 infection are likely to be older, have advanced to midstate disease, and are receiving medication. Also, high blood pressure and cognitive impairment are comorbidities in these individuals. People with encephalopathy are at greater risk of death during hospitalization
(i) Larger cohorts of PD individuals with COVID-19 infection, including long-term follow up (ii) Small sample size (iii) A small percentage of individuals were misdiagnosed as Parkinson’s disease
The main objective was to determine the effects of COVID-19 on motor and nonmotor symptoms in a community-based PD cohort
Cohort
Mean = 8.2 yrs
N = 48, EG = 12 (5 M, 7 F), AgeM = 65.5 yrs, CG = 36 (15 M, 21 F), and AgeM = 66.3 yrs
(i) Clinical examinations (ii) MDS-UPDRS (iii) NMSS (iv) CISI-PD
Baseline and End of study
Worsening of MDSUPDRS Part II and the Part IV total scores and the NMSS total score were explained by COVID-19 alone (,,)
Regardless of the age and duration of the disease, patients with PD may experience significant worsening of motor and non-motor symptoms during mild to moderate COVID-19 disease
(i) sample size of PD patients with and without COVID-19 (ii) Larger cohorts of PD individuals with COVID-19 infection, including long-term follow up
This study aimed to evaluate the risk of hospitalization for COVID-19 and death
Cohort
Not mentioned
N = 48, EG (Parkinson’s disease) = 696 (409 M, 287 F), AgeM = 75.0 yrs EG (Parkinsonism) = 184 (105 M, 79 F), AgeM = 80.5 yrs CG = 8590 (5000 M, 3590 F), and AgeM = 76.0 yrs
(i) Hoehn and Yahr scale score, (ii) clinical examinations, and (iii) MDS-UPDRS
Baseline and End of study
The 3-month hospitalization rate for COVID-19 was 0.6% in Parkinson’s disease, 3.3% in parkinsonism, and 0.7% in controls. The adjusted hazard ratio () in parkinsonism compared with controls
Parkinsonism, Parkinson’s disease alone, is assumably not a risk factor for the rising hospitalization of patients with COVID-19
(i) different risk found for PD and PS suggests that this factor could have biased the results only in a small part
The study aimed to provide a nationwide analysis on hospitalized PD patients in Germany and evaluate the impact of the COVID-19 pandemic
Cross-sectional
Not mentioned
N (COVID-19 + PD) = 693 (419 M, 274 F), AgeM = 80.8 yrs N (COVID-19 + NOPD) = 30,179 (16,373 M, 13806 F), AgeM = 67.4 yrs
(i) Hoehn and Yahr scale score (ii) clinical examinations (iii) NMSS (iv) Hoehn and Yahr scale
Assessment during COVID-19
COVID-19 frequency was significantly higher in the population of 64,434 PD patients than in non- PD patients. Especially in subjects with advanced age (≥65 years); COVID-19 inpatient mortality rate was much higher in PD patients than in non-PD patients ()
Patients with PD are more frequently influenced by COVID-19 and sorrow from increased COVID-19 associated mortality than non-PD patients
(i) A risk of selection bias (ii) limited generalizability of results
