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Background Parkinson’s Disease (PD) is among one of the common comorbidities in older patients. People with PD may be more vulnerable to severe pneumonia, due to the impairment of pulmonary function. Currently, the association between PD and COVID-19 is not yet established. This study aims to analyze the relationship between PD and in-hospital outcomes of COVID-19. Materials and Methods We systematically searched the PubMed and Europe PMC database using specific keywords related to our aims until December 25 th , 2020. All articles published on COVID-19 and Parkinson’s Disease were retrieved. The quality of the study was assessed using the Newcastle Ottawa Scale (NOS) tool for observational studies and Joanna Briggs Institute (JBI) Critical Appraisal Tools for cross-sectional studies. Statistical analysis was done using Review Manager 5.4 software. Results A total of 12 studies with 103,874 COVID-19 patients were included in this meta-analysis. This meta-analysis showed that Parkinson’s Disease was associated with poor in-hospital outcomes [[OR 2.64 (95% CI 1.75 – 3.99), p < 0.00001, I 2 = 81%] and its subgroup which comprised of severe COVID-19 [OR 2.61 (95% CI 1.98 – 3.43), p < 0.00001, I 2 = 0%] and mortality from COVID-19 [RR 2.63 (95% CI 1.50 – 4.60), p = 0.0007, I 2 = 91%]. Meta-regression showed that the association was influenced by age (p = 0.05), but not by gender (p = 0.46) and dementia (p = 0.23). Conclusions Extra care and close monitoring should be provided to Parkinson’s Disease patients to minimize the risk of infections, preventing the development of severe and mortality outcomes.

Aims GLP-1RA has many beneficial properties, including anti-inflammatory, anti-obesogenic, pulmonary protective effects as well as beneficial impact on gut microbiome. However, the evidence regarding the benefit of GLP-1RA in Covid-19 patients with diabetes is still unclear. This study sought to analyze the benefit of pre-admission use of GLP-1RA in altering the mortality outcomes of coronavirus disease 2019 (Covid-19) patients with diabetes mellitus. Methods Using specific keywords, we comprehensively searched the potential articles on PubMed, Europe PMC, and medRxiv database until June 12 th , 2021. All published studies on Covid-19 and GLP-1RA were retrieved. Statistical analysis was conducted using Review Manager 5.4 and Comprehensive Meta-Analysis version 3 software. Results A total of 9 studies with 19,660 diabetes mellitus patients who were infected by SARS-CoV-2 were included in the meta-analysis. Our data suggested that pre-admission use of GLP-1RA was associated with reduction in mortality rate from Covid-19 in patients with diabetes mellitus (OR 0.53; 95%CI: 0.43 – 0.66, p <0.00001, I 2 = 0%, random-effect modelling). Further analysis showed that the associations were not influenced by age ( p =0.213), gender (p=0.421), hypertension (p=0.131), cardiovascular disease (p=0.293), nor the use of metformin (p=0.189) and insulin (p=0.117). Conclusions Our study suggests that pre-admission use of GLP-1RA may offer beneficial effects on Covid-19 mortality in patients with diabetes mellitus. However, more randomized clinical trials are required to confirm this conclusion.

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