A 6-month longitudinal study on worsening of Parkinson’s disease during the COVID-19 pandemic

Abstract

Further studies are required to investigate the impact of the COVID-19 pandemic on Parkinson’s disease (PD) progression. This study investigated the motor and non-motor progression of people with PD (PWP) at 6 months during the COVID-19 pandemic compared with that during the pre-pandemic period. Patients were recruited from Ain Shams University Hospitals, Cairo, in the period between April 2019 and December 2020. Fifty patients were included, of whom 17 and 33 patients were followed for 6 months before and during the pandemic, respectively. All patients were assessed at baseline and at 6 months using the MDS-UPDRS, Schwab and England scale (S&E), Hoehn and Yahr scale (H&Y), Berg Balance Scale, Timed Up and Go test (TUG), International Physical Activity Questionnaire, New Freezing of Gait Questionnaire, Non-Motor Symptoms Scale, and Beck Depression Inventory (BDI). Both groups were matched in age, gender, and disease characteristics. Patients followed during the pandemic showed more significant worsening of the total, part I and motor part of MDS-UPDRS, and balance scores (p < 0.001) than those followed during the pre-COVID-19 period. Gait (TUG), balance, and physical activity worsening were significantly correlated with baseline BDI, gait and balance scores, total and part I MDS-UPDRS scores, H&Y, and S&E OFF scores. Gait deterioration (TUG) was correlated with baseline physical activity (r = −0.510, p = 0.002). PWP showed worsening of motor and non-motor symptoms during the COVID-19 pandemic at the 6-month follow-up. Worsening of gait, balance, and physical activity was correlated with baseline motor and physical activity OFF scores.

Remote Assessment of Parkinson’s Disease Patients Amidst the COVID-19 Lockdown in Mexico

“…Unfortunately, demographic data for the sample in that study were not provided, making it difficult to determine the reason for the lack of detectable motor impairment. In contrast, studies by Ineichen et al [32], Shalash et al [25], and Capecci et al [34], which had evaluation periods longer than six months, yielded results consistent with our findings. These studies reported an increase in the UPDRS Part III score during the lockdown period.…”

“…However, it is noteworthy that 58.3% of the patients required medication adjustments for non-motor symptoms, indicating the importance of addressing these aspects during virtual consultations (Table 1). Previous studies, including Falla et al [24] and Shalash et al [25], have also reported a deterioration in the non-motor aspects of daily life, as measured by UPDRS Part I. It is important to note that these findings may vary across different populations and countries, reflecting the unique experiences and conditions of each study population during the pandemic.…”

“…Previous studies have reported the worsening of motor symptoms in individuals with PD during the confinement period, as evident from subjective questionnaires [13][14][15]17,25,[31][32][33][34][35][36][37]. However, several studies that evaluated the UPDRS Part III did not find significant changes between the pandemic and pre-pandemic periods [13,24], or the changes were only marginally significant [31].…”

Fatigue and long duration of infection are associated with worsen motor and non‐motor symptoms in Parkinson's disease following Omicron COVID‐19 pandemic

“…The clinical deterioration was explained by the infection-related mechanisms and impaired pharmacokinetics of dopaminergic therapy (Cilia et al, 2020). Another retrospective study also reported a worsening of motor and non-motor symptoms with a significant increase in disease progression during the COVID-19 pandemic (Shalash et al, 2022).…”

“…Previous studies have reported that COVID-19 not only aggravates motor and non-motor symptoms (Brown et al, 2020;D'Iorio et al, 2022) but also exacerbates the disease progression in PD patients (Shalash et al, 2022). Many of these studies have focused on the relationship between COVID-19 pandemic and clinical features of PD.…”