Covid‐19 Infection and Parkinsonism: Is There a Link?

Abstract

A BS TRACT: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an opportunistic pathogen that infects the upper respiratory tract in humans and causes serious illness, including fatal pneumonia and neurological disorders. Several studies have reported that SARS-CoV-2 may worsen the symptoms of Parkinson's disease (PD), with the potential to increase mortality rates in patients with advanced disease. The potential risk of SARS-CoV-2 to induce PD has also been suggested because the virus can enter the brain, where it can trigger cellular processes involved in neurodegeneration. In this review, we will discuss the potential of SARS-CoV-2 to exacerbate and cause certain neurological disorders, including PD. We will then elucidate its impact on the brain while examining its pathways and mechanisms of action.

Impact of COVID-19 Pandemic on (Health) Care Situation of People with Parkinson’s Disease in Germany (Care4PD)

“…Data are inconclusive on whether the diagnosis of Parkinson’s Disease (PD) is a specific risk factor for a negative COVID-19 outcome [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ] or whether a COVID-19 infection itself could cause a neurodegenerative disease such as PD [ 8 , 9 , 10 , 11 ]. The International Parkinson and Movement Disorder Society published a viewpoint with behavioral recommendations—independent of the general social restrictions to prevent the viral spread—such as strictly practicing social distancing, avoiding in-hospital stays for non-emergency reasons, postponing elective DBS surgery, and using telemedicine instead of direct outpatient visits [ 1 ].…”

Hospital Admissions for Neurodegenerative Diseases during the First Wave of the COVID-19 Pandemic: A Nationwide Cross-Sectional Study from Germany

“…In the future, both indirect (e.g., changes in hospital care utilization) and direct health effects (e.g., possible causation or exacerbation of NDD) of the COVID-19 pandemic most likely will continue to affect people living with NDD. Even if some studies suggest a causal role of SARS-CoV-2 for neurodegeneration [ 19 ], long-term data on COVID-19-related incidence of NDD and conclusive evidence on underlying mechanisms, such as neurodegeneration secondary to microglial neuroinflammation [ 20 ], are currently lacking [ 21 , 22 , 23 ]. Therefore, the question whether or not the COVID-19 pandemic may lead to increased numbers of NDD admissions in the long-term can only be answered by future epidemiological research [ 21 , 23 ].…”

“…Even if some studies suggest a causal role of SARS-CoV-2 for neurodegeneration [ 19 ], long-term data on COVID-19-related incidence of NDD and conclusive evidence on underlying mechanisms, such as neurodegeneration secondary to microglial neuroinflammation [ 20 ], are currently lacking [ 21 , 22 , 23 ]. Therefore, the question whether or not the COVID-19 pandemic may lead to increased numbers of NDD admissions in the long-term can only be answered by future epidemiological research [ 21 , 23 ]. Limitations of this report include small group sizes, especially for HD and MSA.…”

Parkinson’s Disease in Light of the COVID-19 Pandemic

“…In this review we attempt to collate the existing scientific evidence regarding the possible role of SARS-CoV-2 in the pathophysiology of PD/parkinsonism, as well as to investigate the impact of PD on the clinical course of the viral infection itself. Prior to the COVID-19 pandemic, multiple neurotropic viruses were already recognized, i.e., herpes simplex virus (HSV), poliovirus, influenza A virus, and representatives of the Coronaviridae viral family [9][10][11]. Viral RNA and proteins identified in the brain specimens during post-mortem examinations of patients diagnosed with COVID-19 strongly suggest neurotropic characteristics of SARS-CoV-2 as well [12,13].…”

“…Nonetheless, the interplay between SARS-CoV-2 and abundant ACE2 receptors gives solid grounds to discuss the role of COVID-19 in neurodegenerative conditions. Recent studies indicate that there may exist (not yet elucidated) a molecular link between the infection and the pathogenesis of Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease (PD)/parkinsonism [ 1 , 3 , 6 , 7 , 8 , 9 ].…”