Impact of the <scp>COVID</scp>‐19 Pandemic on Parkinson's Disease and Movement Disorders

Papa, Stella M.; Brundin, Patrik; Fung, Victor S.C.; Kang, Un Jung; Burn, David J.; Colosimo, Carlo; Chiang, Han‐Lin; Alcalay, Roy N.; Trenkwalder, Claudia

doi:10.1002/mds.28067

Cited by 165 publications

(189 citation statements)

References 27 publications

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“…19 Presently, there is insufficient evidence in the literature showing that PD by itself worsens COVID-19 outcome. 20 However, patients with advanced PD with restricted pulmonary capacity attributed to axial akinesia are at higher risk for pulmonary decompensation. In addition, it is well known that parkinsonism tends to decompensate with acute stress and particularly with fever, both key symptoms of COVID-19.…”

Section: Does Advanced Pd Pose An Increased Risk Of Morbidity and Mormentioning

confidence: 99%

Management of Advanced Therapies in Parkinson's Disease Patients in Times of Humanitarian Crisis: The COVID‐19 Experience

Fasano

Antonini

Katzenschlager

et al. 2020

Movement Disord Clin Pract

129

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Background Although the COVID‐19 pandemic is affecting a relatively small proportion of the global population, its effects have already reached everyone. The pandemic has the potential to differentially disadvantage chronically ill patients, including those with Parkinson's disease (PD). The first health care reaction has been to limit access to clinics and neurology wards to preserve fragile patients with PD from being infected. In some regions, the shortage of medical staff has also forced movement disorders neurologists to provide care for patients with COVID‐19. Objective To share the experience of various movement disorder neurologists operating in different world regions and provide a common approach to patients with PD, with a focus on those already on advanced therapies, which may serve as guidance in the current pandemic and for emergency situations that we may face in the future. Conclusion Most of us were unprepared to deal with this condition given that in many health care systems, telemedicine has been only marginally available or only limited to email or telephone contacts. In addition, to ensure sufficient access to intensive care unit beds, most elective procedures (including deep brain stimulation or the initiation of infusion therapies) have been postponed. We all hope there will soon be a time when we will return to more regular hospital schedules. However, we should consider this crisis as an opportunity to change our approach and encourage our hospitals and health care systems to facilitate the remote management of chronic neurological patients, including those with advanced PD.

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Section: Does Advanced Pd Pose An Increased Risk Of Morbidity and Mormentioning

confidence: 99%

Management of Advanced Therapies in Parkinson's Disease Patients in Times of Humanitarian Crisis: The COVID‐19 Experience

Fasano

Antonini

Katzenschlager

et al. 2020

Movement Disord Clin Pract

129

View full text Add to dashboard Cite

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“…5 In addition, antibodies against the coronavirus were found in the cerebrospinal fluid of patients with Parkinson's disease, suggesting a possible role of viral infection in neurodegeneration. 6 Taken together, the evidence given previously might point out to the possibility of a cause and effect relationship between the development of Parkinson's disease and coronavirus infectious disease 2019. The answer to this question is essential and certainly requires further investigations.…”

mentioning

confidence: 88%

Reply to: “Can the 2019 Novel Coronavirus Cause Parkinson's Disease?”

et al. 2020

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“…These include older age, male sex, cardiovascular and cerebrovascular disease, diabetes and immunosuppression [12,13]. There is no evidence to date that patients with movement disorders are at increased risk from COVID-19, but patients with Parkinson's disease and pneumonia have longer hospitalizations [14]. Additional consideration should be whether a patient resides in a nursing home or another group facility that puts them and other residents at increased risk of infection spread.…”

Section: Covid-19 Specific Risk Factorsmentioning

confidence: 99%

Recommendations for Deep Brain Stimulation Device Management During a Pandemic

Miocinovic

Ostrem

Okun

et al. 2020

JPD

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U n c o r r e c t e d A u t h o r P r o o f Journal of Parkinson's Disease xx (20xx) x-xxAbstract. Most medical centers are postponing elective procedures and deferring non-urgent clinic visits to conserve hospital resources and prevent spread of COVID-19. The pandemic crisis presents some unique challenges for patients currently being treated with deep brain stimulation (DBS). Movement disorder (Parkinson's disease, essential tremor, dystonia), neuropsychiatric disorder (obsessive compulsive disorder, Tourette syndrome, depression), and epilepsy patients can develop varying degrees of symptom worsening from interruption of therapy due to neurostimulator battery reaching end of life, device malfunction or infection. Urgent intervention to maintain or restore stimulation may be required for patients with Parkinson's disease who can develop a rare but potentially life-threatening complication known as DBS-withdrawal syndrome. Similarly, patients with generalized dystonia can develop status dystonicus, patients with obsessive compulsive disorder can become suicidal, and epilepsy patients can experience potentially life-threatening worsening of seizures as a result of therapy cessation. DBS system infection can require urgent, and rarely emergent surgery. Elective interventions including new implantations and initial programming should be postponed. For patients with existing DBS systems, the battery status and electrical integrity interrogation can now be performed using patient programmers, and employed through telemedicine visits or by phone consultations. The decision for replacement of the implantable pulse generator to prevent interruption of DBS therapy should be made on a case-by-case basis taking into consideration battery status and a patient's tolerance to potential therapy disruption. Scheduling of the procedures, however, depends heavily on the hospital system regulations and on triage procedures with respect to safety and resource utilization during the health crisis. U n c o r r e c t e d A u t h o r P r o o f 32The novel coronavirus (COVID-19) pandemic is 33 rapidly changing how we live and practice medicine 34 globally. Patients treated with deep brain stimula-35 tion (DBS) for movement disorders, neuropsychiatric 36 disorders, and epilepsy face unique challenges. High-37 lighted in this article are practical management 38 recommendations for DBS providers during COVID-39 19 pandemic. Since public health guidelines vary 40 across countries, states and local municipalities and 41 rapidly change, each medical center needs to be 42 nimble and develop strategies to care for patients 43 within the home setting. DBS practices range from 44 large, tertiary centers to community clinics and vary 45 widely in terms of workflow, resource availability, 46 and level of expertise available on site. We provide 47 general recommendations and workflow algorithm 48 that centers can modify and adopt quickly while 49 exercising compliance at multiple levels. This cri-50 sis highlights the challenge of postponing electiv...

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Impact of the COVID‐19 Pandemic on Parkinson's Disease and Movement Disorders

Cited by 165 publications

References 27 publications

Management of Advanced Therapies in Parkinson's Disease Patients in Times of Humanitarian Crisis: The COVID‐19 Experience

Management of Advanced Therapies in Parkinson's Disease Patients in Times of Humanitarian Crisis: The COVID‐19 Experience

Reply to: “Can the 2019 Novel Coronavirus Cause Parkinson's Disease?”

Recommendations for Deep Brain Stimulation Device Management During a Pandemic

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