Parkinson’s Disease, SARS-CoV-2, and Frailty: Is There a Vicious Cycle Related to Hypovitaminosis D?

Abstract

The literature has long established the association between aging and frailty, with emerging evidence pointing to a relationship between frailty and SARS-CoV-2 contagion. The possible neurological consequences of SARS-CoV-2 infection, associated with physical and cognitive frailty, could lead to a worsening of Parkinson’s disease (PD) in infected patients or—more rarely—to an increase in the Parkinsonian symptomatology. A possible link between those clinical pictures could be identified in vitamin D deficiency, while the whole process would appear to be associated with alterations in the microbiota–intestine–brain axis that fall within the α-Synuclein Origin site and Connectome (SOC) model, and allow for the identification of a body-first PD and a brain-first PD. The model of care for this condition must consider intrinsic and extrinsic variables so that care by a multidisciplinary team can be successfully predicted. A multidimensional screening protocol specifically designed to identify people at risk or in the early stages of the disease should begin with the investigation of indices of frailty and microbiota–intestine–brain axis alterations, with a new focus on cases of hypovitaminosis D.

Neuropsychological measures of post-COVID-19 cognitive status

“…The combination of these limitations did not allow us to corroborate with clinical data several hypotheses currently under investigation in this field of research. For example, the contribution of persistent neuroinflammation such as that observed in the so-called chemo-fog (Fernández-Castañeda et al, 2022 ); or the fact that COVID-19 may bring out neurocognitive and motor disorders already present in a subclinical form (Fearon and Fasano, 2021 ; Palermo G. et al, 2023 ; Palermo S. et al, 2023 ). Further investigation is therefore essential to get a clearer idea of this extremely articulate matter.…”

Advances in Social Cognitive and Affective Neuroscience: Ten Highly Cited Articles Published in Brain Sciences in 2022–2023

“…Palermo et al [13] investigated the interplay between Parkinson's disease (PD), SARS-CoV-2 infection, and frailty. They proposed a multidimensional screening protocol for identifying individuals at risk.…”

Bioinorganic Chemistry of Micronutrients Related to Alzheimer’s and Parkinson’s Diseases

“…Over the last few years, scientific research on vitamin D and its relationship with PD has exploded in terms of contributions. On this issue, a large number of reviews have been published in the last five years (see, for example, [ 58 , 59 , 60 , 61 , 62 ]). Several studies have shown low vitamin D levels in PD patients along with a connection between high vitamin D concentration and reduced risk of PD [ 63 , 64 ].…”