Self-reported needs of patients with Parkinson’s disease during COVID-19 emergency in Italy

Abstract

Because of COVID-19 outbreak, regular clinical services for Parkinson's disease (PD) patients have been suddenly suspended, causing worries, confusion and unexpected needs in such frail population. Here, we reviewed the messages spontaneously sent by patients to an Italian PD clinic during the first two weeks of COVID-19 lockdown (9-21 March 2020), in order to highlight their main needs and then outline appropriate strategies of care for this critical period. One hundred sixty-two messages were analysed. Forty-six percent queried about clinical services; 28% communicated an acute clinical worsening for which a therapeutic change was done in 52% of cases; 17% (those patients with younger age and milder disease) asked about the relationship between PD and COVID-19; 8% informed about an intercurrent event. Our analysis suggests that PD patients' needs during COVID-19 emergency include appropriate and complete information, a timely update on changes in clinical services, and the continuity of care, even in a remote mode. By addressing these issues, acute clinical worsening, complications and subsequent therapeutic changes could be prevented. In this perspective, telecommunication systems and virtual medicine should be implemented.

Physical Activity Changes and Correlate Effects in Patients with Parkinson's Disease during COVID‐19 Lockdown

“…Up to 80% of patients doing physiotherapy interrupted treatments during COVID‐19 emergency. Although this was felt as a major issue, 3 we did not find a significant association with health self‐perception in patients. Indeed, regardless of physiotherapy, the majority of patients, especially those with shorter disease duration, continued sport activities.…”

“…Our survey was essentially focused on physical activity, however, many other factors could have contributed to patients' perception of worsening during COVID‐19 emergency. Definitely, worries about the pandemic and its consequences on health, economy, and society might have caused anxiety and stress, which is known to precipitate symptomatology in PD 3,13 . Although we roughly assessed depression by the self‐administered BDI, we could not provide a comprehensive neuropsychological evaluation.…”

“…Daily routine has profoundly changed in a short time for patients with chronic diseases, including Parkinson's disease (PD). Indeed, PD patients missed their follow‐up visits and quit regular activities such as physiotherapy or trained sport, with inevitable consequences on their daily life and well‐being 2,3 …”

COVID-19 and possible links with Parkinson’s disease and parkinsonism: from bench to bedside

“…A community-based case control study in Italy of 12 PD COVID-19 cases suggested substantial worsening of motor and non-motor symptoms during mild to moderate COVID-19 illness, independent of age and disease duration 144 , in line with an original case report series by Antonini et al In another survey across the Lombardy region of Italy, 105 probable COVID-19 cases were identified and the authors concluded that the risk, morbidity, and mortality in patients with mild-to moderate PD with COVID-19 did not differ from the general population 145 . Several viewpoints and editorials have been published on the topic in addition to extensive coverage in social media and journal viewpoint papers [146][147][148][149][150][151] .…”

Severe acute respiratory syndrome coronavirus 2 may be an underappreciated pathogen of the central nervous system

“…Whilst governments around the world are using various measures, such as lockdowns, quarantine and contact tracing, to control the spread of infection, it is worth noting that these approaches might significantly impact patients with chronic neurological disorders in unintended ways. For example, the COVID-19 quarantine in Italy created uncertainty and confusion about the availability of clinical services and continuity of care amongst PD patients [120]. Negative effects on mental health have been observed in those whose daily life was disrupted by the various public health measures [121].…”