Worsened Parkinson’s Disease Progression: Impact of the COVID-19 Pandemic

Ineichen, Christian; Baumann‐Vogel, Heide; Sitzler, Matthias; Waldvogel, Daniel; Baumann, Christian

doi:10.3233/jpd-212779

Cited by 16 publications

(24 citation statements)

References 34 publications

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“…In contrast to most previously published analyses on the impact of the COVID-19 pandemic on PD patients [8,17,18,[25][26][27][28][29][30][31][32][33], we present here the perspective of their attending physicians. We invited physicians from 67 expert health care facilities, 40 of which participated, resulting in a comparably high response rate [34].…”

Section: Discussionmentioning

confidence: 99%

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Impact of the COVID-19 Pandemic on Patients with Parkinson’s Disease from the Perspective of Treating Physicians—A Nationwide Cross-Sectional Study

et al. 2022

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The COVID-19 pandemic has posed challenges to maintaining medical care for patients with Parkinson’s disease (PD). The Parkinson’s Disease during the COVID-19 Pandemic (ParCoPa) survey was conducted as an online, nationwide, cross-sectional survey from December 2020 to March 2021 and aimed to assess the impact of the pandemic on the medical care of PD patients from the physicians’ perspective. Invitations containing a randomly generated registration code were mailed to healthcare professionals from sixty-seven specialty centers in Germany. Confounders for the worsening of subjective treatment quality, perceived health risk due to the profession, and adequate protective measures against SARS-CoV-2 were assessed using logistic regression analysis. Of all forty physicians who responded, 87.5% reported a worsening of motor and nonmotor symptoms in their patients, 97.5% experienced cancellation of appointments, and difficulties in organizing advanced and supplementary therapies were reported by over 95%. Participants offered alternative consultation options, mostly in the form of telephone (77.5%) or online (64.1%) consultations, but telephone consultations were the most accepted by patients (“broadly accepted”, 40.0%). We identified pandemic-related deficits in providing care for patients with PD and areas of improvement to ensure continued care for this vulnerable patient population.

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Section: Discussionmentioning

confidence: 99%

“…Reduction of exercise [7,11,12] and social isolation [13] also correlated with the worsening of PD symptoms. Accompanying these disruptions to medical care, various cross-sectional assessments of symptom burden have found significant symptom deterioration in these patients [8,[14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Patients with Parkinson’s Disease from the Perspective of Treating Physicians—A Nationwide Cross-Sectional Study

et al. 2022

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“…A recent retrospective study has reported a worsening of motor symptoms with a significant increase in motor disease progression during pandemic-related restrictions compared with that during the pre-pandemic period. The assessment was limited to ON-state and motor aspects 7 . Therefore, longitudinal studies are warranted to investigate the possibility of altered progression of motor and non-motor aspects of PD during the pandemic.…”

Section: Introductionmentioning

confidence: 99%

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

Shalash

Helmy

Salama

et al. 2022

npj Parkinsons Dis.

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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.

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“…Pneumonia, another marker of disease progression ( 18 ), could be a direct consequence of motor impairment after a major injury [e.g., a fracture ( 31 )] and/or due to the reduction of primary care contacts ( 32 ). Some empirical data consistently show a reduction in the daily walking activity during the confinement period compared to the pre-confinement period ( 33 ), the reduction in the amount, duration, and frequency of exercise ( 34 , 35 ) and physiotherapy ( 20 ) in people with PD, with possible subjective and objective worsening of both motor and non-motor features ( 20 , 34 , 36 – 39 ).…”

Section: Discussionmentioning

confidence: 98%

The Indirect Impact of COVID-19 on Major Clinical Outcomes of People With Parkinson's Disease or Parkinsonism: A Cohort Study

et al. 2022

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BackgroundThe indirect impact of the COVID-19 epidemic on major clinical outcomes of people with Parkinson's disease (PD) or other parkinsonism is unknown.ObjectivesThe study aimed to (1) describe changes in healthcare services during the first epidemic bout in people with PD or parkinsonism; (2) compare the occurrence of hospitalization for any PD-related major clinical outcomes in 2020 with 2019; (3) investigate the factors, including changes in healthcare services, associated with major clinical outcomes and death.MethodsAll healthcare services of the province of Bologna and major clinical outcomes were assessed through a record linkage study (ParkLink Bologna) using clinical data and health databases. Same analyses were performed in a random cohort of controls matched for age, sex, district of residence, and comorbidities with the ParkLink cohort (ratio of 1:10).ResultsA cohort of subjects with PD (759) or other parkinsonism (192) was included together with a cohort of controls (9,226). All indicators of healthcare services dropped at least below 50% during the lockdown period in all cohorts, mostly impacting physiotherapy in people with PD (−93%, 95% CI 88–96%). In 2020, compared to 2019, a three-fold risk of major injuries (RR 3.0, 95% CI 1.5–6.2) and infections (RR 3.3, 95% CI 1.5–7.2), excluding COVID-19, was observed only in people with PD, and neither in people with parkinsonism nor in controls. Decreased physiotherapy was associated with the occurrence of at least one major clinical outcome (OR 3.3, 95% CI 1.1–9.8) in people with PD. Experiencing at least one major clinical outcome was the strongest risk factor for death (OR 30.4, 95% CI 11.1–83.4) in people with PD.ConclusionsDuring the first COVID-19 epidemic peak, healthcare services were drastically reduced in a province of northern Italy, regardless of the disease condition. However, compared to 2019, in 2020, only people with PD had a higher risk of major clinical outcomes, that were associated with higher mortality. Strategies to maintain physical activity in people with PD should be implemented in possible future health emergencies.

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Worsened Parkinson’s Disease Progression: Impact of the COVID-19 Pandemic

Cited by 16 publications

References 34 publications

Impact of the COVID-19 Pandemic on Patients with Parkinson’s Disease from the Perspective of Treating Physicians—A Nationwide Cross-Sectional Study

Impact of the COVID-19 Pandemic on Patients with Parkinson’s Disease from the Perspective of Treating Physicians—A Nationwide Cross-Sectional Study

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

The Indirect Impact of COVID-19 on Major Clinical Outcomes of People With Parkinson's Disease or Parkinsonism: A Cohort Study

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