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J Parkinsons Dis . COVID-19 and Parkinson's Disease: What We Know So Far?

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  • J Parkinsons Dis . COVID-19 and Parkinson's Disease: What We Know So Far?


    J Parkinsons Dis


    . 2021 Mar 18.
    doi: 10.3233/JPD-202463. Online ahead of print.
    COVID-19 and Parkinson's Disease: What We Know So Far?


    Carlo Alberto Artusi 1 2 , Alberto Romagnolo 1 2 , Claudia Ledda 1 2 , Maurizio Zibetti 1 2 , Mario Giorgio Rizzone 1 2 , Elisa Montanaro 2 , Marco Bozzali 1 2 3 , Leonardo Lopiano 1 2



    Affiliations

    Abstract

    Background: Many studies on Parkinson's disease (PD) patients affected by Coronavirus-disease-2019 (COVID-19) were recently published. However, the small sample size of infected patients enrolled in most studies did not allow to draw robust conclusions on the COVID-19 impact in PD.
    Objective: We aimed to assess whether the prevalence and outcome of COVID-19 in PD patients are different from those observed in the general population.
    Methods: We conducted a systematic review of studies reporting data on PD patients with a diagnosis of COVID-19 (PD-COVID+). We extracted prevalence, clinical-demographic data, outcome, and mortality. We also analyzed risk or protective factors based on comparisons between PD-COVID+ and control populations with PD without COVID-19 or without PD with COVID-19.
    Results: We included 16 studies reporting on a total of 11,325 PD patients, 1,061 with a confirmed diagnosis of COVID-19. The median infection prevalence ranged from 0.6% to 8.5%. PD-COVID+ patients had a median age of 74 and a disease duration of 9.4 years. Pooling all PD-COVID+ patients from included studies, 28.6% required hospitalization, 37.1% required levodopa dose increasing, and 18.9% died. The case fatality was higher in PD-COVID+ patients than the general population, with longer PD duration as a possible risk factor for worse outcome. Amantadine and vitamin D were proposed as potential protective factors.
    Conclusion: Available studies indicate a higher case fatality in PD patients affected by COVID-19 than the general population. Conversely, current literature does not definitively clarify whether PD patients are more susceptible to get infected. The potential protective role of vitamin D and amantadine is intriguing but deserves further investigation.

    Keywords: COVID-19; Parkinson?s disease; amantadine; infection; mortality; outcome.

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