Impact of social and mobility restrictions in Parkinson's disease during COVID-19 lockdown.

BACKGROUND: The consequences of strict COVID-19 mobility restrictions on motor/non-motor features in Parkinson's disease (PD) have not been systematically studied but worse mobility and quality of life have been reported. To elucidate this question, 12 mild to moderate PD patients were assessed in March 2020 before and after two months of isolation as part of a clinical study that had to be interrupted due to the pandemic and the implementation of COVID19 mobility restrictions. METHODS: Twelve patients were systematically evaluated before and after the lockdown period as part of a larger cohort that previously underwent thermal water rehabilitation. Clinical outcomes were the Body Mass index, the Mini-Balance Evaluation Systems Test, the MDS-Unified Parkinson's Disease Rating Scale part III, the 6 Minute Walking Test and the New Freezing of Gait Questionnaire. Global cognition was evaluated with the Montreal Cognitive Assessment scale. The impact of COVID-19 restrictions on quality of life and functional independence was evaluated with The Parkinson's disease Quality of life (PDQ-39), the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living questionnaires (IADL) and the Parkinson's disease cognitive functional rating scales (PD-CFRS). RESULTS: After two months of isolation the Mini-BESTest score worsened (p=0.005), and four patients reported one or more falls during the lockdown. BMI increased (p=0.031) while the remaining clinical variables including quality of life did not change. CONCLUSION: We observed moderate worsening at Mini-BESTest, greater risk of falls and increased body weight as consequence of prolonged immobility. We believe negative effects were partially softened since patients were in contact with our multidisciplinary team during the lockdown and had previously received training to respond to the needs of this emergency isolation. These findings highligh the importnace of patient-centered interventions in PD management.

Potential Mucosal Irritation Discrimination of Surface Disinfectants Employed against SARS-CoV-2 by Limacus flavus Slug Mucosal Irritation Assay.

Preventive measures have proven to be the most effective strategy to counteract the spread of the SARS-CoV-2 virus. Among these, disinfection is strongly suggested by international health organizations' official guidelines. As a consequence, the increase of disinfectants handling is going to expose people to the risk of eyes, mouth, nose, and mucous membranes accidental irritation. To assess mucosal irritation, previous studies employed the snail Arion lusitanicus as the mucosal model in Slug Mucosal Irritation (SMI) assay. The obtained results confirmed snails as a suitable experimental model for their anatomical characteristics superimposable to the human mucosae and the different easily observed readouts. Another terrestrial gastropod, Limacus flavus, also known as " Yellow slug ", due to its larger size and greater longevity, has already been proposed as an SMI assay alternative model. In this study, for the first time, in addition to the standard parameters recorded in the SMI test, the production of yellow pigment in response to irritants, unique to the snail L. flavus, was evaluated. Our results showed that this species would be a promising model for mucosal irritation studies. The study conducted testing among all those chemical solutions most commonly recommended against the SARS-CoV-2 virus.

Do Ocular Fluids Represent a Transmission Route of SARS-CoV-2 Infection?

The spread of the new SARS-CoV-2 is marked by a short timeline. In this scenario, explaining or excluding the possible transmission routes is mandatory to contain and manage the spread of the disease in the community. In the recent pandemic, it is still unclear how coronavirus can end up in ocular fluids. Nevertheless, eye redness and irritation in COVID-19 patients have been reported, suggesting that a possible ocular manifestation of SARS-CoV-2 infection may be conjunctivitis. On the basis of epidemiological data provided by previous SARS-Cove infection, numerous theories have been proposed: (1) conjunctiva as the site of direct inoculation by infected droplets; (2) the nasolacrimal duct as a migration route of the virus to the upper respiratory tract, or (3) haematogenic infection of the tear gland. The demand for further investigations to verify ocular involvement in COVID-19 infection came out from the results of recent meta-analysis studies, so the eye cannot be completely excluded as a transmission route of the infection. Thus, healthcare personnel and all the people that enter in contact with infected or suspected patients must always use the prescribed protective equipment.