Subject(s)
COVID-19 , Emergency Medical Services , Stroke , Humans , Pandemics , Stroke/epidemiology , Stroke/therapy , COVID-19/epidemiology , Emergency Service, HospitalABSTRACT
A few cases of parkinsonism linked to COVID-19 infection have been reported so far, raising the possibility of a post-viral parkinsonian syndrome. The objective of this review is to summarize the clinical, biological, and neuroimaging features of published cases describing COVID-19-related parkinsonism and to discuss the possible pathophysiological mechanisms. A comprehensive literature search was performed using NCBI's PubMed database and standardized search terms. Thirteen cases of COVID-19-related parkinsonism were included (7 males; mean age: 51 years ± 14.51, range 31-73). Patients were classified based on the possible mechanisms of post-COVID-19 parkinsonism: extensive inflammation or hypoxic brain injury within the context of encephalopathy (n = 5); unmasking of underlying still non-symptomatic Parkinson's Disease (PD) (n = 5), and structural and functional basal ganglia damage (n = 3). The various clinical scenarios show different outcomes and responses to dopaminergic treatment. Different mechanisms may play a role, including vascular damage, neuroinflammation, SARS-CoV-2 neuroinvasive potential, and the impact of SARS-CoV-2 on α-synuclein. Our results confirm that the appearance of parkinsonism during or immediately after COVID-19 infection represents a very rare event. Future long-term observational studies are needed to evaluate the possible role of SARS-CoV-2 infection as a trigger for the development of PD in the long term.
Subject(s)
COVID-19 , Parkinson Disease , Parkinsonian Disorders , COVID-19/complications , Humans , Male , Middle Aged , Parkinson Disease/complications , SARS-CoV-2Subject(s)
COVID-19 , Parkinson Disease , Brain/pathology , Humans , Nerve Degeneration/pathology , Parkinson Disease/pathology , SARS-CoV-2ABSTRACT
â¢COVID-19 infection could led to a pro-inflammatory and pro-thrombotic state.â¢Cerebrovascular involvement may occur in COVID-19 infection even in young patients.â¢Physicians should be aware that stroke may be the first COVID-19 manifestation.