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2.
Mov Disord Clin Pract ; 9(6): 846-849, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1866555
3.
Can J Neurol Sci ; : 1-6, 2022 May 26.
Article in English | MEDLINE | ID: covidwho-1864695
4.
Int Rev Neurobiol ; 165: 35-62, 2022.
Article in English | MEDLINE | ID: covidwho-1797348

ABSTRACT

The global explosion of COVID-19 necessitated the rapid dissemination of information regarding SARS-CoV-2. Hence, COVID-19 prevalence and outcome data in Parkinson's disease patients were disseminated at a time when we only had part of the picture. In this chapter we firstly discuss the current literature on the prevalence of COVID-19 in people with PD. We then discuss outcomes from COVID-19 in people with PD, specifically risk of hospitalization and mortality. Finally, we discuss specific contributing and confounding factors which may put PD patients at higher or lower risk from COVID-19.


Subject(s)
COVID-19 , Parkinson Disease , COVID-19/epidemiology , Hospitals , Humans , Parkinson Disease/complications , Parkinson Disease/epidemiology , Parkinson Disease/therapy , Prevalence , SARS-CoV-2
6.
Parkinsonism Relat Disord ; 89: 199-205, 2021 08.
Article in English | MEDLINE | ID: covidwho-1300965

ABSTRACT

The use of telemedicine in the management of chronic neurological conditions including movement disorders has expanded over time. In addition to enabling remote access to specialized care, telemedicine has also been shown to reduce caregiver burden and to improve patient satisfaction. With the COVID-19 pandemic, implementation of telehealth for patients with movement disorders, particularly those with more severe mobility issues, has increased rapidly. Although telemedicine care has been shown to be effective for patients with various movement disorders, its utilization for patients with device aided therapies such as deep brain stimulation (DBS) is limited due to challenges related to adjusting these devices remotely and to the lack of consensus recommendations for using telemedicine in this patient population. Thus, guidelines for telemedicine and DBS will assist clinicians on the appropriate implementation of telemedicine to provide care to DBS patients. Optimizing the use of telemedicine for DBS will expand this type of therapy to remote locations with limited access to programming expertise, and also reduce the need for patient travel. Telemedicine is particularly important during the ongoing pandemic due to infection risk and limited access to clinic visits. In this article we review the currently available and emerging strategies for telemedicine and remote care for DBS. We then outline common principles and recommendations for telemedicine care in patients with DBS, review patient selection and best practices. Finally, we briefly discuss the current state of reimbursement for DBS telemedicine visits.


Subject(s)
Deep Brain Stimulation/trends , Telemedicine/trends , COVID-19 , Deep Brain Stimulation/standards , Humans , Pandemics , Remote Consultation , Telemedicine/standards
8.
J Parkinsons Dis ; 11(2): 431-444, 2021.
Article in English | MEDLINE | ID: covidwho-1045531

ABSTRACT

Studies focusing on the relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), coronavirus disease 2019 (COVID-19), and Parkinson's disease (PD) have provided conflicting results. We review the literature to investigate: 1) Are PD patients at higher risk for contracting COVID-19 and are there specific contributing factors to that risk? 2) How does COVID-19 affect PD symptoms? 3) How does COVID-19 present in PD patients? 4) What are the outcomes in PD patients who contract COVID-19? 5) What is the impact of COVID-19 on PD care? 6) Does COVID-19 increase the risk of developing PD? A literature search was performed from 1979 to 2020 using the terms: 'Parkinson's disease' and 'parkinsonism' combined with: 'COVID-19'; 'SARS-CoV-2' and 'coronavirus'. It does not appear that PD is a specific risk factor for COVID-19. There is evidence for direct/indirect effects of SARS-CoV-2 on motor/non-motor symptoms of PD. Although many PD patients present with typical COVID-19 symptoms, some present atypically with isolated worsening of parkinsonian symptoms, requiring increased anti-PD therapy and having worse outcomes. Mortality data on PD patients with COVID-19 is inconclusive (ranging from 5.2%to 100%). Patients with advanced PD appear to be particularly vulnerable. Single cases of acute hypokinetic-rigid syndrome have been described but no other convincing data has been reported. The rapidity with which COVID-19 has swept across the globe has favored the proliferation of studies which lack scientific rigor and the PD literature has not been immune. A coordinated effort is required to assimilate data and answer these questions in larger PD cohorts.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , Parkinson Disease/diagnosis , Parkinson Disease/epidemiology , Antiparkinson Agents/therapeutic use , COVID-19/drug therapy , Humans , Mortality/trends , Pandemics/prevention & control , Parkinson Disease/drug therapy , Risk Factors
10.
Parkinsonism Relat Disord ; 78: 134-137, 2020 09.
Article in English | MEDLINE | ID: covidwho-712120

ABSTRACT

INTRODUCTION: Specific pre-existing medical conditions (e.g. hypertension or obesity), advanced age and male sex appear linked to more severe manifestations of SARS Co-V2 infection, thus raising the question of whether Parkinson's disease (PD) poses an increased risk of morbidity and mortality in COVID-19 patients. METHODS: In order to describe the outcome of COVID-19 in multi-centre a cohort of PD patients and explore its potential predictors, we gathered the clinical information of 117 community-dwelling patients with COVID-19 followed in 21 tertiary centres in Italy, Iran, Spain, and the UK. RESULTS: Overall mortality was 19.7%, with a significant effect of co-occurrence of dementia, hypertension, and PD duration. CONCLUSIONS: The frailty caused by advanced PD poses an increased risk of mortality during COVID-19.


Subject(s)
COVID-19/mortality , Dementia/epidemiology , Hospitalization/statistics & numerical data , Hypertension/epidemiology , Parkinson Disease/epidemiology , Aged , Aged, 80 and over , Antiparkinson Agents/therapeutic use , COVID-19/epidemiology , Comorbidity , Deep Brain Stimulation , Female , Humans , Iran/epidemiology , Italy/epidemiology , Male , Middle Aged , Parkinson Disease/therapy , Risk Factors , Severity of Illness Index , Spain/epidemiology , Time Factors , United Kingdom/epidemiology
11.
Mov Disord ; 35(7): 1089-1093, 2020 07.
Article in English | MEDLINE | ID: covidwho-459275

ABSTRACT

BACKGROUND: It is unknown whether patients with PD are at greater risk of COVID-19, what their risk factors are, and whether their clinical manifestations differ from the general population. OBJECTIVES: The study aimed to address all these issues. METHODS: In a case-controlled survey, we interviewed 1,486 PD patients attending a single tertiary center in Lombardy, Italy and 1,207 family members (controls). RESULTS: One hundred five (7.1%) and 92 controls (7.6%) were identified as COVID-19 cases. COVID-19 patients were younger, more likely to suffer from chronic obstructive pulmonary disease, to be obese, and vitamin D nonsupplemented than unaffected patients. Six patients (5.7%) and 7 family members (7.6%) died from COVID-19. Patients were less likely to report shortness of breath and require hospitalization. CONCLUSIONS: In an unselected large cohort of nonadvanced PD patients, COVID-19 risk and mortality did not differ from the general population, but symptoms appeared to be milder. The possible protective role of vitamin D supplementation warrants future studies. © 2020 International Parkinson and Movement Disorder Society.


Subject(s)
Coronavirus Infections/epidemiology , Obesity/epidemiology , Parkinson Disease/epidemiology , Pneumonia, Viral/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Vitamin D/therapeutic use , Vitamins/therapeutic use , Age Factors , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , Case-Control Studies , Comorbidity , Coronavirus Infections/mortality , Coronavirus Infections/physiopathology , Dyspnea/epidemiology , Dyspnea/physiopathology , Female , Hospitalization/statistics & numerical data , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics , Pneumonia, Viral/mortality , Pneumonia, Viral/physiopathology , Protective Factors , Risk Factors , SARS-CoV-2 , Tertiary Care Centers
12.
Mov Disord Clin Pract ; 7(4): 361-372, 2020 May.
Article in English | MEDLINE | ID: covidwho-259913

ABSTRACT

BACKGROUND: Although the COVID-19 pandemic is affecting a relatively small proportion of the global population, its effects have already reached everyone. The pandemic has the potential to differentially disadvantage chronically ill patients, including those with Parkinson's disease (PD). The first health care reaction has been to limit access to clinics and neurology wards to preserve fragile patients with PD from being infected. In some regions, the shortage of medical staff has also forced movement disorders neurologists to provide care for patients with COVID-19. OBJECTIVE: To share the experience of various movement disorder neurologists operating in different world regions and provide a common approach to patients with PD, with a focus on those already on advanced therapies, which may serve as guidance in the current pandemic and for emergency situations that we may face in the future. CONCLUSION: Most of us were unprepared to deal with this condition given that in many health care systems, telemedicine has been only marginally available or only limited to email or telephone contacts. In addition, to ensure sufficient access to intensive care unit beds, most elective procedures (including deep brain stimulation or the initiation of infusion therapies) have been postponed. We all hope there will soon be a time when we will return to more regular hospital schedules. However, we should consider this crisis as an opportunity to change our approach and encourage our hospitals and health care systems to facilitate the remote management of chronic neurological patients, including those with advanced PD.

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