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1.
J Parkinsons Dis ; 12(s1): S45-S51, 2022.
Article in English | MEDLINE | ID: covidwho-2141612

ABSTRACT

The cause of Parkinson's disease (PD) is unknown, but environmental factors are purported to influence risk. Interest in PD as a sequel of infection dates back to reports of parkinsonism arising from encephalitis lethargica. The objective of this paper is to review the literature as it relates to infections and changes in microbiome and the genesis of PD. There is evidence to support prior infection with Helicobacter pylori, hepatitis C virus, Malassezia, and Strep pneumonia in association with PD. A large number of studies support an association between changes in commensal bacteria, especially gut bacteria, and PD. Extant literature supports a role for some infections and changes in commensal bacteria in the genesis of PD. Studies support an inflammatory mechanism for this association, but additional research is required for translation of these findings to therapeutic options.


Subject(s)
Gastrointestinal Microbiome , Helicobacter pylori , Microbiota , Parkinson Disease , Humans , Parkinson Disease/microbiology
2.
PLoS One ; 17(11): e0277645, 2022.
Article in English | MEDLINE | ID: covidwho-2140657

ABSTRACT

BACKGROUND: Dance provides a range of beneficial effects for older adults including individuals with age-related neurological conditions such as Parkinson's disease (PD). The COVID-19 pandemic accelerated the development of at-home dance programs delivered digitally through live and pre-recorded media, but little is known about how participants may engage with and benefit from these resources. OBJECTIVE: This study explored experiences and potential benefits of digital dance participation among healthy older adults and people with PD. METHODS: An online survey consisting of fixed-choice and open questions was designed in collaboration with dance program providers and distributed between June and November 2020. RESULTS: Healthy older adults (N = 149) and people with PD (N = 178) participating in at-home dance programs reported frequent engagement and a range of benefits. People with PD reported greater levels of motor (e.g., ease of movement, balance) than non-motor (e.g., energy, confidence) outcomes, while healthy older adults reported similar numbers of motor and non-motor outcomes. Positive outcomes were associated with the use of movement imagery during dance in both groups, while singing was associated with benefits in people with PD and vocalising was associated with benefits in older adults. At-home dance resources were found to offer convenience and flexibility, but participants missed the interaction, support, and routine provided by in-person classes. The majority expressed a preference to continue with both digital and in-person participation in the future. Qualitative analysis of participants' comments further revealed that digital participation could help to maintain connection and well-being, as well as identifying further considerations for improving accessibility and facilitating digital engagement. CONCLUSIONS: At-home dance appears to be accessible, engaging, and potentially beneficial for older adults and people with PD, although barriers to participation should be addressed. Digital resources will be increasingly important to enable cost-effective, large-scale provision of home-based therapeutic activities.


Subject(s)
COVID-19 , Dance Therapy , Parkinson Disease , Humans , Aged , Parkinson Disease/therapy , Pandemics , Surveys and Questionnaires
3.
Medicine (Baltimore) ; 101(46): e31813, 2022 Nov 18.
Article in English | MEDLINE | ID: covidwho-2135744

ABSTRACT

The hypothesis is that there is 0a relationship between Parkinson's disease and coronavirus disease 2019 (COVID-19). By summarizing the pathogenesis of Parkinson's disease and COVID-19 and the impact of COVID-19 on the central nervous system, the relationship between Parkinson's disease and COVID-19 was analyzed, including whether Parkinson's disease is a predisposition factor for COVID-19 and whether COVID-19 causes the occurrence of Parkinson's disease. Discuss the impact of COVID-19 on patients with Parkinson's disease, including symptoms and life impact. To summarize the principles, goals and methods of home rehabilitation for Parkinson's disease patients during COVID-19. Through the analysis of this paper, it is believed that COVID-19 may cause Parkinson's disease. Parkinson's disease has the condition of susceptibility to COVID-19, but this conclusion is still controversial.


Subject(s)
COVID-19 , Parkinson Disease , Pneumonia , Humans , Parkinson Disease/complications , Parkinson Disease/pathology , COVID-19/complications , SARS-CoV-2 , Central Nervous System/pathology
4.
J Phys Chem Lett ; 13(45): 10642-10648, 2022 Nov 17.
Article in English | MEDLINE | ID: covidwho-2122924

ABSTRACT

The neurological symptoms of long COVID and viral neuroinvasion have raised concerns about the potential interactions between SARS-CoV-2 protein segments and neuronal proteins, which might confer a risk of post-infection neurodegeneration, but the underlying mechanisms remain unclear. Here, we reported that the receptor-binding domain (RBD) of the spike protein and the nine-residue segment (SK9) of the envelope protein could bind to α-synuclein (αSyn) with Kd values of 503 ± 24 nM and 12.7 ± 1.6 µM, respectively. RBD could inhibit αSyn fibrillization by blocking the non-amyloid-ß component region and mediating its antiparallel ß-sheet structural conversions. Omicron-RBD (BA.5) was shown to have a slightly stronger affinity for αSyn (Kd = 235 ± 10 nM), which implies similar effects, whereas SK9 may bind to the C-terminus which accelerates the formation of parallel ß-sheet-containing oligomers and abruptly increases the rate of membrane disruption by 213%. Our results provide plausible molecular insights into the impact of SARS-CoV-2 post-infection and the oligomerization propensity of αSyn that is associated with Parkinson's disease.


Subject(s)
COVID-19 , Coronavirus Envelope Proteins , Parkinson Disease , Spike Glycoprotein, Coronavirus , alpha-Synuclein , Humans , alpha-Synuclein/metabolism , Parkinson Disease/metabolism , Protein Binding , SARS-CoV-2 , Spike Glycoprotein, Coronavirus/metabolism , Coronavirus Envelope Proteins/metabolism
5.
Int J Environ Res Public Health ; 19(22)2022 Nov 11.
Article in English | MEDLINE | ID: covidwho-2110092

ABSTRACT

Mild cognitive impairment is frequent among people with Parkinson's disease. Cognitive training seems effective for cognitive status and for mitigating anxiety and depression. With the COVID-19 outbreak, such therapeutic interventions were delivered online. This longitudinal mixed-method study was aimed at evaluating the effectiveness of an online cognitive treatment, carried out during COVID times and based on Parkinson's-Adapted Cognitive Stimulation Therapy, on cognitive domains and mood of 18 older people with Parkinson's disease. After screening, the cognitive status and mood were assessed three times by Addenbrooke's Cognitive Examination-Revised scale and the Geriatric Depression Scale-Short Form. At the follow-up, patients were also interviewed for understanding their experience with the technology. Such treatment was effective on the participants' cognitive functions, but not on their mood. Despite some initial problems with the technology, the online intervention was experienced as a way of not being 'left behind', staying in contact with others, and being safe during the lockdown. This suggests that online cognitive treatment can be adopted to integrate face-to-face interventions by increasing their efficacy, accessibility, and long-term outcomes. Suggestions for future research are given.


Subject(s)
COVID-19 , Parkinson Disease , Humans , Aged , Pilot Projects , Parkinson Disease/complications , Parkinson Disease/therapy , COVID-19/therapy , Communicable Disease Control , Cognition
6.
Parkinsonism Relat Disord ; 93: 97-102, 2021 12.
Article in English | MEDLINE | ID: covidwho-2119837

ABSTRACT

Inequalities in mental healthcare and lack of social support during the COVID-19 pandemic have lowered quality of life and increased overall burden of disease in people with Parkinson's (PWP). Although the pandemic has brought attention to these inequalities, they are long standing and will persist unless addressed. Lack of awareness of mental health issues is a major barrier and even when recognized disparities based on race, gender, and socioeconomic factors limit access to already scarce resources. Stigma regarding mental illness is highly prevalent and is a major barrier even when adequate care exists. Limited access to mental healthcare during the pandemic and in general increases the burden on caregivers and families. Historically, initiatives to improve mental healthcare for PWP focused on interventions designed for specialty and academic centers generally located in large metropolitan areas, which has created unintended geographic disparities in access. In order to address these issues this point of view suggests a community-based wellness model to extend the reach of mental healthcare resources for PWP.


Subject(s)
Healthcare Disparities/trends , Mental Disorders/therapy , Mental Health/trends , Parkinson Disease/therapy , Social Support/trends , Health Resources/trends , Humans , Mental Disorders/epidemiology , Mental Disorders/psychology , Parkinson Disease/epidemiology , Parkinson Disease/psychology , Social Support/psychology
7.
medrxiv; 2022.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2022.12.07.22283213

ABSTRACT

Background and Objectives Teleneurology is common in clinical practice partly due to the SARS CoV-2 pandemic. Impressions about teleneurology from patients and providers alike are generally favorable; some of the reported benefits include ease of access to specialized healthcare, savings of time and money, and similar quality of care as an in-person visit. However, comparisons between patient and provider impressions about the same teleneurology encounter have not been described. Here we describe patient impressions about a teleneurology encounter and evaluate concordance with provider impressions about the same encounter. Methods Patients and providers at the University of Pennsylvania Hospital Neurology Department were surveyed about their impressions of teleneurology between April 27 th and June 16 th , 2020. A convenience sample of patients, whose providers completed a questionnaire, were contacted by telephone to solicit their impressions the same encounter. Unique questionnaires for patients and providers focused on similar themes, such as adequacy of technology, assessment of history obtained, and overall quality of the visit. Summaries of patient responses are reported with the raw percent agreement between patients and providers for similar questions. Results One hundred thirty-seven patients completed the survey; 64 (47%) were male and 73 were (53%) female. Sixty-six (47%) patients had a primary diagnosis of PD, 42 (30%) a non-PD movement disorder, and 29 (21%) a non-movement disorder neurological disease. One hundred one (76%) were established patient visits and 36 (26%) were new patient visits. Provider responses from 8 different physicians were included. The majority of patients responded that the ease of joining their visit, their comfort engaging with their physicians during their visit, understanding their plan of care after their visit, and the quality of care from their teleneurology visit were satisfactory. Patients and providers agreed about their impressions of the quality of the history obtained (87% agreement), patient-provider relationship (88% agreement), and overall quality of their experience (70% agreement). Discussion Patients had favorable impressions about their clinical experience with teleneurology and expressed an interest in incorporating telemedicine visits into their ongoing care. Patients and providers were highly concordant for the history obtained, patient-provider relationship, and overall quality.


Subject(s)
Parkinson Disease , Movement Disorders
8.
medrxiv; 2022.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2022.11.24.22282716

ABSTRACT

Introduction: Health systems in fragile settings face multiple challenges in the implementation of responsive Non-Communicable Disease (NCD) care models. Models based on comprehensive person-centred primary care approaches can improve health system responsiveness and trust in healthcare. In Lebanon, NCDs dominate the health profile, but the health system is fragmented with evidence suggesting varied experiences with the care model. This study aims to identify people's perceptions of the Lebanese care model for NCDs and trust in the health system among others, and test association between them. Methods: This study is a household survey using multistage random sampling and targeting adult community members (both Syrian and Lebanese) living with NCDs in Greater Beirut. Three main outcomes (barriers to care seeking, perceptions of the care model and trust in healthcare) were assessed including by multiple linear regressions. Results: A total of 941 respondents participated in this study. Reported NCDs were hypertension (51.3%) and diabetes (34.5%), followed by chronic respiratory conditions (21.9%) and other cardiovascular diseases (20.0%). Communities reported seeking care from different sources. While 78% of Lebanese participants had visited private clinics at least once within the 6 months preceding the survey, 56% of Syrian refugees had done so. Determinants of access to care were health coverage, gender, and employment among Lebanese, and socio-economic status among Syrian refugees. Lebanese community members had more positive perceptions of the care model compared to Syrian refugees and determinants included socio-demographic characteristics and the type of providers. Trust in the health system was higher among Syrian compared to Lebanese participants and was significantly influenced by the care model score and barriers to care seeking. Conclusion: Our study generated evidence about the experience of people living with NCDs with Lebanon's care model, and can inform service delivery reforms towards a more inclusive person-centred approach.


Subject(s)
Parkinson Disease , Diabetes Mellitus , Cardiovascular Diseases , Communicable Diseases , Hypertension
9.
Front Public Health ; 10: 1009226, 2022.
Article in English | MEDLINE | ID: covidwho-2099275

ABSTRACT

Background: Integrating mental health services into primary care is a potentially cost-effective way to decrease the treatment gap for anxiety in older adults but data on the epidemiology of anxiety symptoms in older Chinese adults in primary care settings have been very limited. This study investigated the prevalence and correlates of anxiety symptoms in Chinese older primary care patients. Methods: A total of 753 older primary care patients (≥65 years) were consecutively recruited from 13 primary care clinics in Wuhan, China, and interviewed with the validated Chinese version of the short form of the Geriatric Anxiety Inventory (GAI-SF). Results: The prevalence of anxiety symptoms (GAI-SF ≥ 3) in older primary care patients was 21.1%. Statistically significant correlates of anxiety symptoms were female sex (vs. male, OR = 1.85, P = 0.002), poor economic status (vs. good, OR = 2.31, P = 0.013), fair and poor family relationship (vs. good, OR = 1.85, P = 0.006), hypertension (OR = 2.01, P < 0.001), chronic gastric ulcer (OR = 6.82, P < 0.001), and Parkinson's disease (OR = 7.83, P = 0.031). Conclusions: Anxiety symptoms are prevalent among older adults attending primary care clinics. Efforts for preventing or reducing anxiety symptoms in older primary care patients may be more useful to target those who are women, have poor financial status, don't have a good family relationship, suffer from hypertension, have chronic gastric ulcer, and suffer from Parkinson's disease.


Subject(s)
Hypertension , Parkinson Disease , Stomach Ulcer , Humans , Female , Male , Middle Aged , Aged , Prevalence , Anxiety/epidemiology , Anxiety/psychology , China/epidemiology , Primary Health Care
10.
WMJ ; 121(3): E46-E49, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2092955

ABSTRACT

INTRODUCTION: Atypical Parkinson's syndromes are a rare set of neurodegenerative conditions in which a patient experiences the typical symptoms of Parkinson's disease, in addition to various other unrelated issues. CASE PRESENTATION: We present the case of a 71-year-old White man with a 1-year history of weakness and upper extremity tremors that, per patient report, rapidly worsened after receiving the second dose of the Moderna COVID-19 vaccine. His symptoms were consistent with an asymmetric atypical Parkinson's disease, with electromyogram results indicating chronic motor neuron involvement. DISCUSSION: There have been multiple reports of deterioration in patients with Parkinson's disease and atypical Parkinson's syndromes in response to contracting COVID-19. However, there are few, if any, case reports that describe an acute change in Parkinson-related symptoms in association with the COVID-19 vaccines. CONCLUSIONS: As the pandemic continues, we must continue to remain vigilant as we learn more about the long-lasting effects of the virus and vaccines.


Subject(s)
COVID-19 Vaccines , COVID-19 , Parkinson Disease , Aged , Humans , Male , 2019-nCoV Vaccine mRNA-1273 , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Parkinson Disease/complications , Parkinson Disease/diagnosis , Parkinson Disease/genetics , Syndrome
11.
Front Public Health ; 10: 977940, 2022.
Article in English | MEDLINE | ID: covidwho-2089936

ABSTRACT

Background: As coronavirus disease 2019 (COVID-19) vaccination campaign underway, little is known about the vaccination coverage and the underlying barriers of the vaccination campaign in patients with Parkinson's disease (PD). Objective: To investigate the vaccination status and reasons for COVID-19 vaccine acceptance and hesitancy among PD patients. Methods: In concordance with the CHERRIES guideline, a web-based, single-center survey was promoted to patients with PD via an online platform from April 2022 and May 2022. Logistic regression models were used to identify factors related to COVID-19 vaccine hesitancy. Results: A total of 187 PD cases participated in this online survey (response rate of 23%). COVID-19 vaccination rate was 54.0%. Most participants had a fear of COVID-19 (77.5%) and trusted the efficacy (82.9%) and safety (66.8%) of COVID-19 vaccine. Trust in government (70.3%) and concerns about the impact of vaccine on their disease (67.4%) were the most common reasons for COVID-19 vaccine acceptance and hesitancy, respectively. COVID-19 vaccine hesitancy was independently associated with the history of flu vaccination (OR: 0.09, p < 0.05), trust in vaccine efficacy (OR: 0.15, p < 0.01), male gender (OR: 0.47, p < 0.05), disease duration of PD (OR: 1.08, p < 0.05), and geographic factor (living in Shanghai or not) (OR: 2.87, p < 0.01). Conclusions: The COVID-19 vaccination rate remained low in PD patients, however, most individuals understood benefits of vaccination. COVID-19 vaccine hesitancy was affected by multiple factors such as geographic factor, history of flu vaccination, disease duration and trust in efficacy of vaccine. These findings could help government and public health authorities to overcome the barrier to COVID-19 vaccination and improve vaccine roll-out in PD patients.


Subject(s)
COVID-19 , Influenza Vaccines , Parkinson Disease , Humans , Male , COVID-19 Vaccines , Patient Acceptance of Health Care , COVID-19/prevention & control , Health Knowledge, Attitudes, Practice , China
12.
arxiv; 2022.
Preprint in English | PREPRINT-ARXIV | ID: ppzbmed-2211.08208v1

ABSTRACT

In this work, we discuss the SIR epidemiological model and different variations of it applied to the propagation of the COVID-19 pandemia; we employ the data of the state of Guanajuato and of Mexico. We present some considerations that can improve the predictions made by those models. We consider a time-dependent infection rate, which we adjust to the data. Starting from a linear regime where the populations are much smaller that the country or state population and the population of susceptible (S) can be approximated in convenient units to S approximately 1, we make fits of the parameters. We also consider the case when the susceptible starts departing from 1, for this case we adjust an effective contagion rate. We also explore the ratio of detected populations and the real ones, obtaining that -for the analyzed case it is of approximately 10%. We estimate the number of deaths by making a fit versus the recovered cases, this fit is in first approximation linear, but other powers can give a good agreement. By predictions to past data, we conclude that adaptations of the SIR model can be of great use in describing pandemia's propagation, specially in limited time periods.


Subject(s)
Parkinson Disease , COVID-19
13.
medrxiv; 2022.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2022.11.07.22282049

ABSTRACT

Altered myeloid inflammation and lymphopenia are hallmarks of severe infections, including with SARS-CoV-2. Here, we identified a gene program, defined by correlation with EN-RAGE (S100A12) gene expression, which was up-regulated in airway and blood myeloid cells from COVID-19 patients. The EN-RAGE program was expressed in 7 cohorts and observed in patients with both COVID-19 and acute respiratory distress syndrome (ARDS) from other causes. This program was associated with greater clinical severity and predicted future mechanical ventilation and death. EN-RAGE+ myeloid cells express features consistent with suppressor cell functionality, with low HLA-DR and high PD-L1 surface expression and higher expression of T cell-suppressive genes. Sustained EN-RAGE signature expression in airway and blood myeloid cells correlated with clinical severity and increasing expression of T cell exhaustion markers, such as PD-1. IL-6 treatment of monocytes in vitro upregulated many of the severity-associated genes in the EN-RAGE gene program, along with potential mediators of T cell suppression, such as IL-10. Blockade of IL-6 signaling by tocilizumab in a placebo-controlled clinical trial led to a rapid normalization of ENRAGE and T cell gene expression. This identifies IL-6 as a key driver of myeloid dysregulation associated with worse clinical outcomes in COVID-19 patients and provides insights into shared pathophysiological mechanisms in non-COVID-19 ARDS.


Subject(s)
Parkinson Disease , Respiratory Distress Syndrome , Death , Chronobiology Disorders , Lymphopenia , COVID-19 , Inflammation
14.
WMJ ; 121(3): E46-E49, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2084108

ABSTRACT

INTRODUCTION: Atypical Parkinson's syndromes are a rare set of neurodegenerative conditions in which a patient experiences the typical symptoms of Parkinson's disease, in addition to various other unrelated issues. CASE PRESENTATION: We present the case of a 71-year-old White man with a 1-year history of weakness and upper extremity tremors that, per patient report, rapidly worsened after receiving the second dose of the Moderna COVID-19 vaccine. His symptoms were consistent with an asymmetric atypical Parkinson's disease, with electromyogram results indicating chronic motor neuron involvement. DISCUSSION: There have been multiple reports of deterioration in patients with Parkinson's disease and atypical Parkinson's syndromes in response to contracting COVID-19. However, there are few, if any, case reports that describe an acute change in Parkinson-related symptoms in association with the COVID-19 vaccines. CONCLUSIONS: As the pandemic continues, we must continue to remain vigilant as we learn more about the long-lasting effects of the virus and vaccines.


Subject(s)
COVID-19 Vaccines , COVID-19 , Parkinson Disease , Aged , Humans , Male , 2019-nCoV Vaccine mRNA-1273 , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Parkinson Disease/complications , Parkinson Disease/diagnosis , Parkinson Disease/genetics , Syndrome
15.
Arq Neuropsiquiatr ; 80(5 Suppl 1): 105-115, 2022 05.
Article in English | MEDLINE | ID: covidwho-2065215

ABSTRACT

For more than 30 years, Deep Brain Stimulation (DBS) has been a therapeutic option for Parkinson's disease (PD) treatment. However, this therapy is still underutilized mainly due to misinformation regarding risks and clinical outcomes. DBS can ameliorate several motor and non-motor symptoms, improving patients' quality of life. Furthermore, most of the improvement after DBS is long-lasting and present even in advanced PD. Adequate patient selection, precise electric leads placement, and correct DBS programming are paramount for good surgical outcomes. Nonetheless, DBS still has many limitations: axial symptoms and signs, such as speech, balance and gait, do not improve to the same extent as appendicular symptoms and can even be worsened as a direct or indirect consequence of surgery and stimulation. In addition, there are still unanswered questions regarding patient's selection, surgical planning and programming techniques, such as the role of surgicogenomics, more precise imaging-based lead placement, new brain targets, advanced programming strategies and hardware features. The net effect of these innovations should not only be to refine the beneficial effect we currently observe on selected symptoms and signs but also to improve treatment resistant facets of PD, such as axial and non-motor features. In this review, we discuss the current state of the art regarding DBS selection, implant, and programming, and explore new advances in the DBS field.


Subject(s)
Deep Brain Stimulation , Parkinson Disease , Deep Brain Stimulation/methods , Humans , Parkinson Disease/drug therapy , Quality of Life , Treatment Outcome
16.
preprints.org; 2022.
Preprint in English | PREPRINT-PREPRINTS.ORG | ID: ppzbmed-10.20944.preprints202210.0409.v1

ABSTRACT

The COVID-19 pandemic creates anxiety among hospitalised SARS-CoV-2 patients. Therefore, this study aims to determine the prevalence of anxiety and its associated factors among stable inpatient COVID-19 patients in Malaysia. A cross-sectional study was conducted using a web-based online survey involving 401 patients from Malaysia's leading COVID-19 hospitals from 15th April until 30th June 2020 who were chosen using quota sampling. General Anxiety Disorders 7 items (GAD-7), Coping Orientation to Problems Experienced Inventory (Brief-COPE) and Socio-demographic profile questionnaire were used. Descriptive analysis and multiple logistic regression were performed using SPSS v23 to determine the prevalence of anxiety and its associated factors. The results showed that prevalence of anxiety was 7.0%. Multiple logistic regression analysis revealed that female (p < 0.05), fear of infection (p < 0.05), lack of information (p < 0.05), maladaptive coping mechanism of behavioural disengagement (p < 0.001) and self-blame (p < 0.001) were significantly associated with anxiety. Whereas adaptive coping mechanisms via instrumental support (p < 0.001) was a significant protective predictor of anxiety. COVID-19 infection has had a significant influence on the mental health of patients. Findings in our study provides baseline findings on prevalence of anxiety among stabilized COVID-19 inpatient in Malaysia. Despite the relative low prevalence, the data has the potential to improve the present mental health monitoring system and the deployment of suitable treatments in dealing with similar circumstances


Subject(s)
Anxiety Disorders , Parkinson Disease , COVID-19
17.
Int Rev Neurobiol ; 165: 17-34, 2022.
Article in English | MEDLINE | ID: covidwho-2060263

ABSTRACT

Coronavirus disease 2019 (Covid-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection is primarily regarded as a respiratory disease; however, multisystemic involvement accompanied by a variety of clinical manifestations, including neurological symptoms, are commonly observed. There is, however, little evidence supporting SARS-CoV-2 infection of central nervous system cells, and neurological symptoms for the most part appear to be due to damage mediated by hypoxic/ischemic and/or inflammatory insults. In this chapter, we report evidence on candidate neuropathological mechanisms underlying neurological manifestations in Covid-19, suggesting that while there is mostly evidence against SARS-CoV-2 entry into brain parenchymal cells as a mechanism that may trigger Parkinson's disease and parkinsonism, that there are multiple means by which the virus may cause neurological symptoms.


Subject(s)
COVID-19 , Central Nervous System Depressants , Nervous System Diseases , Parkinson Disease , Central Nervous System , Humans , SARS-CoV-2
18.
Int Rev Neurobiol ; 165: 173-196, 2022.
Article in English | MEDLINE | ID: covidwho-2060262

ABSTRACT

The Coronavirus Disease 2019 (Covid-19) pandemic has created many challenges for the Parkinson's Disease (PD) care service delivery, which has been established over the past decades. The need for rapid adjustments to the new conditions has highlighted the role of technology, which can act as an enabler both in patient-facing aspects of care, such as clinical consultations, as well as in professional development and training. The Parkinson's Disease Nurse Specialists (PNSs) play a vital role in the effective management of people with PD (PwP). Maintaining optimum functionality and availability of device aided therapies is essential in order to ensure patients' quality of life. PwP are particularly recommended to use vaccination as a basic protection from the virus. The long-term consequences of this pandemic on PwP are highly uncertain, and education, support and reassurance of patients and their families may help ease their burden.


Subject(s)
COVID-19 , Parkinson Disease , COVID-19/prevention & control , Humans , Parkinson Disease/drug therapy , Quality of Life , Vaccination
19.
Int Rev Neurobiol ; 165: 63-89, 2022.
Article in English | MEDLINE | ID: covidwho-2060261

ABSTRACT

The Coronavirus Disease 2019 (Covid-19), caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), has led to unprecedented challenges for the delivery of healthcare and has had a clear impact on people with chronic neurological conditions such as Parkinson's disease (PD). Acute worsening of motor and non-motor symptoms and long-term sequalae have been described during and after SARS-CoV-2 infections in people with Parkinson's (PwP), which are likely to be multifactorial in their origin. On the one hand, it is likely that worsening of symptoms has been related to the viral infection itself, whereas social restrictions imposed over the course of the Covid-19 pandemic might also have had such an effect. Twenty cases of post-Covid-19 para-infectious or post-infectious parkinsonism have been described so far where a variety of pathophysiological mechanisms seem to be involved; however, a Covid-19-induced wave of post-viral parkinsonism seems rather unlikely at the moment. Here, we describe the interaction between SARS-CoV-2 and PD in the short- and long-term and summarize the clinical features of post-Covid-19 cases of parkinsonism observed so far.


Subject(s)
COVID-19 , Parkinson Disease , Parkinsonian Disorders , COVID-19/complications , Humans , Pandemics , Parkinson Disease/complications , SARS-CoV-2
20.
J Neural Transm (Vienna) ; 129(11): 1377-1385, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2059861

ABSTRACT

The prevalence of Parkinson's disease (PD) is rising, rendering it one of the most common neurodegenerative diseases. Treatment and monitoring of patients require regular specialized in- and outpatient care. Patients with PD are more likely to have a complicated disease course if they become infected with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Regular in-hospital appointments place these patients at risk of exposure to SARS-CoV-2 due to travel and contact with other patients and staff. However, guidelines for the management of outpatients with PD during times of increased risk of infection are currently lacking. These are urgently needed to conduct risk-benefit evaluations to recommend the best medical treatment. This article discusses best practice approaches based on the current literature, as suggested by the multidisciplinary Network of University Medicine (NUM) in Germany. These include measures such as mask-wearing, hand hygiene, social distancing measures, and appropriate testing strategies in outpatient settings, which can minimize the risk of exposure. Furthermore, the urgency of appointments should be considered. Visits of low urgency may be conducted by general practitioners or via telemedicine consultations, whereas in-person presentation is required in case of moderate and high urgency visits. Classification of urgency should be carried out by skilled medical staff, and telemedicine (telephone or video consultations) may be a useful tool in this situation. The currently approved vaccines against SARS-CoV-2 are safe and effective for patients with PD and play a key role in minimizing infection risk for patients with PD.


Subject(s)
COVID-19 , Parkinson Disease , COVID-19 Vaccines , Humans , Outpatients , Pandemics/prevention & control , Parkinson Disease/therapy , SARS-CoV-2
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