Neurological manifestations, comorbidities, and outcomes of COVID-19 in parkinson's disease patients

ABSTRACT

Objective: The aim of this study was to report neurologic manifestations, medical comorbidities and discharge outcomes of COVID-19 in ten patients with Parkinson's Disease (PD). Background: There is a rapidly accumulating literature regarding neurologic manifestations of COVID-19, but few studies investigating COVID-19 in PD specifically. Individuals with PD are at risk for neurologic manifestations in the context of COVID-19 and share common characteristics with patients at risk for severe COVID-19, such as age and medical comorbidities. Design/Methods: We reviewed 503 consecutive patients with COVID-19 between February 20, 2020 and July 5, 2020 at Evergreen Hospital, Kirkland, Washington, USA. We identified 10 patients with PD and examined their charts for COVID-related neurologic manifestations, medical comorbidities, and discharge outcomes. Results: The mean age of our PD sample was 71 years old. Three patients had pre-existing dementia. The majority presented with neurologic manifestations. Metabolic encephalopathy was detected in four patients. Three patients had worsening of tremor and two patients reported falls. Six patients presented with cough and four patients presented with fever. The most common comorbid condition was hypertension in three patients. Two patients died of acute respiratory failure. The remaining eight were discharged to their pre-admission living situation, recovered to baseline PD status, and continued with the same dose of PD medications. One of the deceased patients had pre-existing dementia and experienced metabolic encephalopathy. The other patient had hypertension, atrial fibrillation, and organic heart disease. Conclusions: Cough was the most common presenting symptom of COVID-19 in PD patients. The most common comorbid condition was hypertension. Deaths were due to respiratory failure rather than PD related complications. The majority of patients returned to their premorbid PD status after recovering from COVID-19. More research regarding COVID-19 in PD is needed.