Evaluating Outcomes in Parkinson ' s Disease Patients Following COVID-19 Interventions

ABSTRACT

Objective: COVID-19 pandemic public health interventions upended many aspects of daily life. However, the effects on outcomes in Parkinson's Disease (PD) patients remained unclear. This study was conducted to determine the impact those interventions had on the mood, movement, and quality of life (QOL) of PD patients. Background: Several studies have demonstrated an association between certain lifestyle behaviors, including exercise and social interaction, and positive PD outcomes. This study investigated specific PD patient outcome changes following both the disruption of many of those behaviors and the introduction of tele-medicine as the mainstay of outpatient visits. Design/Methods: Comprehensive clinical assessments were conducted for 150 PD patients both before and after the onset of COVID-19 public health interventions. Through a retrospective chart review, quantitative disease markers and qualitative lifestyle changes were recorded and analyzed to determine changes in disease outcomes and QOL measures between the two subsequent visits. These changes were also differentiated by visit type in-person versus video versus telephone call. Results: The paired analysis showed an increase in Hoehn and Yahr scale in the post-COVID patient visit in comparison to the pre-COVID visit from 1.86 to 2.02 (n = 122, p = 0.006.) Several non-movement PD symptoms worsened in the subsequent visits, including activities of daily living status, exercise frequency, and sleep disturbance frequency. Overall movement symptoms did not worsen, including bradykinesia, rigidity, resting tremor, gait abnormality, and falls, and patients did not have greater Levodopa needs. Outcome changes differentiated by visit type is pending. Conclusions: The implementation of COVID-19 public health interventions was associated with worsening sleep habits and exercise frequency, as well as greater dependency in daily living among patients with PD. While QOL measures and non-movement PD symptoms worsened, no association was demonstrated between the pandemic interventions and worsening movement symptoms or greater levodopa needs.