Dementia, Hypertension Linked to COVID-19 Mortality in Parkinson Disease

Among patients with Parkinson disease (PD), co-occurrence of dementia and hypertension, as well as duration of PD, were significantly associated with mortality due to coronavirus disease 2019 (COVID-19), according to study findings published in Parkinsonism and Related Disorders.

In a previous interview on the implications of COVID-19 in the PD community, it was found that similar to any other infection, COVID-19 can cause worsening of motor and non-motor symptoms. Moreover, adverse mental effects of the pandemic, which is already prominent in those with PD, were cited as additional causes of concern.

While these factors, along with reported instances of urinary issues and fatigue, may warrant adjustments to therapy, the distinct mortality risk of patients with PD who are infected with COVID-19 has yet to be determined.

Similar to other pre-existing medical conditions such as hypertension or obesity, authors of the current study note that patients infected with COVID-19 who have PD may pose an increased risk of morbidity and mortality. They examined the clinical outcomes, and associated predictors, of COVID-19 in patients with PD (n = 120) who were followed in 21 clinics: Italy (n = 14), Iran (n = 5), and Spain (n = 1), and the United Kingdom (n = 1).

“COVID-19 diagnosis was confirmed by means of real-time PCR assay or when symptoms were compatible with COVID-19 and the patient has been in contact with a PCR-confirmed case (usually a family member),” expanded the study authors.

Overall, researchers uncovered a mortality rate of 19.7% among the PD population, a distinct increase from the COVID-19 mortality rate of those aged 50 and over without PD (9.5%). In examining the potential role of comorbidities associated with adverse COVID-19 outcomes, hypertension was indicated as a statistically significant trend (63.6% in deceased patients vs. 37.6% in mild/admitted cases; P = .054).

Dementia (26.1% in deceased patients vs. 8.5% in mild/admitted cases; P = .049), and PD duration (11.7 ± 8.8 in deceased patients vs. 6.6 ± 5.4 years in mild/admitted cases, P = .029) were additional factors linked with adverse COVID-19 outcomes.

Researchers highlighted that the study findings come with notable limitations, including the cohort size and inability to delineate sub-group differences based on treatment utilization. The study was additionally conducted in the midst of the national lockdowns, noted researchers, with many patients refusing to be further investigated

“In spite of some important limitations, our study is the largest series of PD patients with COVID-19 collected so far, thus allowing a more accurate definition of their mortality and–more importantly–highlighting the risk factors that should guide the actions of the medical community engaged in the care of these patient,” said the study authors.

Researchers concluded that further research is warranted to confirm findings of this study.

Reference

Fasano A, Elia AE, Dallocchio C, et al. Predictors of COVID-19 outcome in Parkinson’s disease. Parkinsonism Relat Disord. Published online August 13, 2020. doi:10.1016/j.parkreldis.2020.08.012