Higher Inpatient Risk of COVID-19–Related Mortality Associated With Parkinson Disease

Patients with Parkinson disease (PD) hospitalized with COVID-19 may be at greater risk of death, especially if they are older or at an advanced disease stage, according to study findings published in Movement Disorders.

In assessing the impact of COVID-19 on patients with PD, a prior study found that co-occurence of dementia and hypertension, and duration of PD, were significantly associated with mortality in those infected with the virus. However, these findings came with several notable limitations, particularly the study’s small cohort size.

“Comprehensive, nationwide data regarding PD hospitalizations, COVID-19 in-hospital frequency, and COVID-19–associated inpatient mortality during the first wave of the COVID-19 pandemic are not available,” noted the study authors.

Seeking to gauge the impact of COVID-19 across a nationwide population of those with PD, they conducted a cross-sectional analysis of hospitalized patients with the condition in Germany. Researchers derived administrative claims data covering 1468 hospitals and 5,210,432 patient hospitalizations, which included a total of 30,872 COVID-19 cases between January 16 and May 15, 2020.

Researchers focused on 3 principal questions in the analysis:

• How did hospitalizations of PD develop during the pandemic?
• Are patients with PD particularly affected by COVID-19 and what are the characteristics of patients with PD diagnosed with COVID-19?
• Are patients with PD more at risk of COVID-19-associated death?

Of the inpatient COVID-19 cases observed, 693 patients also had PD—marking a 1.1% COVID-19 prevalence in the overall PD population (n = 64,434) that was indicated to be significantly higher than that found in the general population (0.6%; P < .001). Moreover, this prevalence disparity increased in groups aged 65 years and higher and those with more advanced PD (Hoehn & Yahr scale [HY] < 3, 0.8%; HY 3-4, 1.0%; HY 5, 1.4%).

In assessing characteristics of patients with PD who had COVID-19 compared with patients with the condition who did not have COVID-19, researchers found that those who were positive for COVID-19 exhibited slightly but significantly higher rates of hypertension (54.1% vs 53.3%; P < .001) and chronic kidney disease (22.4% vs 21.0%, P < .001)

“Advanced age and male sex were significantly more frequent in COVID-19 positive than in COVID-19–negative patients with PD,” added the study authors.

Furthermore, COVID-19 inpatient mortality was found to be markedly higher in patients with PD than those without the condition (35.4% vs 20.7%; P < .001), particularly in patients aged 75 to 79 years, whose odds of COVID-19–related death were 1.5 times greater if they had PD (odds ratio [OR], 1.526; 95% CI, 1.089-2.139; P = .012).

Overall, inpatient mortality of patients with PD was significantly higher in 2020 than in 2019 independent of COVID-19 status (5.7% vs 4.9%; P < .001), with patients aged 65 to 74 years and 75 to 79 years showing significantly greater mortality risk in 2020 (65-74 years: 3.3% vs 2.7%; relative difference, 21.9%; P < .001; 75-79 years: 5.2% vs 4.3%; relative difference, 20.0%; P < .001).

“Inpatients with PD are more frequently affected by COVID-19 and suffer from increased COVID-19–associated mortality in comparison to patients without PD,” concluded the study authors. “More comprehensive studies are needed to assess the significance of associated comorbidities for COVID-19 risk and mortality in PD.”

Reference

Scherbaum R, Kwon EH, Richter D, et al. Clinical profiles and mortality of COVID-19 inpatients with Parkinson’s disease in Germany. Mov Disord. Published online May 4, 2021. doi:10.1002/mds.28586