High Prevalence of COVID-Related Hospitalization, Mortality in PD

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Not only has the prevalence of COVID-19 been high among patients with Parkinson’s disease (PD), but related hospitalization and mortality rates have also been high, results of a meta-analysis show.

Dr Salman Hussain

“The new results are important because Parkinson’s disease patients who contract COVID-19 will need extra care to prevent more severe outcomes and mortality,” study investigator Salman Hussain, PhD, Czech National Center for Evidence-Based Healthcare and Knowledge Translation, Brno, Czech Republic, told Medscape Medical News.

The findings were presented at the International Congress of Parkinson’s Disease and Movement Disorders (MDS) 2022.

“Close Monitoring” Needed

COVID-19 has severely affected millions of patients around the globe, including those with PD. Previous epidemiologic studies have shown a positive association between COVID-19 and PD, but these studies had small sample sizes, said Hussain.

He said it is important to understand the impact of COVID-19 on the clinical outcome of patients with PD because this could affect treatment approaches.

After carrying out a literature search in major databases such as PubMed, Embase, Cochrane, and Scopus, Hussain included in his meta-analysis 20 studies of 1029 patients with PD who had been confirmed to have had COVID-19.

Results showed the pooled prevalence of COVID-19 among the participants was 25.2% (95% CI, 12.5% – 44.3%). The pooled prevalence of hospitalization was 43.7% (95% CI, 32.5% – 55.6%).

“This means that, based on the number of patients in the analysis [of] just over 1000 subjects, we can say that if PD patients get COVID-19, they have a high chance of being hospitalized” ― with many being admitted to an intensive care unit, Hussain said.

The mortality rate was also high, with a pooled prevalence of 24.6% (95% CI, 19.2% – 31%).

The prevalence of COVID-19 was significantly higher among male patients with PD, as were rates of hospitalization and mortality due to COVID, in comparison with female patients (P < .05).

Hussain said he aims to carry out additional subgroup analyses. He also said it would also be interesting to examine the outcomes of patients with neurodegenerative diseases other than PD.

He noted that the new data are useful for neurologists. “If they’re looking after a PD patient who also develops COVID-19, they would need to provide extra care and close monitoring,” said Hussain.

Myoclonus and SARS-CoV-2

The topic of COVID-19 featured prominently elsewhere at the MDS Congress. For example, investigators conducted a systematic literature review to assess movement disorders (MDs) associated with SARS-CoV-2 infection.

Conducted primarily by researchers in the Department of Neurology, All India Institute of Medical Sciences, New Delhi, the study included data from 118 patients (78% men; mean age, 55 years) with SARS-CoV-2-associated MDs from 73 studies.

Results showed that a combination of myoclonus and ataxia was the most frequent MD associated with SARS-CoV-2 (28%) and that myoclonus was more frequent among patients older than 40 years.

The longest latency period for developing an MD after SARS-CoV-2 infectionwas for tremor (41.5 days). The investigators note that myoclonus and parkinsonism can develop weeks after infection, whereas chorea, dystonia, and ataxia show up within a shorter period.

In this analysis, comorbidities did not influence type of MD. In addition, the type of MD did not appear to influence survival outcomes.

Hussain’s study was supported by the Operational Programme Research, Development, and Education Project. The investigators have disclosed no relevant financial relationships.

International Congress of Parkinson’s Disease and Movement Disorders (MDS) 2022: Abstracts 43 and 90. Presented September 15, 2022.

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