How is COVID-19 impacting on the Parkinson’s community: what we know so far

Original article: Papa, S. M., Brundin, P., Fung, V. S. C., Kang, U. J., Burn, D. J., Colosimo, C., . . . and the, M. D. S. S. I. C. (2020). Impact of the COVID-19 Pandemic on Parkinson’s Disease and Movement Disorders. Mov Disord. doi:10.1002/mds.28067 https://onlinelibrary.wiley.com/doi/full/10.1002/mds.28067

The takeaway

It will take months or possibly years to definitively appreciate how the COVID-19 pandemic will affect people with Parkinson’s as no research evidence has been produced yet. The pandemic is however changing how care is delivered and impacting on research.

Why is it important?

Telemedicine offers a validated solution to the challenge of delivering routine neurological care for people with Parkinson’s while avoiding hospital visits during the pandemic. To this end, an online guide on its implementation in the clinic has been made available to clinicians. The piece also highlights the importance of minimizing disruption on research and trials into disease modifying therapies which are vital for the community.

Background

As the COVID-19 pandemic continues, the Movement Disorders Society addresses the issue of how people with Parkinson’s and related disorders are and will be affected, as we do not yet have research-based evidence on the exact effects of COVID-19 on the Parkinson’s community. We do know however that older age is the most important risk factor for Parkinson’s, as it is for a number of other conditions such as coronary artery disease and heart failure. Population-based research has shown that people with Parkinson’s are more likely to have these conditions, which we now know also increase the risk of more severe illness from COVID-19. For these reasons, there are concerns about the potentially greater health risks from COVID-19 in people with Parkinson’s and other movement disorders.

In addition, ensuring that people with Parkinson’s receive their standard neurological care at a time when resources are stretched is important. Fortunately, many of the necessary assessments can be undertaken through telemedicine, that is, through live or recorded video enabling clinicians to assess movement remotely.

 The authors also address the impact of the pandemic on ongoing research, which due to strained resources and measures to stop the spread of COVID-19 and prevent further transmissions, is either on hold, or prevented from starting. The authors highlight the unmet need for disease modifying therapies for people with Parkinson’s and other movement disorders, and the importance of this work continuing where possible at this time.

Next steps

The Movement Disorders Society has published a practical guide on their website, with instructions for clinicians on how to implement telemedicine in the clinic. The authors also call for a case-by-case evaluation of individual trials rather than uniformly stopping all research, to minimise delays and prevent loss of financial investment and scientific effort into much needed disease modifying therapies.

Related work and trials

https://www.cureparkinsons.org.uk/news/our-news-covid-19

Fine, JM, Stroebel, BM, Faltesek, KA, Terai, K, Haase, L, Knutzen, KE, Kosyakovvsky, J, Bowe, TJ, Fuller, AK, Frey, WH, Hanson LR. (2020). Intranasal delivery of low-dose insulin ameliorates motor dysfunction and dopaminergic cell death in a 6-OHDA rat model of Parkinson’s Disease
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