Preliminary Study Finds Association Between COVID-19 Infection and Risk of Death in People with PD

Around the world, more than two million people have died from COVID-19 thus far — with more than 514,000 of those deaths happening here in the U.S. According to the Centers for Disease Control and Prevention (CDC), the U.S. estimated death toll may reach nearly 550,000 by the end of March.   

People of any age can get COVID-19 (even healthy young adults and children). Older individuals — particularly those with underlying medical conditions, such as heart disease, COPD, diabetes, obesity and kidney disease — are at increased risk for severe illness and death.

 The goal of a preliminary study, titled, “Coronavirus Disease 2019 Case Fatality and Parkinson's Disease” (Zhang, Schultz, Aldridge, Simmering, & Narayanan, 2020) was to determine whether people with PD had a higher COVID-19 Case Fatality Rate (CFR) than people without PD.

Preliminary study: an initial review of a topic. These studies often identify a larger trend, proving that a more detailed, controlled study may or may not be pursued.

The study measured Case Fatality Rate, meaning, over a specific period, how many people who get a particular disease, later die from it. It is calculated by dividing the number of people initially diagnosed, by the number of people who died of that disease at a later moment in time. The specific time period assessed for this study was eight weeks (July 15, 2020 to September 9, 2020). The health records of 79,049 people with COVID-19 used for this study were gleaned from the TriNetX COVID-19 research network — a database with more than 50 million medical records, mostly from the U.S.

Results
At the start point, July 15, 2020, 694 people with PD had tested positive for COVID-19, and 78,355 people without PD had tested positive COVID-19. These two groups were not perfectly matched: The average age of the non-PD and PD group was 50 vs 70, respectively; the sex balance was 55% female vs female 40%; and the racial composition of African Americans was 20% vs 9.7%. 

Eight weeks later, September 9, 2020:

  • Of the 78,355 without PD, 4,290 people died (6%)
  • Of the 694 people with PD, 148 people died (21%)
  • Even after accounting for the differences in age, sex and race, the risk of dying from COVID-19 was significantly elevated in the group of people with Parkinson’s and COVID-19.

Covid RiskWhat Does It Mean?

Previous studies have not clarified whether having PD is associated with higher mortality rates in COVID-19 patients. In this preliminary study people with PD were observed to have a higher risk of mortality from COVID-19 than those who did not have PD.  
 
There are serious implications to be considered. For example, because the U.S. supply of the COVID-19 vaccine is currently limited, the specific recommendations to federal, state and local governments as to which populations should get the vaccine first could be modified. Following CDC guidelines, state governments have made efforts to include people with underlying medical conditions in the early phases of their vaccine rollout plans. At this time, what qualifies as an underlying medical condition varies across the country and may be subject to state or local interpretation. 

COVID-19 is a virus we will likely be studying for many years. We must study how it interacts with Parkinson’s and other diseases. Some areas of focus may include: 

  • Given that a diagnosis of Parkinson’s may increase COVID-19 mortality rates we will need to better understand if having Parkinson’s and COVID-19 is associated with more acute symptoms and longer recovery times? Do persons with Parkinson’s have a greater risk for the COVID long-hauler syndrome? 
  • How might increased knowledge of the impact of COVID-19 on people with Parkinson’s influence PD treatment during this pandemic and beyond?  
  • How will this study and other research influence future vaccine rollout plans? 

To provide optimal care to people with Parkinson’s, these, and many more questions must be addressed. The study authors stated that it will be “critical to develop effective strategies whereby healthcare providers can prevent the transmission of COVID-19 while providing neurological care to patients with PD.” 

Learn More
The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about COVID-19 and PD by visiting the below Parkinson’s Foundation resources, or by calling our free Helpline at 1-800-4PD-INFO (473-4636) for answers to your Parkinson’s questions. 

References

Bhidayasiri, R., Virameteekul, S., Kim, J. M., Pal, P. K., & Chung, S. J. (2020). COVID-19: An Early Review of Its Global Impact and Considerations for Parkinson's Disease Patient Care. J Mov Disord, 13(2), 105-114. doi:10.14802/jmd.20042 

Elbeddini, A., To, A., Tayefehchamani, Y., & Wen, C. (2020). Potential impact and challenges associated with Parkinson's disease patient care amidst the COVID-19 global pandemic. J Clin Mov Disord, 7, 7. doi:10.1186/s40734-020-00089-4 

Kubota, T., & Kuroda, N. (2021). Exacerbation of neurological symptoms and COVID-19 severity in patients with preexisting neurological disorders and COVID-19: A systematic review. Clin Neurol Neurosurg, 200, 106349. doi:10.1016/j.clineuro.2020.106349 

Sulzer, D., Antonini, A., Leta, V., Nordvig, A., Smeyne, R. J., Goldman, J. E., . . . Ray Chaudhuri, K. (2020). COVID-19 and possible links with Parkinson's disease and parkinsonism: from bench to bedside. NPJ Parkinsons Dis, 6, 18. doi:10.1038/s41531-020-00123-0 

Tan, E. K., Albanese, A., Chaudhuri, K., Lim, S. Y., Oey, N. E., Shan Chan, C. H., . . . Cardoso, F. (2021). Adapting to post-COVID19 research in Parkinson's disease: Lessons from a multinational experience. Parkinsonism Relat Disord, 82, 146-149. doi:10.1016/j.parkreldis.2020.10.009 

Wang, X., Zeng, F., Jin, W. S., Zhu, C., Wang, Q. H., Bu, X. L., . . . Wang, Y. J. (2017). Comorbidity burden of patients with Parkinson's disease and Parkinsonism between 2003 and 2012: A multicentre, nationwide, retrospective study in China. Sci Rep, 7(1), 1671. doi:10.1038/s41598-017-01795-0 

Zhang, Q., Schultz, J. L., Aldridge, G. M., Simmering, J. E., & Narayanan, N. S. (2020). Coronavirus Disease 2019 Case Fatality and Parkinson's Disease. Mov Disord, 35(11), 1914-1915. doi:10.1002/mds.28325

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