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A fresh study of about 80,000 patients shows that people with Parkinson’s disease (PD) have a 30% greater risk of dying from COVID-19 than individuals without the neurodegenerative condition.
The new analysis conducted by researchers at University of Iowa Health Care based on patient information in the TriNetX COVID-19 research network suggests that Parkinson’s disease is an independent risk factor for dying from COVID-19.
The UI research team headed by neurologists Qiang Zhang, MD, and Nandakumar Narayanan, MD, PhD, identified the COVID-19 patient cohort as of July 15 and examined the mortality data eight weeks later. They found that 5.5percent (4,290 out of 78,355) of COVID-19 patients without PD expired compared to 21.3% (148 of 694) COVID-19 patients who had PD.
All these factors also increase the risk of death from COVID-19.
So, the UI team used two strategies to account for these differences: logistic regression with age, gender, and race as covariates, and fitting each PD individual with five non-PD patients with the precise age, gender, and race, and executing a conditional logistic regression. The findings have been published in the journal Movement Disorders.
The researchers say the findings should also inform patients with PD, and their physicians, of the greater importance of preventing COVID-19 infection in these patients.
“For our own patients, we can give advice that it is important that you wear a mask. It’s important that you socially space,” says Zhang, an associate in the UI Department of Neurology.
Zhang adds that doctors should also weigh the increased risk of death from COVID-19 when contemplating how to care for PD patients in person during the pandemic.
A potential reason why PD patients have a higher risk of death from COVID-19 might be associated with the fact that COVID can lead to pneumonia and pneumonia is a leading cause of death in patients with PD. This is partially because Parkinson’s patients may have difficulty swallowing or choking that can cause aspiration.
“We are all focused on COVID right now, but this is a clear instance of a respiratory illness that leads to increased mortality [in PD patients]. These findings may also have implications for understanding risks for PD patients from different diseases, including influenza,” Narayanan says. “I would recommend a flu vaccine and pneumonia vaccine to attempt to avoid these issues in patients with PD.”
University of Iowa Health Care
Zhang, Q., et al. (2020) COVID‐19 case fatality and Parkinson’s disease. Movement Disorders. doi.org/10.1002/mds.28325.