Background
COVID-19 and PD
Subject | Topic | Highlight |
---|---|---|
Impact of COVID-19 on PD | Effect on motor and non-motor symptoms | 1. Worsening of motor symptoms, such as rigidity and tremor 2. Experiencing motor fluctuations 3. Triggering new motor symptoms 4. Worsening non-motor symptoms, such as mood, sleep, cognition, dysautonomia and hallucination 5. COVID-19 has harmful effects on motor and non-motor symptoms in PD patients both directly and indirectly |
Effect on disease progression | 1. Only one retrospective longitudinal study revealed increased motor symptom progression of PD during the COVID-19 pandemic | |
Effect on PD-related mortality | 1. Increased PD-related mortality rates during the COVID-19 pandemic 2. PD with older age, advanced course, reduction in medication and comorbidities are more likely to have increased risk of mortality 3. Negative findings indicated that the mortality of COVID-19 in PD patients does not differ from the general population | |
Trigger for PD | 1. Cases have been reported with development of parkinsonism after COVID-19 infection 2. Infection of dopaminergic neurons with the H1N1 influenza virus results in aggregation of α-synuclein 3. Viral infections trigger α-synucleinopathies in animal models 4. COVID-19 infection could trigger neurodegeneration with mechanisms not clearly determined | |
Impact of PD on COVID-19 | Vulnerability to COVID-19 infection | 1. Possibly higher risks of COVID-19 infection and hospitalization 2. Contrary results were also reported that PD do not differ from general population in the COVID-19 risk |
Prognosis of COVID-19 infection | 1. Enhanced risk of disease severity and mortality in PD patients than in non-PD patients 2. Inconsistent results were also reported that the prognosis of COVID‐19 patients seems comparable in patients with PD and those without it | |
Management of PD during COVID-19 pandemic | Modification of care strategies in PD | 1. Pandemic profoundly changes the way of PD management 2. Telemedicine services with digital-visits, e-rehabilitation, and remote programming are accessible and efficient for PD during the pandemic |
Potential impact of drug therapies for PD on COVID-19 | 1. Amantadine can be potentially used for the prevention of COVID-19 2. Levodopa has potential impacts on SARS-CoV-2 3. Dopamine agonists may worsen the outcomes of patients with COVID-19 infection 4. Entacapone may be a potential drug against SARS-CoV-2 5. Clozapine treatment is linked with an increased risk of COVID-19 infection 6. Vitamin D supplementation is identified as a protective factor for COVID-19 infection | |
Effect of COVID-19 vaccines on PD | 1. COVID-19 vaccines were known or expected not to interact with PD 2. Types or incidence of side effects of vaccines in PD seem no different from the general population 3. Case reports of developing severe dyskinesia or worsening of parkinsonian symptoms after receiving vaccines 4. A case report of improvement of motor and non-motor symptoms after receiving vaccines 5. Amantadine was hypothesized of potential interference with COVID-19 vaccines | |
Mechanisms of the link between COVID-19 and PD | 1. SARS-CoV-2 virus enters the CNS through olfactory bulb, by axonal transport from peripheral nerves, or by the hematogenous pathway via BBB 2. Systemic inflammation and sepsis which promote hypercoagulable response to form clots in brain vessels, and cytokine storm leading to hyper-inflammation and neuroinflammation 3. SARS-CoV-2 could bind to ACE2 receptors on dopaminergic neurons, which might cause neuroinflammation, excessive oxidative stress, abnormal immune response and pathological α-synuclein accumulation, leading to dopaminergic neuronal death |
Impact of COVID-19 on PD
Effect on motor and non-motor symptoms
Effect on disease progression of PD
Effect on PD-related mortality
Trigger for PD
The impact of PD on COVID-19
Susceptibility to COVID-19 infection
Prognosis of COVID-19 infection
Management of PD during the COVID-19 pandemic
Modification of care strategies for PD
Potential impact of drug therapies for PD on COVID-19
Effect of COVID-19 vaccines on PD
Mechanisms of the link between COVID-19 and PD
Neuroinflammation
Oxidative stress
Immune response
Dysregulated proteostasis
COVID-19 and AD
Subject | Topic | Highlight |
---|---|---|
Impact of COVID-19 on AD | Effect on dementia severity | 1. COVID-19 and prolonged hypoxia would exacerbate severity of pre-existing cognitive impairment of AD 2. COVID-19 pandemic and related restriction aggravate cognitive impairment in AD |
Effect on neuropsychiatric symptoms | 1. Clinical presentations of COVID-19 in AD patients are atypical, and neuropsychiatric symptoms are common 2. COVID-19 leads to the worsening of pre-existing neuropsychiatric symptoms in AD 3. COVID-19 pandemic and related restriction aggravate neuropsychiatric symptoms in AD 4. Worsened hyperactivity and bizarre behaviors emerge in AD animal model after isolation | |
Effect on disease progression | 1. There is no consensus on the effect of COVID-19 pandemic and related restrictions on dementia progression in AD patients | |
Trigger for AD | 1. AD-like features are involved in COVID-19 neuropathology 2. SARS-CoV-2 intrudes brain structure and causes brain functional abnormalities at 6-month longitudinal follow-up 3. Increased risks of memory problems and AD are shown at 12 months following acute COVID-19 infection 4. COVID-19-related social isolation and loneliness increase the risk of cognition decline and future dementia | |
Impact of AD on COVID-19 | Vulnerability to COVID-19 infection | 1. AD patients are at increased risk of COVID-19 infection 2. Biological and socioeconomic factors work together to make individuals with AD vulnerable to COVID-19 infection |
Prognosis of COVID-19 infection | 1. Pre-existing dementia is associated with the largest risk of COVID-19 hospitalization and mortality 2. Age, comorbidities, APOE ε4 allele, and OAS1 gene variant are associated with poor outcomes of COVID-19 infection | |
Management of AD during COVID-19 pandemic | Modification of care strategies in AD | 1. The COVID-19 pandemic profoundly changes the way of AD management 2. Telemedicine is feasible and well accepted in assessing and managing AD during the COVID-19 pandemic |
Potential impact of drug therapies for AD on COVID-19 | 1. Cholinesterase inhibitors therapies have not been reported on reducing the infection rate and mortality of COVID-19 thus far 2. Prescribing ARBs but not ACEIs is significantly associated with a lower risk of COVID-19 occurrence among AD patients 3. The impact of CCB usage upon the efficacy of COVID-19 in AD patients remains to be clarified | |
Effect of COVID-19 vaccines on AD | 1. Vaccinated AD patients are still at increased risk for COVID-19 breakthrough infection 2. AD patients may be vulnerable to delirium after taking the COVID-19 vaccine 3. Accelerated focal amyloid-β deposition induced by low-level inflammation after COVID-19 vaccination in AD patients 4. The combination of anti-amyloid-β immunotherapies and adenoviral COVID-19 vaccines may increase the risk of cerebral hemorrhage in patients with AD | |
Mechanisms of the link between COVID-19 and AD | 1. Inflammation, aging, insulin resistance, acetylcholine, and amyloid-β might mediate the mechanistic links between COVID-19 and AD 2. Risk alleles of APOE and OAS1 are associated with both AD and poor COVID-19 outcomes 3. Dysregulated immunity may play a key role in the mechanistic link between COVID-19 and AD |