People with Parkinson’s disease (PD) have a 30% higher death rate from COVID-19 than people without the neurodegenerative condition, a database analysis of approximately 80,000 patients suggests. The findings are published in the journal Movement Disorders.

The new analysis conducted by researchers with University of Iowa Health Care is based on patient data in the TriNetX COVID-19 research network.

The UI research team led by neurologists Qiang Zhang, MD, and Nandakumar Narayanan, MD, PhD, identified the COVID-19 patient cohort as of July 15 and analyzed the mortality data eight weeks later. They suggest that 5.5% (4,290 out of 78,355) of COVID-19 patients without PD died compared to 21.3% (148 of 694) COVID-19 patients who also had PD.

However, the patients with PD were generally older, more likely to be male, and less likely to be African American than the patients without PD. All of these factors also increase the risk of death from COVID-19, a media release from University of Iowa Health Care explains.

How to Account for These Differences

The UI team used two approaches to account for these differences: logistic regression with age, sex, and race as covariates, and matching each PD patient with five non-PD patients with the exact age, sex, and race, and performing a conditional logistic regression. In both cases, the researchers found that the risk of dying from COVID-19 was 30% higher for patients with PD.

“We recognize the limitations of this study; it is retrospective data from a single database, but we are confident that these data show that Parkinson’s disease is independent risk factor for death in COVID-19.

“We believe this observation will be of interest to clinicians treating patients with Parkinson’s disease, and public health officials.”

— Nandakumar Narayanan, MD, PhD, UI associate professor of neurology and a member of the Iowa Neuroscience Institute

The researchers say the findings should also inform patients with PD, and their physicians, of the increased importance of preventing COVID-19 infection in these patients.

“For our own patients, we can give advice that it’s important that you wear a mask. It’s important that you socially distance.”

— Qiang Zhang, MD, an associate in the UI Department of Neurology

Zhang adds that physicians should also weigh the increased risk of death from COVID-19 when considering how to care for PD patients in person during the pandemic, the release continues.

A Potential Reason Why

A potential reason why PD patients have an increased risk of death from COVID-19 may be related to the fact that COVID can cause pneumonia and pneumonia is a leading cause of death in patients with PD. This is partly because Parkinson’s patients can have trouble swallowing or choking that can cause aspiration.

“We are all focused on COVID right now, but this is a clear example 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 other diseases, including influenza.

“I would recommend a flu vaccine and pneumonia vaccine to try to prevent these problems in patients with PD.”

— Nandakumar Narayanan

[Source(s): University of Iowa Health Care, Science Daily]

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