by Juliette Dufour
For September 2022, we have selected: Zenesini C et al, Risk of SARS-CoV-2 infection, hospitalization, and death for COVID-19 in people with Parkinson disease or parkinsonism over a 15-month period: A cohort study. Eur J Neurol, 2022, DOI: 10.1111/ene.15505.
In hospitalised subjects, after COVID‐19 infection, the presence of a neurodegenerative disease increases the risk of an unfavourable short‐term outcome. People with PD often show a significant clinical worsening; however, controversial data are reported about the risk of hospitalisation or death.
The aim of this study was to assess (i) the risk of SARS‐CoV‐2 infection, (ii) the risk of hospital admission for COVID‐19, and (iii) the 30‐day mortality risk after a positive SARS‐CoV‐2 test or hospitalisation, in a population‐based cohort of people with Parkinson’s Disease (PD) or Parkinsonism (PS) compared to a matched population cohort, during the period March 2020–May 2021, in Bologna, Northern Italy.
Our authors of the month retrospectively analysed 759 PD and 192 PS patients from the ParkLink Bologna cohort, an ongoing record linkage system started in 2015, including consecutive prevalent and incident cases of PD or PS, living in the area of the LHT of Bologna. They compared this cohort with 9,226 controls anonymously matched (ratio = 1:10) for sex, age, district, and comorbidity. Data were analysed in the whole period and in the two different pandemic waves (March–May 2020 and October 2020–May 2021).
The results are the following:
- Adjusted hazard ratio of SARS-CoV-2 infection was 1.3 (95% confidence interval [CI] = 1.04–1.7) in PD and 1.9 (95% CI = 1.3–2.8) in PS compared to the controls. The trend was detected in both the pandemic waves.
- Adjusted hazard ratio of hospitalisation for COVID-19 was 1.1 (95% CI = 0.8–1.7) in PD and 1.8 (95% CI = 0.97–3.1) in PS. A higher risk of hospital admission was detected in PS only in the first wave. There was no difference in the length of hospital stay.
- The 30-day mortality risk after hospitalisation was higher (p = 0.048) in PS (58%) than in PD (19%) and controls (26%).
The authors concluded that, compared with controls, after adjustment for key covariates, people with PD and PS showed a higher risk of SARS-CoV-2 infection throughout the first 15 months of the pandemic. COVID-19 hospitalisation risk was increased only in people with PS and only during the first wave. This group of patients was burdened by a very high risk of death after infection and hospitalisation.
The authors therefore enriched real world epidemiological data on risk factors and prognosis after SARS‐CoV‐2 among people with PD and PS. PD and PS are high‐risk conditions and particular attention should be paid to people with PD/PS.