These are hard times for everyone. COVID-19 pandemic is fast growing in India. Elderly and people with co-morbidities like diabetes and hypertension are at a greater risk of getting a severe disease. But what about people with chronic neurological conditions like Parkinson’s disease (PD)? Are they at a greater risk of getting the infection? What factors would decide the severity of the disease if they get it? How lockdown and restricted mobility impact PD symptoms and what can be done to reduce their effect? These questions at some time or the other would have troubled many PD patients or their caregivers. In the section that follows, I would try to address these questions.
Current evidence suggests that patients with PD are not at a higher risk of getting COVID-19. A study from Italy, which was the epicenter of COVID-19 has shown this risk to be similar to the general population. Diabetes, cardiovascular diseases, and respiratory disorders which may coexist with PD can increase the risk of severe infection. Dementia and duration of PD are independent risk factors for poor outcomes.
The COVID-19 symptoms in patients with PD are similar to the general population. PD related symptoms like stiffness and tremors do increase with COVID-19 but that is seen with any viral illness. Patients with advanced PD often have respiratory muscle weakness and rigidity due are lack of mobility and exercise or abnormal posture. This may predispose them to more severe respiratory symptoms.
Patients with advanced PD are often homebound and may have a deficiency of Vitamin D. A protective effect of Vitamin D in COVID-19 has been observed in multiple European studies. This protective effect could be due to its property of reducing the level of inflammatory cytokines. Patients deficient in Vitamin D can take supplements to replenish their stores. One of the major impacts of lockdown on the life of PD patients has been a reduction in physical activity. PD patients are also at a higher risk for depression and anxiety, which can become worse during these times. Keeping oneself engaged in hobbies like reading, cooking, puzzles, etc. can go a long way in improving mental health. Regular aerobic and stretching exercises can be done at home to improve the level of fitness and respiratory muscle strength. Rules of social distancing and hand sanitization should be followed strictly. We need to be extra careful and stay safe till the time this Pandemic is over. With strict precautions and regular exercise victory over COVID-19 is possible.
- Dr. Aditya Murgai
Consultant Neurologist and Movement Disorders Specialist
Clinical Fellowship in Movement Disorders, Western University, Canada
PDF in Movement disorders, UTHSC, USA