Objective: To review the outcomes of COVID 19 during the first wave in patients with Parkinson’s in West Berkshire, UK.

Background: UK is one of the countries hardest hit by COVID 19 pandemic. This has huge implications for patients with a chronic progressive neurological disorder such as Parkinson’s. To date,   evidence is lacking to show that Parkinson’s itself puts patients at higher risk of severe COVID-19 infections (1) The comorbidities along with the older age of Parkinson’s patients can increase their risk for more severe forms of COVID-19(2)

Method: Demographic and clinical data was collected from EPR (Electronic Patient Record) of Parkinson’s patients from West Berkshire, who had a positive PCR swab for COVID 19 during the 1^st wave of the pandemic (March to August 2020).

Results: 25 patients (male 14) were included in the study, average age was 81.4 years (69-95 years).72% (18/25) patients presented to hospital from home whilst 24% (6/25) and 4% (1/25) presented from nursing homes and residential homes, respectively. 84% (21/25) required hospital admission whilst 16% (4/25) were managed in community. Common comorbidities are shown in the Table 1 below, however there was a considerable overlap.
A review of pre-existing frailty markers as shown in the Table 2 reflects complex stage PD.
A Do Not Resuscitate (DNACPRR) decision was in place for 24/25(96%) patients. 52% (13/25) died within 28 days of a positive COVID 19 test. 4 patients died within 90 days of a positive COVID 19 test taking the overall mortality to 68%. The cause of death for the patients dying in hospital was COVID 19 pneumonia (5/10), COVID 19 Infection (3/10), Hospital Acquired Pneumonia (1/10) and Aspiration pneumonia (1/10).

Conclusion: Majority of Parkinson’s patients who contracted COVID 19 during the first wave of the pandemic required hospital admission. Older age, Hypertension and IHD were the commonest comorbidities whilst frailty related to Parkinson’s included falls and functional dependence. Mortality was high in this group due to the underlying comorbidities. Although a small number of patients had pre-existing airways disease, the majority of  patients died of COVID 19  induced lung pathology.

References: 1- Fasano A, Antonini A, Katzenschlager R, Krack P, Odin P, Evans AH, et al. Management of Advanced Therapies in Parkinson’s disease patients in times of humanitarian crisis: the COVID-19 experience. Mov Disord Clin Pract. 2020;7(4):361–72. 2- Elbeddini, A., To, A., Tayefehchamani, Y. et al. Potential impact and challenges associated with Parkinson’s disease patient care amidst the COVID-19 global pandemic. J Clin Mov Disord 7, 7 (2020). https://doi.org/10.1186/s40734-020-00089-4

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-outcomes-in-parkinsons-with-covid-19-during-the-first-wave-in-west-berkshire-united-kingdom-uk/