Objective: To review the clinical presentation and management of SARS-CoV 2 in older patients with Parkinson’s during the first wave of the pandemic in West Berkshire, United Kingdom (UK).

Background: In December 2019 a cohort of cases of pneumonia of unknown cause was identified in Wuhan, the capital city of Hubei province of China. A novel beta-coronavirus was isolated, which was later designated as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2). The World Health Organization declared the disease caused by this virus as Coronavirus disease 2019 (COVID-19) and in March 2020 a pandemic was declared.
Clinicians across the globe were learning about the presentation of the illness, its treatment and impact on chronic diseases. Little was known about the presentation and impact of SARS-CoV2 in Parkinson’s.
 We present our experience of management of SARS-CoV2 in older patients with Parkinson’s in West Berkshire, UK.

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 SARS-CoV2 during the 1st wave of the pandemic (March to August 2020).

Results: 25 patients were included in the study. The average age was 81.4 years (69-95 years) and 14 patients were male. 84% (21/25) patients were managed in hospital while 16% (4/25) in care homes. A breakdown of presenting symptoms is shown in Table 1.
Table 2 shows the investigations and management of COVID 19.
In 80% (17/21) patients, no changes were made to Parkinson’s drugs. In patients with pre-existing swallowing problems, rotigotine patch and NG tube were used in 2 patients. The average length of stay for hospitalised patients was 10 days (Range 1 to 62 days). More than half the patients (13/25) passed away within 28 days of a positive COVID-19 test.

Conclusion: The majority of older patients with Parkinson’s presented with upper respiratory symptoms. Management of COVID 19 during the first wave was mainly supportive with oxygen and antibiotics. Parkinson’s drug therapy was largely unaltered. Subsequent clinical research has shown the evidence for use of steroids, antivirals, and immune modulating therapies in the acute illness. Clinicians should monitor for development of any chronic problems affecting lungs, cardiac function or indeed symptoms related to ‘long COVID’.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sars-cov2-in-older-patients-with-parkinsons/