Objective: To evaluate the socio-demographic profile and clinical needs of advanced Parkinson’s disease patients who were admitted to the neurological department at TASMC during the second year of the Covid-19 Pandemic in Israel.

Background: Slowly progressive neurodegenerative disorders such as PD and AD are mostly managed well in an ambulatory settings. However, it is well established that social distancing, reduced physical activity and outings in combination with reduced access to rehabilitation activities and/or physician appointments can be associated with a more rapid functional deterioration. On the other hand during the Covid-19 exacerbations some patients may prefer to stay home due to fear of the virus and delay utilization of medical care. Taken together, these factors may result in hospital admissions which has potential risks and discomfort for the patients and their caregivers.

Method: We retrospectively analyzed socio-demographic and clinical data of inpatients carrying a PD diagnosis who were admitted to the TASMC Neurological Department in May 2021 – February 2022. We included only patients whose primary admission etiology was parkinsonian symptoms exacerbation and excluded  other neurological etiologies such as stroke, AIDP  as well as PD- related elective admissions.

Results: 23/42 PD in-patients were included in the analysis (78% males), Most of the patients were 60-75 y.o.. Approximately 30% of the admissions were in July 2021 when Covid -19 incidence was relatively low and. Only 65% of the patients lived at home with a spouse prior to admission. The mean years since PD diagnosis were 9.59+6.89. Modified Rankin Score at admission was 2-3 for 87% 0f the patients.  4 patients were treated with advance treatments (LCIG, DBS). About 22% of the patients were Covid-19 positive in the previous 12 months. Motor symptoms worsening  were reported as the main reason for admission (70%) followed by psycho-cognitive symptoms (30%).

Conclusion: According to these preliminary findings there might be several risk factors for inpatient hospital admissions in the advanced PD population. These include clinical determinants such as gait and psycho-cognitive symptoms but also social support systems, and global factors such as world pandemic. Health systems together with social services should aid in improving access to both medical, rehabilitation, and mental resources in the outpatient settings.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-unmet-needs-for-advanced-parkinson-disease-in-patients-during-the-covid-19-pandemic-in-israel/