One reported case of Parkinson’s onset after COVID-19 infection has scientists and the general community wondering about a connection between the coronavirus and Parkinson’s disease (PD).
“The evidence has not yet given us a reason to think that people who recover from COVID-19 have increased risk of Parkinson’s, but we’re learning more each day about the coronavirus and its impact,” said Rachel Dolhun, MD, The Michael J. Fox Foundation (MJFF)’s Vice President of Medical Communications. “We need to continue gathering and analyzing data to better understand how this virus affects people living with PD today and whether it could increase Parkinson’s risk in the future.”
Here’s what we currently know about a COVID-19 and Parkinson’s connection and what research may help support investigations into this issue.
Researchers Ponder Case of Parkinson’s Following COVID-19
A paper published in The Lancet Neurology this month describes the case of a 45-year-old Israeli man who developed symptoms of tremor, slowness and stiffness while recovering from COVID-19. He had no family history of PD and tested negative for known Parkinson’s genetic mutations (e.g., LRRK2, GBA).
Scientists are not certain why he developed PD symptoms. Some speculate that the immune system’s response to COVID-19 may have triggered cellular dysfunction that led to PD. Others believe the physiological stress of COVID-19 may have “unmasked” Parkinson’s disease that had not yet shown symptoms.
“COVID-19 infection may have been a stressor that brings previously subtle, unrecognized symptoms to a point of awareness,” Alberto Espay, MD, MSc, from the University of Cincinnati, who was not involved with the case, told MedPage Today. “It's not that those exposures caused Parkinson's but, rather they acted as precipitants, exacerbating subtle Parkinson's symptoms to a threshold of severity making them noticeable for the first time to patients and physicians.”
Scientists Are Profiling COVID-19 Biology to Look for Overlaps with Parkinson’s
While this report is only one case of Parkinson’s after COVID-19, there are scientific reasons to watch for correlation between the two and to monitor for long-term effects. Researchers are looking at what happens in the body and brain during and after a COVID-19 infection, and doctors are paying close to attention to neurological effects of the virus, especially those that overlap with Parkinson’s. For example, some people with COVID-19 have trouble with confusion and memory changes, and smell loss is both an early sign of PD and a symptom of COVID-19. Read more about smell loss in coronavirus and Parkinson’s.
Additionally, scientists are profiling the virus’ presence in the brain and the body’s immune response to COVID-19. Better understanding of the biology and experience of COVID-19 can help understand its long-term effects and the likelihood of developing other conditions after recovery.
Researchers Learning about COVID-19 in People with Parkinson’s
Studies also are looking at the impact of COVID-19 on people living with Parkinson’s. It does not seem that having Parkinson’s increases one’s risk of contracting COVID-19, but a survey from the MJFF online study Fox Insight reported that many people with PD experienced worse motor and non-motor symptoms with the virus. Such worsening is common with any infection, though, says Dr. Dolhun.
Scientists are also examining the severity of COVID-19 that people with Parkinson’s may experience. One recent study people with PD may have a higher likelihood of death from COVID. But the Parkinson’s group was older and more male (both risk factors for worse COVID-19). In the same study, among five COVID-19 patients with and without PD who were matched for age, sex and race, those with PD did have a 27 percent increased risk of death, but this does take into account other health problems (such as heart disease or diabetes) that may have worsened the severity of COVID-19.
“It still does not appear that Parkinson's in and of itself is an independent risk factor for getting COVID-19 or having a worse course with COVID,” said Dr. Dolhun. “That said, people with Parkinson’s who are older, have other health conditions or have limited mobility do have an increased risk of worse virus and should be especially cautious. Everyone, Parkinson’s or not, should practice precautions to guard against infection — wash your hands, wear a mask and keep physical distance.”
That distance is having an impact too, though. In the Fox Insight survey, people with Parkinson’s not diagnosed with COVID-19 reported disrupted medical care (64%), exercise (21%), and social activities (57%), and worsened motor (43%) and non-motor (52%) symptoms.
“It is challenging,” Dr. Dolhun said. “And while we’re all growing tired of the limitations, it is important to do what you can. Virtual social events, physically distanced exercise classes and telemedicine visits all make a difference in staying connected and managing Parkinson’s disease.”
Data Is Key to Understanding Connection
To look at Parkinson’s risk in people who have had COVID-19 and understand the effects of the virus in people with Parkinson’s, more data is critical. MJFF’s Fox Insight COVID-19 survey remains open, and people both with and without Parkinson’s can contribute their experiences. And, to better understand the long-term impact of COVID-19, Fox Insight plans to resurvey people who reported they had COVID-19 for more data on its effects.
Visit www.foxinsight.org to learn more. If you’re already a Fox Insight participant, find the COVID-19 questionnaire in the Survey Center under Related Research.
Another resource for better understanding Parkinson’s and its connections are patient registries. MJFF is funding the California Parkinson’s Disease Registry and advocating for similar databases in other states. These resources aim to collect health history on people with Parkinson’s to recognize connections to, for example, environmental exposures or prior infections.
Visit our COVID-19 Resource Hub for the latest news on the virus and Parkinson’s and tips on navigating this uncertain time.