COVID-19 and Parkinsonism: A Critical Appraisal.
Francesco CavallieriValentina FioravantiFrancesco BoveEleonora Del PreteSara MeoniSara GrisantiMaria Luisa ZeddeRosario PascarellaElena MoroFranco ValzaniaPublished in: Biomolecules (2022)
A few cases of parkinsonism linked to COVID-19 infection have been reported so far, raising the possibility of a post-viral parkinsonian syndrome. The objective of this review is to summarize the clinical, biological, and neuroimaging features of published cases describing COVID-19-related parkinsonism and to discuss the possible pathophysiological mechanisms. A comprehensive literature search was performed using NCBI's PubMed database and standardized search terms. Thirteen cases of COVID-19-related parkinsonism were included (7 males; mean age: 51 years ± 14.51, range 31-73). Patients were classified based on the possible mechanisms of post-COVID-19 parkinsonism: extensive inflammation or hypoxic brain injury within the context of encephalopathy (n = 5); unmasking of underlying still non-symptomatic Parkinson's Disease (PD) (n = 5), and structural and functional basal ganglia damage (n = 3). The various clinical scenarios show different outcomes and responses to dopaminergic treatment. Different mechanisms may play a role, including vascular damage, neuroinflammation, SARS-CoV-2 neuroinvasive potential, and the impact of SARS-CoV-2 on α-synuclein. Our results confirm that the appearance of parkinsonism during or immediately after COVID-19 infection represents a very rare event. Future long-term observational studies are needed to evaluate the possible role of SARS-CoV-2 infection as a trigger for the development of PD in the long term.
Keyphrases
- sars cov
- parkinson disease
- drug induced
- respiratory syndrome coronavirus
- brain injury
- coronavirus disease
- oxidative stress
- end stage renal disease
- subarachnoid hemorrhage
- systematic review
- ejection fraction
- deep brain stimulation
- newly diagnosed
- chronic kidney disease
- climate change
- cerebral ischemia
- randomized controlled trial
- type diabetes
- risk assessment
- current status
- lipopolysaccharide induced
- skeletal muscle
- emergency department
- combination therapy
- prognostic factors
- blood brain barrier
- human health
- glycemic control