Clinical features and outcomes of hospitalised patients with COVID-19 and Parkinsonian disorders: A multicentre UK-based study.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2023
Historique:
received: 21 04 2023
accepted: 18 07 2023
medline: 2 8 2023
pubmed: 31 7 2023
entrez: 31 7 2023
Statut: epublish

Résumé

Parkinson's disease has been identified as a risk factor for severe Coronavirus disease 2019 (COVID-19) outcomes. However, whether the significant high risk of death from COVID-19 in people with Parkinson's disease is specific to the disease itself or driven by other concomitant and known risk factors such as comorbidities, age, and frailty remains unclear. To investigate clinical profiles and outcomes of people with Parkinson's disease and atypical parkinsonian syndromes who tested positive for COVID-19 in the hospital setting in a multicentre UK-based study. A retrospective cohort study of Parkinson's disease patients with a positive SARS-CoV-2 test admitted to hospital between February 2020 and July 2021. An online survey was used to collect data from clinical care records, recording patient, Parkinson's disease and COVID-19 characteristics. Associations with time-to-mortality and severe outcomes were analysed using either the Cox proportional hazards model or logistic regression models, as appropriate. Data from 552 admissions were collected: 365 (66%) male; median (inter-quartile range) age 80 (74-85) years. The 34-day all-cause mortality rate was 38.4%; male sex, increased age and frailty, Parkinson's dementia syndrome, requirement for respiratory support and no vaccination were associated with increased mortality risk. Community-acquired COVID-19 and co-morbid chronic neurological disorder were associated with increased odds of requiring respiratory support. Hospital-acquired COVID-19 and delirium were associated with requiring an increase in care level post-discharge. This first, multicentre, UK-based study on people with Parkinson's disease or atypical parkinsonian syndromes, hospitalised with COVID-19, adds and expands previous findings on clinical profiles and outcomes in this population.

Sections du résumé

BACKGROUND
Parkinson's disease has been identified as a risk factor for severe Coronavirus disease 2019 (COVID-19) outcomes. However, whether the significant high risk of death from COVID-19 in people with Parkinson's disease is specific to the disease itself or driven by other concomitant and known risk factors such as comorbidities, age, and frailty remains unclear.
OBJECTIVE
To investigate clinical profiles and outcomes of people with Parkinson's disease and atypical parkinsonian syndromes who tested positive for COVID-19 in the hospital setting in a multicentre UK-based study.
METHODS
A retrospective cohort study of Parkinson's disease patients with a positive SARS-CoV-2 test admitted to hospital between February 2020 and July 2021. An online survey was used to collect data from clinical care records, recording patient, Parkinson's disease and COVID-19 characteristics. Associations with time-to-mortality and severe outcomes were analysed using either the Cox proportional hazards model or logistic regression models, as appropriate.
RESULTS
Data from 552 admissions were collected: 365 (66%) male; median (inter-quartile range) age 80 (74-85) years. The 34-day all-cause mortality rate was 38.4%; male sex, increased age and frailty, Parkinson's dementia syndrome, requirement for respiratory support and no vaccination were associated with increased mortality risk. Community-acquired COVID-19 and co-morbid chronic neurological disorder were associated with increased odds of requiring respiratory support. Hospital-acquired COVID-19 and delirium were associated with requiring an increase in care level post-discharge.
CONCLUSIONS
This first, multicentre, UK-based study on people with Parkinson's disease or atypical parkinsonian syndromes, hospitalised with COVID-19, adds and expands previous findings on clinical profiles and outcomes in this population.

Identifiants

pubmed: 37523365
doi: 10.1371/journal.pone.0285349
pii: PONE-D-23-09726
pmc: PMC10389727
doi:

Types de publication

Multicenter Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0285349

Informations de copyright

Copyright: © 2023 Sorrell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Lexy Sorrell (L)

University of Plymouth, Plymouth, United Kingdom.

Valentina Leta (V)

Department of Basic and Clinical Neuroscience, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom.
Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom.

Anton Barnett (A)

University of Plymouth, Plymouth, United Kingdom.

Kara Stevens (K)

Exploristics Ltd, Belfast, Northern Ireland, United Kingdom.

Angela King (A)

University of Plymouth, Plymouth, United Kingdom.

Jemma Inches (J)

University of Plymouth, Plymouth, United Kingdom.
University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.

Christopher Kobylecki (C)

Division of Neuroscience and Experimental Psychology, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.
Department of Neurology, Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom.

Richard Walker (R)

Department of Medicine, North Tyneside Hospital, Northumbria Healthcare NHS Foundation Trust, North Shields, United Kingdom.
Population Health Science Institute, Newcastle University, Newcastle, United Kingdom.

K Ray Chaudhuri (KR)

Department of Basic and Clinical Neuroscience, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom.
Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom.

Hannah Martin (H)

University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom.

Jane Rideout (J)

Expert by Experience, London, United Kingdom.

J Robert Sneyd (JR)

Expert by Experience, London, United Kingdom.

Sarah Campbell (S)

University of Plymouth, Plymouth, United Kingdom.

Camille Carroll (C)

University of Plymouth, Plymouth, United Kingdom.
University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.
Newcastle University, Newcastle, United Kingdom.

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