Bhidayasiri Roongroj, Virameteekul Sasivimol, Kim Jong-Min, Pal Pramod Kr, Chung Sun-Ju
Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
J Mov Disord. 2020 May;13(2):105-114. doi: 10.14802/jmd.20042. Epub 2020 Apr 30.
While many infectious disorders are unknown to most neurologists, COVID-19 is very different. It has impacted neurologists and other health care workers, not only in our professional lives but also through the fear and panic within our own families, colleagues, patients and their families, and even in the wider public. COVID-19 affects all sorts of individuals, but the elderly with underlying chronic conditions are particularly at risk of severe disease, or even death. Parkinson's disease (PD) shares a common profile as an age-dependent degenerative disorder, frequently associated with comorbidities, particularly cardiovascular diseases, so PD patients will almost certainly fall into the high-risk group. Therefore, the aim of this review is to explore the risk of COVID-19 in PD based on the susceptibility to severe disease, its impact on PD disease severity, potential long-term sequelae, and difficulties of PD management during this outbreak, where neurologists face various challenges on how we can maintain effective care for PD patients without exposing them, or ourselves, to the risk of infection. It is less than six months since the identification of the original COVID-19 case on New Year's Eve 2019, so it is still too early to fully understand the natural history of COVID-19 and the evidence on COVID-19-related PD is scant. Though the possibilities presented are speculative, they are theory-based, and supported by prior evidence from other neurotrophic viruses closely related to SARS-CoV-2. Neurologists should be on high alert and vigilant for potential acute and chronic complications when encountering PD patients who are suspected of having COVID-19.
虽然大多数神经科医生对许多感染性疾病并不了解,但新型冠状病毒肺炎(COVID-19)却截然不同。它不仅在我们的职业生涯中,而且通过我们自己的家人、同事、患者及其家人甚至更广泛公众中的恐惧和恐慌,对神经科医生和其他医护人员产生了影响。COVID-19影响各类人群,但患有基础慢性病的老年人尤其有患重症甚至死亡的风险。帕金森病(PD)作为一种与年龄相关的退行性疾病,具有共同特征,常伴有合并症,尤其是心血管疾病,所以PD患者几乎肯定会属于高危人群。因此,本综述的目的是基于对重症疾病的易感性、其对PD疾病严重程度的影响、潜在的长期后遗症以及在此次疫情爆发期间PD管理的困难,探讨PD患者感染COVID-19的风险,在此期间神经科医生面临各种挑战,即如何在不使PD患者或我们自己面临感染风险的情况下,为他们维持有效的治疗。自2019年除夕发现首例COVID-19病例以来还不到六个月,所以要全面了解COVID-19的自然史还为时过早,而且关于COVID-19相关PD的证据也很少。尽管所提出的可能性是推测性的,但它们基于理论,并得到了与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)密切相关的其他神经营养病毒的先前证据的支持。当遇到疑似感染COVID-19的PD患者时,神经科医生应高度警惕并密切关注潜在的急性和慢性并发症。