Fasano Alfonso, Antonini Angelo, Katzenschlager Regina, Krack Paul, Odin Per, Evans Andrew H, Foltynie Thomas, Volkmann Jens, Merello Marcelo
Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, University Health Network, Division of Neurology University of Toronto Toronto Ontario Canada.
Krembil Brain Institute Toronto Ontario Canada.
Mov Disord Clin Pract. 2020 May 4;7(4):361-372. doi: 10.1002/mdc3.12965. eCollection 2020 May.
Although the COVID-19 pandemic is affecting a relatively small proportion of the global population, its effects have already reached everyone. The pandemic has the potential to differentially disadvantage chronically ill patients, including those with Parkinson's disease (PD). The first health care reaction has been to limit access to clinics and neurology wards to preserve fragile patients with PD from being infected. In some regions, the shortage of medical staff has also forced movement disorders neurologists to provide care for patients with COVID-19.
To share the experience of various movement disorder neurologists operating in different world regions and provide a common approach to patients with PD, with a focus on those already on advanced therapies, which may serve as guidance in the current pandemic and for emergency situations that we may face in the future.
Most of us were unprepared to deal with this condition given that in many health care systems, telemedicine has been only marginally available or only limited to email or telephone contacts. In addition, to ensure sufficient access to intensive care unit beds, most elective procedures (including deep brain stimulation or the initiation of infusion therapies) have been postponed. We all hope there will soon be a time when we will return to more regular hospital schedules. However, we should consider this crisis as an opportunity to change our approach and encourage our hospitals and health care systems to facilitate the remote management of chronic neurological patients, including those with advanced PD.
尽管新冠疫情影响的全球人口比例相对较小，但其影响已波及每个人。这场疫情有可能对慢性病患者，包括帕金森病（PD）患者造成不同程度的不利影响。医疗保健的首要反应是限制进入诊所和神经科病房，以保护脆弱的PD患者不被感染。在一些地区，医护人员短缺也迫使运动障碍神经科医生为新冠患者提供治疗。
分享世界各地不同运动障碍神经科医生的经验，并为PD患者提供一种通用的治疗方法，重点关注那些已经接受先进疗法的患者，这可能为当前疫情以及我们未来可能面临的紧急情况提供指导。
鉴于在许多医疗保健系统中，远程医疗仅在边缘可用或仅限于电子邮件或电话联系，我们大多数人都没有准备好应对这种情况。此外，为确保有足够的重症监护病房床位，大多数择期手术（包括脑深部电刺激或开始输液治疗）都已推迟。我们都希望很快能回到更正常的医院日程安排。然而，我们应该将这场危机视为一个改变我们治疗方法的机会，并鼓励我们的医院和医疗保健系统促进对慢性神经疾病患者，包括晚期PD患者的远程管理。
