Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore.
Ann Clin Transl Neurol. 2022 Oct;9(10):1504-1513. doi: 10.1002/acn3.51616. Epub 2022 Sep 6.
The clinical, neuropsychological, and socioeconomic factors affecting Parkinson's disease (PD) during COVID-19 pandemic across different populations have not been systematically studied. To address this, we conducted a meta-analysis of factors that impact the well-being of PD patients during the pandemic.
Medline and Embase were searched for articles published between 2020 and 2022. We conducted random-effects pooling of estimates and meta-regression.
Twenty-seven studies involving 13,878 patients from America, Europe, Asia, and Africa were included. There is a high prevalence of decreased physical activity and exercise, and worsening motor and neuropsychiatric symptoms (17-56%). Patients in lower-income countries more frequently reported worsening anxiety (adjusted OR [aOR] 8.94, 95% confidence interval [CI] 1.62-49.28, p = 0.012), sleep (aOR 5.16, 95% CI 1.15-23.17, p = 0.032), and PD symptoms (aOR 3.57, 95% CI 0.96-13.34, p = 0.058). Lockdown was associated with decreased exercise levels (aOR 0.13, 95% CI 0.02-0.78, p = 0.025) and worsening mood (aOR 0.48, 95% CI 0.24-0.95, p = 0.035). Younger age correlated with decreased physical activity (β -0.30, 95% CI -0.53 to -0.07, p = 0.012), exercise (β -0.11, 95% CI -0.15 to -0.07, p < 0.001), worsening PD symptoms (β -0.08, 95% CI -0.15 to -0.01, p = 0.018), and sleep (β -0.14, 95% CI -0.27 to 0, p = 0.044). Female PD patients reported a greater decrease in physical activity (β 11.94, 95% CI 2.17-21.71, p = 0.017) and worse sleep (β 10.76, 95% CI 2.81-18.70, p = 0.008).
This large meta-analysis of PD patients in diverse populations identified a high prevalence of physical and mental worsening during the COVID-19 pandemic, with patients in lower-income countries being exceptionally vulnerable.
在不同人群中，COVID-19 大流行期间影响帕金森病（PD）的临床、神经心理学和社会经济因素尚未得到系统研究。为了解决这个问题，我们对影响大流行期间 PD 患者健康的因素进行了荟萃分析。
检索 2020 年至 2022 年期间发表的 Medline 和 Embase 文章。我们对估计值进行了随机效应汇总和荟萃回归。
共纳入来自美洲、欧洲、亚洲和非洲的 27 项研究，涉及 13878 名患者。身体活动和运动减少以及运动和神经精神症状恶化的发生率很高（17-56%）。来自低收入国家的患者更频繁地报告焦虑（调整后的比值比[aOR] 8.94，95%置信区间[CI] 1.62-49.28，p=0.012）、睡眠（aOR 5.16，95%CI 1.15-23.17，p=0.032）和 PD 症状（aOR 3.57，95%CI 0.96-13.34，p=0.058）恶化。封锁与运动水平降低（aOR 0.13，95%CI 0.02-0.78，p=0.025）和情绪恶化（aOR 0.48，95%CI 0.24-0.95，p=0.035）相关。年龄较小与身体活动减少（β-0.30，95%CI-0.53 至-0.07，p=0.012）、运动减少（β-0.11，95%CI-0.15 至-0.07，p<0.001）、PD 症状恶化（β-0.08，95%CI-0.15 至-0.01，p=0.018）和睡眠（β-0.14，95%CI-0.27 至 0，p=0.044）有关。PD 女性患者报告身体活动减少（β 11.94，95%CI 2.17-21.71，p=0.017）和睡眠恶化（β 10.76，95%CI 2.81-18.70，p=0.008）更明显。
本荟萃分析对不同人群中的 PD 患者进行了大规模研究，发现 COVID-19 大流行期间身体和心理恶化的发生率很高，低收入国家的患者尤其脆弱。
