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帕金森病和新冠肺炎的治疗模式。

Treatment paradigms in Parkinson's Disease and Covid-19.

机构信息

Medical School, University of Crete, Heraklion, Crete, Greece; Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital NHS Foundation Trust, London, United Kingdom.

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

出版信息

Int Rev Neurobiol. 2022;165:135-171. doi: 10.1016/bs.irn.2022.03.002. Epub 2022 May 28.

Abstract

People with Parkinson's Disease (PwP) may be at higher risk for complications from the Coronavirus Disease 2019 (Covid-19) due to older age and to the multi-faceted nature of Parkinson's Disease (PD) per se, presenting with a variety of motor and non-motor symptoms. Those on advanced therapies may be particularly vulnerable. Taking the above into consideration, along with the potential multi-systemic impact of Covid-19 on affected patients and the complications of hospitalization, we are providing an evidence-based guidance to ensure a high standard of care for PwP affected by Covid-19 with varying severity of the condition. Adherence to the dopaminergic medication of PwP, without abrupt modifications in dosage and frequency, is of utmost importance, while potential interactions with newly introduced drugs should always be considered. Treating physicians should be cautious to acknowledge and timely address any potential complications, while consultation by a neurologist, preferably with special knowledge on movement disorders, is advised for patients admitted in non-neurological wards. Non-pharmacological approaches, including the patient's mobilization, falls prevention, good sleep hygiene, emotional support, and adequate nutritional and fluid intake, are essential and the role of telemedicine services should be strengthened and encouraged.

摘要

帕金森病患者(PwP)由于年龄较大以及帕金森病(PD)本身的多方面性质,可能面临 2019 年冠状病毒病(Covid-19)并发症的更高风险,表现出各种运动和非运动症状。那些接受先进治疗的人可能特别脆弱。考虑到上述因素,以及 Covid-19 对受影响患者的潜在多系统影响以及住院治疗的并发症,我们提供了循证指导,以确保对病情轻重不一的受 Covid-19 影响的 PwP 患者提供高标准的护理。PwP 的多巴胺能药物的依从性非常重要,不应突然改变剂量和频率,同时应始终考虑与新引入的药物的潜在相互作用。治疗医生应谨慎注意并及时解决任何潜在的并发症,同时建议患有非神经科病房的患者咨询神经病学家,最好是具有运动障碍专业知识的神经病学家。非药物治疗方法,包括患者的活动、预防跌倒、良好的睡眠卫生、情感支持以及充足的营养和液体摄入,至关重要,应加强和鼓励远程医疗服务的作用。

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