新型冠状病毒肺炎合并帕金森病患者的临床特征及预后：中国上海一项基于医院的病例对照研究
Clinical characteristics and outcome of COVID-19 patients with Parkinson's disease: a hospital-based case-control study in Shanghai, China.
作者信息
Wu Li, Shen Jun, Jiang Yuhan, Shen Xiaolei, Wang Ping, Nie Xin, Kang Wenyan, Liu Jianren, Chen Wei
机构信息
Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Biostatistics Office of Clinical Research Unit, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Front Aging Neurosci. 2023 May 5;15:1138418. doi: 10.3389/fnagi.2023.1138418. eCollection 2023.
BACKGROUND
Clinical manifestations of Parkinson's disease (PD) after Corona Virus Disease 2019 (COVID-19) infection are poorly investigated.
OBJECTIVE
We aimed to explore the clinical features and outcomes of hospitalized PD patients with COVID-19.
METHODS
A total of 48 PD patients and 96 age-and sex-matched non-PD patients were included. Demographics, clinical characteristics and outcomes were compared between two groups.
RESULTS
PD patients with COVID-19 were elderly (76.69 ± 9.21 years) with advanced stage (H-Y stage 3-5 as 65.3%). They had less clinical symptoms (nasal obstruction, etc.), more proportions of severe/critical COVID-19 clinical classification (22.9 vs. 1.0%, < 0.001), receiving oxygen (29.2 vs. 11.5%, = 0.011), antibiotics (39.6 vs. 21.9%, = 0.031) therapies, as well as longer hospitalization duration (11.39 vs. 8.32, = 0.001) and higher mortality (8.3% vs. 1.0%, = 0.001) relative to those without PD. Laboratory results showed that the PD group had higher white blood cell counts (6.29 vs. 5.16*10, = 0.001), neutrophil-to-lymphocyte ratio (3.14 vs. 2.11, < 0.001) and C-reactive protein level (12.34 vs. 3.19, < 0.001).
CONCLUSION
PD patients with COVID-19 have insidious clinical manifestation, elevated proinflammatory markers and are prone to the development of severe/critical condition, contributing to a relatively poor prognosis. Early identification and active treatment of COVID-19 are pivotal to advanced PD patients during the pandemic.
背景
2019年冠状病毒病（COVID-19）感染后帕金森病（PD）的临床表现研究较少。
目的
我们旨在探讨住院的COVID-19合并PD患者的临床特征及预后。
方法
共纳入48例PD患者和96例年龄及性别匹配的非PD患者。比较两组的人口统计学、临床特征及预后。
结果
COVID-19合并PD患者年龄较大（76.69±9.21岁），处于晚期（H-Y分期3-5期占65.3%）。他们的临床症状较少（如鼻塞等），COVID-19临床分型为重型/危重型的比例更高（22.9% 对1.0%，P<0.001），吸氧比例更高（29.2% 对11.5%，P=0.011），接受抗生素治疗的比例更高（39.6% 对21.9%，P=0.031），住院时间更长（11.39天对8.32天，P=0.001），死亡率更高（8.3% 对1.0%，P=0.001）。实验室检查结果显示，PD组白细胞计数更高（6.29对5.16×10⁹/L，P=0.001），中性粒细胞与淋巴细胞比值更高（3.14对2.11，P<0.001），C反应蛋白水平更高（12.34对3.19，P<0.001）。
结论
COVID-19合并PD患者临床表现隐匿，促炎标志物升高，易发展为重型/危重型，预后相对较差。在疫情期间，早期识别和积极治疗COVID-19对晚期PD患者至关重要。
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