Boura Iro, Qamar Mubasher A, Daddoveri Francesco, Leta Valentina, Poplawska-Domaszewicz Karolina, Falup-Pecurariu Cristian, Ray Chaudhuri K
Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5 Cutcombe Road, London SE5 9RX, UK.
Biomedicines. 2023 Sep 13;11(9):2524. doi: 10.3390/biomedicines11092524.
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has been discussed in the context of Parkinson's disease (PD) over the last three years. Now that we are entering the long-term phase of this pandemic, we are intrigued to look back and see how and why the community of patients with PD was impacted and what knowledge we have collected so far. The relationship between COVID-19 and PD is likely multifactorial in nature. Similar to other systemic infections, a probable worsening of PD symptoms secondary to COVID-19, either transient or persistent (long COVID), has been demonstrated, while the COVID-19-related mortality of PD patients may be increased compared to the general population. These observations could be attributed to direct or indirect damage from SARS-CoV-2 in the central nervous system (CNS) or could result from general infection-related parameters (e.g., hospitalization or drugs) and the sequelae of the COVID-19 pandemic (e.g., quarantine). A growing number of cases of new-onset parkinsonism or PD following SARS-CoV-2 infection have been reported, either closely (post-infectious) or remotely (para-infectious) after a COVID-19 diagnosis, although such a link remains hypothetical. The pathophysiological substrate of these phenomena remains elusive; however, research studies, particularly pathology studies, have suggested various COVID-19-induced degenerative changes with potential associations with PD/parkinsonism. We review the literature to date for answers considering the relationship between SARS-CoV-2 infection and PD/parkinsonism, examining pathophysiology, clinical manifestations, vaccination, and future directions.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）可导致2019冠状病毒病（COVID-19），在过去三年里一直是帕金森病（PD）领域的讨论话题。如今我们正步入这场大流行的长期阶段，不禁回首审视PD患者群体是如何以及为何受到影响，以及我们目前已收集到哪些相关知识。COVID-19与PD之间的关系可能具有多因素性质。与其他全身感染类似，已证实COVID-19继发的PD症状可能会暂时或持续（长期新冠）加重，而与一般人群相比，PD患者的COVID-19相关死亡率可能会增加。这些观察结果可能归因于SARS-CoV-2对中枢神经系统（CNS）的直接或间接损害，也可能是由一般感染相关因素（如住院或药物）以及COVID-19大流行的后遗症（如隔离）导致的。尽管这种关联仍属假设，但已有越来越多SARS-CoV-2感染后新发帕金森症或PD的病例报告，这些病例在COVID-19诊断后不久（感染后）或间隔一段时间（感染旁）出现。这些现象的病理生理基础仍不明确；然而，研究，尤其是病理学研究，已提出了各种由COVID-19引起的退行性变化，这些变化可能与PD/帕金森症存在潜在关联。我们回顾迄今为止的文献，以探寻SARS-CoV-2感染与PD/帕金森症之间关系的答案，审视病理生理学、临床表现、疫苗接种及未来方向。
