Objective: Characterize the risk of seven acute medical events in persons with advanced Parkinson’s disease (PD) using real world data before and within 12 months after the onset of the COVID-19 pandemic in the US.

Background: Individuals with PD can have multiple comorbidities due to the nature of PD, side effects of medications and advanced age. Reports suggest the COVID-19 pandemic may have exacerbated PD symptoms and other PD related comorbidities. Our analysis sought to examine the impact of COVID-19 on differences in the rates of acute medical events in those with advanced PD.

Method: A cohort study was conducted using a US medical and pharmacy claims database. The advanced PD cohort consisted of those: aged 30+ years; both sexes; ≥2 claims with diagnosis codes ICD-10 G20 or ICD-9 332.0 for Parkinson’s disease; therapy for advanced disease (≥30 days average daily oral dose of levodopa or levodopa-containing medication equivalent dose of  ≥600 – <800 mg with any rescue medication; 800+ mg with or without rescue medication; levodopa intestinal infusion; or deep brain stimulation); and alive through both study periods. Those with concomitant neurodegenerative disease were excluded. Medical events studied were acute myocardial infarction, falls, hallucinations, pulmonary embolism, pneumonia, stroke, and suicidality. COVID-19 positivity was defined as laboratory-confirmed infection coded as ICD-10, U07.1. The “pre-“ COVID-19 pandemic period was defined as 1/1/2019 to 12/31/2019; the “post” period was 1/1/2020 to 12/31/2020.

Results: The study cohort consisted of 26,789 persons with advanced Parkinson’s disease (mean age: 74; 64% male; 5% COVID-19-positive). In the post period, this cohort had significantly (p<0.01) higher likelihood of all events studied, except suicidality, than the pre-period (odds ratio [OR] range: mood disorders, 1.12 to hallucinations, 1.58). [table1] COVID-19-positive individuals had significantly (p<0.01) increased risk of all events studied than those who were COVID-19 negative (OR range: hallucinations 1.54, to pneumonia 5.86). [table2]

Conclusion: These data show that the COVID-19 pandemic impacted the health of the general population of persons with advanced Parkinson’s disease and support the need for continued study.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-covid-19-pandemic-impact-on-advanced-parkinsons-disease-in-the-us/