Objective: Our study aimed to evaluate PD patients’ perception regarding clinical aspects, physical activity and restricted access to medication during the pandemic.

Background: Several countries have implemented restrictive measures and social isolation since Covid 19 pandemic onset (1,2). PD patients may have been considerably affected due to restricted access to regular therapies (3,4,5,6)

Method: This is a non-experimental, cross-sectional, quantitative and descriptive study. Patients included were followed at the Movement Disorder Outpatient Clinic of the Hospital Geral de Fortaleza, a tertiary care center in the Northeast of Brazil. They were evaluated using a questionnaire containing 15 questions.

Results: We interviewed a total of 158 PD patients. The mean age was 64.1 ± 11 years. Regarding the duration of the disease, 17% had less than 5 years of onset, 39.3% between 6 and 10 years of disease, and 43.7% over 10 years from the beginning of symptoms. All patients were aware of the pandemic and respected social isolation. Only 18.4% of the patients presented symptoms of COVID and 31% of them had access to diagnostic tests. Subjective anosmia or hyposmia was referred by 27.2% of the patients before the pandemic and 6.1% of the others presented this symptom at some point during the pandemic. From the 45 patients who continued to exercise, 62,2% did not perceive clinical worsening, but this finding was not statistically significant comparing to those who stopped. Exercising was interrupted in 71.5% of responders. From the 75 patients who reported some PD worsening, stiffness was the symptom most often reported (24.1%). Difficulties in regular medication access was present in 37.3% of cases. Of these, 55.9% reported PD symptoms worsening, but without significant difference when compared to patients who did not have treatment interruptions. These findings may be related to a lower functional demand for these patients due to the pandemic or a misperception by the patients of their own symptoms, since objective measurements of motor performance were not properly evaluated.

Conclusion: There was no significant difference on perception of PD symptoms worsening related to physical activity restriction during COVID pandemic. Most patients had no difficulty in accessing their medications and, among those who had, there was no significant worsening of symptoms.

References: 1. Prasad S, Holla VV, Neeraja K, Surisetti BK, Kamble N, Yadav R, Pal PK. Parkinson’s Disease and COVID-19: Perceptions and Implications in Patients and Caregivers. Mov Disord. 2020 Jun;35(6):912-914. 2. Helmich RC, Bloem BR. The Impact of the COVID-19 Pandemic on Parkinson’s Disease: Hidden Sorrows and Emerging Opportunities. J Parkinsons Dis. 2020;10(2):351-354. 3. Fasano A, Antonini A, Katzenschlager R, Krack P, Odin P, Evans AH, Foltynie T, Volkmann J, Merello M. Management of Advanced Therapies in Parkinson’s Disease Patients in Times of Humanitarian Crisis: The COVID-19 Experience. Mov Disord Clin Pract. 2020 May 4;7(4):361-372. 4. Papa SM, Brundin P, Fung VSC, Kang UJ, Burn DJ, Colosimo C, Chiang HL, Alcalay RN, Trenkwalder. Impact of the COVID-19 Pandemic on Parkinson’s Disease and Movement Disorders. Mov Disord. 2020 May;35(5):711-715. 5. Pavel A, Murray DK, Stoessl AJ. COVID-19 and selective vulnerability to Parkinson’s disease. Lancet Neurol. 2020 Sep;19(9):719. 6. Cheong JL, Goh ZHK, Marras C, Tanner CM, Kasten M, Noyce AJ. The Impact of COVID-19 on Access to Parkinson’s Disease Medication. Mov Disord. 2020 Dec;35(12):2129-2133.

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