Objective: To analyze causes of mortality and death certification in Parkinson’s disease patients who had SARS- CoV2 in Reading, West Berkshire, United Kingdom (UK)

Background: Scanty data is available regarding the incidence and causes of mortality in Parkinson’s disease (PD) patients affected with Covid 19.Parkinson’s patients usually have respiratory failure due to aspiration pneumonia related to dysphagia. On the other hand, mortality from Covid has been extensively reviewed and is also associated with ‘cytokine storm’as well as VTE ( venous thromboembolism ).

Method: Parkinson’s patients who had a positive PCR swab for SARS-CoV2 in the period September 2020 to May 2021 were identified by the Hospital Informatics system. Demographic and clinical data was collected from EPR (Electronic Patient Record) and transported to an excel sheet for analysis. The cause of death (COD) was ascertained from online GP records, MCCD (Medical Certificate for cause of Death) as well as Hospital EPR records.

Results: 60% (21/35) had died at the time of assessment in December 2021. The average of patients at the time of death was 82 years (69 – 95 years). 78% (16/21) were male.57 %( 12/21) of the patients were diagnosed in hospital with 90% (11/12) testing positive after 48 hrs of hospitalization, suggesting a Hospital acquired COVID 19 infection. Incidental COVID 19 was detected in 72 %(13/21).80 %( 16/21) of the patients died in the first 3 months of the diagnosis with an overwhelming number of deaths in the hospital compared to the community. The death certificates of 20 patients were reviewed. In 61% (13/21) the cause of death (I a) was unsurprisingly COVID Pneumonitis followed by Aspiration Pneumonia in 30% ( 6/21) .Parkinson’s as a contributor to the death was mentioned in 70 % (14/20)  under Part II.

Conclusion: A high incidence of mortality was noted in Parkinson’s patients who had COVID 19 infection in the second wave of the pandemic in Reading, West Berkshire. Incidental detection and Hospital acquired Covid 19 was more common in the second wave nationally. This also points towards importance of having barrier protective measures (adequete PPE) in place. The cause of death was related to worsening Covid pneumonitis and aspiration pneumonia, the latter being a common cause of death in Parkinson’s. Education of doctors regarding the correct documentation in MCCD is essential, particularly in recording PD as a cause of death.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/mortality-in-parkinsons-patients-following-covid19-infection-in-the-second-wave-of-the-pandemic/