Nov. 05, 2020 -- One of the complications of COVID-19 may be the development of Parkinson's disease, new data suggests.
At least three case reports have been published of relatively young COVID-19 patients who developed Parkinson’s, either by itself or with other symptoms, within 2 to 5 weeks of contracting the disease. A fourth case has not yet been published.
The three published cases and possible explanation for how COVID-19 could cause Parkinson's are discussed in an article published online Oct. 21 in Trends in Neurosciences.
"If this link is real, we might be in for an epidemic of Parkinson's disease in the future," the lead author of the article, Patrik Brundin, MD, told Medscape Medical News.
Brundin is director of the Center for Neurodegenerative Science at Van Andel Research Institute in Grand Rapids, MI. Co-authors are Avindra Nath, MD, from the National Institute of Neurological Disorders and Stroke, and David Beckham, MD, associate professor of medicine–infectious disease at the University of Colorado Anschutz, in Aurora, CO.
They report that the three patients in the published cases were 35, 45, and 58 years old. All had severe respiratory infection that required hospitalization. For two of three patients, symptoms of Parkinson’s diminished when given traditional Parkinson’s drugs. The third patient recovered without medication.
In all cases, brain imaging revealed classic signs of Parkinson’s disease. None had a family history of Parkinson's disease or prodromal Parkinson’s, where patients do not have traditional signs of Parkinson’s but are at higher risk of developing it. . One patient underwent genetic testing and was not found to carry any Parkinson's risk variants.
"These cases of acute Parkinson's in patents with COVID-19 are truly remarkable," Brundin said. "They occurred in relatively young people ― much younger than the average age of developing Parkinson's ― and none had a family history or early signs of Parkinson's prodrome. That is quite a stunning observation."
He added: "Parkinson's is normally a very slowly developing disease, but in these cases, something happened quickly."
Brundin believes COVID-19 may make patients more likely to develop Parkinson's disease either sooner or later.
"It may be that a younger patient will recover from the infection but be left with neurological symptoms, such as brain fog and depression ― we know that this can happen in long-COVID. This is consistent with damage to the brain, and maybe Parkinson's disease will develop later."
He says that mounting evidence suggests COVID-19 can cause long-term effects, including neurologic problems, one of which could be Parkinson's disease.
"It does not appear to be just an acute condition which you survive or don't survive. There are many people for whom long-term outcomes may be affected," he commented.
If such serious conditions as Parkinson's are proven to be a complication of COVID-19, it is even more important for the population to avoid contracting the virus, he notes.
"This really should discourage the idea of trying to achieve herd immunity. It is a very bad idea to expose a large percentage of the population to a virus that we don't understand," Brundin stated. In the article, the authors say this could have "disastrous long-term implications."
The authors say that these cases do not prove that COVID-19 causes Parkinson’s disease.
"Possibly, the reported patients were destined to develop Parkinson's disease … and the viral infection only accelerated an ongoing neurodegenerative process around a critical timepoint.”
The authors say there is a growing number of reports of patients who developed Parkinson’s and later died from COVID-19. One such study of 43 patients found signs associated with Parkinson's disease.
Note: Brundin is supported by funding from the Van Andel Institute and the Farmer Family Foundation on projects related to infections and Parkinon's disease. He has received commercial support as a consultant or for research from Axial Biotherapeutics, Calico Life Sciences, CuraSen, Fujifilm-Cellular Dynamics International, Idorsia, IOS Press Partners, LifeSci Capital LLC, Lundbeck A/S, and Living Cell Technologies LTD, and Roche. He has ownership interests in Acousort AB and Axial Biotherapeutics and is on the steering committee of the NILO-PD trial.