Parkinson’s disease, what risks with Covid and the telltale symptom

James Parkinson in 1817 in his book entitled Essay on the  Shaking Palsy describes a painting that will later be destined to take his name. It is what is called “the disease of great men” and we must not think that it affects only the elderly.

The main symptom Parkinson’s disease is slowness of movement (about 30% of patients do not have tremor) and pain can be the first sign of the disease.

On the occasion of the World Day dedicated to pathology, scheduled for November 27, the experts of the Italian society of Neurology explain how to behave in the era of Covid-19. The National Parkinson Day is organized by the LIMPE-DISMOV Academy (the scientific association of reference in Italy for Parkinson’s disease) belonging to the Italian Society of Neurology, together with the LIMPE Foundation for Parkinson’s Onlus.

The impact of the disease on sufferers and family members

“It is believed that the risk of contract Covid-19 in people suffering from Parkinson’s disease and other parkinsonisms does not differ from the general population – reports Prof. Alfredo Berardelli, President of the Italian Society of Neurology – Recent studies and metanalytical evidence indicate that the risk of hospitalization (about 50%) and death (about 10%) of these patients once they have contracted Covid-19, mainly depends on age, generally advanced and on possible comorbidities “.

Instead, they turned out to be relevant the indirect consequences of Covid-19 such as, for example, the difficulties, and in some cases the unavailability, in accessing medical and physiotherapy treatments during periods of mobility restrictions, which undoubtedly represented a further burden in the clinical management of patients with Parkinson’s and Parkinsonism, including those who had not contracted Covid-19.

“It is important to underline – concludes Berardelli – that the scientific evidence available to date does not contraindicate the use of anti-Covid-19 vaccines in the population of people affected by Parkinson’s disease and other parkinsonisms. For this reason, vaccination of all patients is recommended ”.

How Parkinson’s develops

Parkinson’s disease is a neurodegenerative disorder which today affects 5 million people in the world, of which over 300,000 in Italy alone, and which occurs on average around 60 years of age.

It is estimated that this number is destined to increase in our country and that in the next 15 years there will be 6,000 new cases every year, of which half will be affected in working age. The clinical picture of the disease is classically identified by slowness in movements (called in scientific term bradykinesia), rigidity and tremor, even if the latter is not always present.

Symptoms are related to degeneration and cell death of a small area of ​​the brain called “Black substance” which is the area capable of producing a neurotransmitter, dopamine, involved in the “control” of movement. Symptoms do not always present an equal intensity causing, in relation to the prevalence of one over the other, the onset of different clinical forms.

The disability induced by Parkinson’s disease not only correlates with the “movement disorder” but can also involve other systems such as the cardiovascular, gastrointestinal, urinary systems. There is a great variability in the evolution of the disease and in the degree of disability of patients: the course is generally defined as “chronic-progressive”, but it is possible to recognize protracted phases of stabilization of the picture especially if the patient is carefully treated and controlled .

The diagnosis of “idiopathic Parkinson’s disease” is essentially based on clinical criteria, instrumental tests can be useful to exclude many other pathologies that may have the same symptoms of the disease even if they have a different genesis.

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