Risk of Hospitalization and Death for COVID-19 in People with Parkinson's Disease or Parkinsonism

Mov Disord. 2021 Jan;36(1):1-10. doi: 10.1002/mds.28408. Epub 2020 Dec 2.


Background: The risk of COVID-19 and related death in people with Parkinson's disease or parkinsonism is uncertain. The aim of the study was to assess the risk of hospitalization for COVID-19 and death in a cohort of patients with Parkinson's disease or parkinsonism compared with a control population cohort, during the epidemic bout (March-May 2020) in Bologna, northern Italy.

Methods: Participants of the ParkLink study with the clinical diagnosis of Parkinson's disease or parkinsonism and people anonymously matched (ratio 1:10) for sex, age, district, and Charlson Index were included. The hospital admission rate for COVID-19 (February 26-May 31, 2020) and the death rate for any cause were the outcomes of interest.

Results: The ParkLink cohort included 696 subjects with Parkinson's disease and 184 with parkinsonism, and the control cohort had 8590 subjects. The 3-month hospitalization rate for COVID-19 was 0.6% in Parkinson's disease, 3.3% in parkinsonism, and 0.7% in controls. The adjusted hazard ratio (age, sex, district, Charlson Index) was 0.8 (95% CI, 0.3-2.3, P = 0.74) in Parkinson's disease and 3.3 (1.4-7.6, P = 0.006) in parkinsonism compared with controls. Twenty-nine of the infected subjects died; 30-day fatality rate was 35.1%, without difference among the 3 groups. Six of 10 Parkinson's disease/parkinsonism patients had the infection during hospitalization or in a nursing home.

Conclusions: Parkinson's disease per se probably is not a risk factor for COVID-19 hospitalization. Conversely, parkinsonism is an independent risk factor probably because of a more severe health status, entailing higher care dependence and placement in high-infection-risk accommodations. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Keywords: COVID-19; Parkinson's disease; cohort studies; frail elderly; parkinsonism.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / complications
  • COVID-19 / epidemiology*
  • COVID-19 / mortality
  • Cohort Studies
  • Female
  • Frail Elderly
  • Hospitalization / statistics & numerical data
  • Humans
  • Italy / epidemiology
  • Length of Stay
  • Male
  • Middle Aged
  • Nursing Homes
  • Parkinson Disease / complications
  • Parkinson Disease / epidemiology*
  • Parkinson Disease / mortality
  • Parkinsonian Disorders / complications
  • Parkinsonian Disorders / epidemiology*
  • Parkinsonian Disorders / mortality
  • Patient Admission / statistics & numerical data
  • Risk