There is little evidence that having Parkinson's disease increases the risk of contracting COVID-19. Some researchers have even suggested that the antiviral effects of drugs prescribed for Parkinson's disease, such as amantadine (Symmetrel), may protect against infection, though there's scant proof of that.
Among people infected with COVID-19, early findings from a small pool of patients indicated that people with Parkinson's disease experienced significantly higher death rates than those who don't have the condition. But more recent research with larger sample sizes finds the death rate only slightly higher among people with Parkinson's disease than in the general population.
"Those who have had Parkinson's for longer periods, such as people older than 70, have more problems," says Alfonso Fasano, MD, PhD, chair in neuromodulation and multidisciplinary care at the University Health Network at the University of Toronto. "That's due not so much to the disease itself as to the often co-occurring conditions such as dementia or blood pressure control problems that develop over time in conjunction with Parkinson's disease."
But mortality is only one measure of COVID-19's effect. According to survey data from Fox Insight, an online study co-sponsored by the Michael J. Fox Foundation, most people with Parkinson's disease who came down with COVID-19 reported that their Parkinson's symptoms got worse. As many as 63 percent had new or worse motor symptoms, such as stiffness, tremors, and difficulty walking. But even more—75 percent of survey respondents—had new or worse nonmotor symptoms, including poor or worsening mood, cognitive difficulties, and fatigue.
Just as striking, motor symptoms worsened for 43 percent and nonmotor symptoms worsened for 52 percent of people with Parkinson's disease during the pandemic even if they didn't contract the virus. Many noted disruptions in their medical care, social activities, and exercise routines—all of which can be linked to worsening symptom severity.
To lessen the impact of the pandemic, consider these recommendations from movement disorder specialists.
Keep active. "It's well demonstrated that those who exercise regularly have a better experience with Parkinson's disease overall, a better response to therapy and medication, and a lower accrual of symptoms," says Alberto Espay, MD, FAAN, director of the University of Cincinnati's James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders. Type "Parkinson's exercises" into any search engine for online classes.
Get outside. "A lot of people are reporting increased anxiety and depression to the point that they're reluctant to go outdoors," says Janis Miyasaki, MD, FAAN, director of the Parkinson and Movement Disorders Program at the University of Alberta in Edmonton. Nature can help improve mood and shift your focus from yourself to the beauty of your surroundings. "We take for granted how awe-inspiring the world can be," Dr. Miyasaki says. Dr. Fasano observes that his patients with backyards have tended to fare better during the pandemic than those cooped up in apartments with no accessible outdoor area.
Meditate. Recent studies have found that stress-reducing mindfulness practices can help alleviate nonmotor symptoms such as anxiety and depression and even improve motor symptoms such as tremor, stiffness, and slow movements. Check online for courses offered remotely.
Stay connected. "It's vital to maintain social contacts," says Dr. Miyasaki. "Research shows that socializing is a potent mitigator of cognitive decline." If the weather is too cold to sit outdoors with friends, go online to play socially connected games on apps or join friends on Zoom to discuss a book you've read. For more about staying connected, read 6 Myths About Social Isolation.
Ask for online therapy. Many health care practitioners have adopted telemedicine, so ask your physical therapist if you can do one-on-one sessions online as well.
Find digital resources. Check out patient advocacy websites such as the Michael J. Fox Foundation and the Parkinson's Foundation for articles, podcasts, and webinars on topics like exercise. "Before the pandemic, we focused on local events, but now there's more opportunity to connect people with events in places like New York City or overseas," says Dr. Fasano.
Manage motivation. Parkinson's disease can make it tough to generate enthusiasm and make things happen. So enlist family or socially distanced friends to stop by and drag you out for regular walks or give you incentive to join online activities. "It's hard to do things alone," Dr. Fasano says. "Inviting a person inside your social bubble to participate online helps ensure it's not just you alone in front of your screen."
Stick to a routine. The COVID-19 pandemic has triggered stress by disrupting normal routines and eroding a sense of control. To regain that feeling of control, Dr. Fasano recommends that you go to bed and eat meals at the same time each day if possible.