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Review
. 2022 Jul 11;12(7):970.
doi: 10.3390/biom12070970.

COVID-19 and Parkinsonism: A Critical Appraisal

Francesco Cavallieri  1 , Valentina Fioravanti  1 , Francesco Bove  2 , Eleonora Del Prete  3 , Sara Meoni  4 , Sara Grisanti  5 , Marialuisa Zedde  1 , Rosario Pascarella  6 , Elena Moro  4 , Franco Valzania  1
Affiliations
Review

COVID-19 and Parkinsonism: A Critical Appraisal

Francesco Cavallieri et al. Biomolecules. .

Abstract

A few cases of parkinsonism linked to COVID-19 infection have been reported so far, raising the possibility of a post-viral parkinsonian syndrome. The objective of this review is to summarize the clinical, biological, and neuroimaging features of published cases describing COVID-19-related parkinsonism and to discuss the possible pathophysiological mechanisms. A comprehensive literature search was performed using NCBI's PubMed database and standardized search terms. Thirteen cases of COVID-19-related parkinsonism were included (7 males; mean age: 51 years ± 14.51, range 31-73). Patients were classified based on the possible mechanisms of post-COVID-19 parkinsonism: extensive inflammation or hypoxic brain injury within the context of encephalopathy (n = 5); unmasking of underlying still non-symptomatic Parkinson's Disease (PD) (n = 5), and structural and functional basal ganglia damage (n = 3). The various clinical scenarios show different outcomes and responses to dopaminergic treatment. Different mechanisms may play a role, including vascular damage, neuroinflammation, SARS-CoV-2 neuroinvasive potential, and the impact of SARS-CoV-2 on α-synuclein. Our results confirm that the appearance of parkinsonism during or immediately after COVID-19 infection represents a very rare event. Future long-term observational studies are needed to evaluate the possible role of SARS-CoV-2 infection as a trigger for the development of PD in the long term.

Keywords: COVID-19; Parkinson’s Disease; SARS-CoV-2; extrapyramidal; parkinsonism.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
See this image and copyright information in PMC

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