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. 2025 May;32(5):e70013.
doi: 10.1111/ene.70013.

Impact of COVID-19 on long-term outcomes in Parkinson's disease

Roham Hadidchi  1 , Yousef Al-Ani  1 , Hannah Piskun  1 , Rachel Pakan  1 , Katie S Duong  1 , Hasan Jamil  1 , Stephen H Wang  1   2 , Sonya Henry  1 , Carine W Maurer  3 , Tim Q Duong  1   4
Affiliations

Impact of COVID-19 on long-term outcomes in Parkinson's disease

Roham Hadidchi et al. Eur J Neurol. 2025 May.

Abstract

Objectives: Patients with pre-existing Parkinson's disease (PD) face higher risks of severe acute COVID-19 outcomes than matched controls, but long-term post-COVID-19 outcomes remain largely unknown. This study investigated clinical outcomes up to 3.5 years post-infection in a Bronx inner-city PD population.

Methods: This retrospective study evaluated 3512 patients with PD in the Montefiore Health System (January 2016-July 2023), which serves a large diverse population and was an epicenter of the early COVID-19 pandemic and subsequent infection surges. Comparisons were made with PD patients without a positive SARS-CoV-2 test (defined by polymerase chain reaction test). Outcomes were post-index date all-cause mortality, major adverse cardiovascular events (MACE), altered mental status, fatigue, dyspnea, headache, psychosis, dementia, depression, anxiety, dysphagia, falls, and orthostatic hypotension. Changes in Levodopa prescriptions were also tabulated. Adjusted hazard ratios (aHR) were computed accounting for competing risks.

Results: PD patients with COVID-19 had similar demographics but a higher prevalence of pre-existing comorbidities compared to PD patients without COVID-19. PD patients with COVID-19 had greater risk of mortality (aHR = 1.58 [95% CI: 1.03, 2.41]), MACE (aHR = 1.57 [1.19, 2.07]), dyspnea, fatigue, and fall compared to PD patients without COVID-19. Levodopa dose adjustment was higher post-infection in the COVID-19 cohort.

Conclusions: Among PD patients, COVID-19 was associated with a higher risk of adverse long-term outcomes. PD patients who survive COVID-19 may benefit from heightened clinical awareness and close follow-up. Findings highlight the need to improve post-COVID care for PD patients to mitigate disease progression and maintain quality of life.

Keywords: Parkinson's disease; long COVID.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of patient selection.
FIGURE 2
FIGURE 2
Kaplan–Meier curve of all‐cause mortality 14 days or more post‐index date between COVID‐19 and non‐COVID patients with PD.
FIGURE 3
FIGURE 3
Cumulative incidence curves of outcomes (post‐index date in months). MACE, major adverse cardiovascular events.
See this image and copyright information in PMC

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