Post-covid Parkinsonism and Response to Levodopa: A Case Report
Archives of Advances in Biosciences,
Vol. 14 No. 1 (2023),
19 February 2023
,
Page 1-5
https://doi.org/10.22037/aab.v14i1.41183
Abstract
Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) invades many organs including central nervous system through olfactory nerves and hematogenic pathways causing many disorders ranging from mild to severe. In what follows, we discuss a post-covid Parkinsonism case in a previously healthy 59-year-old man one week after mild covid infection.
Case presentation: A 59-year-old man presented with symmetric resting tremor, symmetric rigidity, festinating gait and balance difficulty with a history of COVID-19 one week before admission. Examination was notable for Parkinsonism. Lab tests and MRI were normal. Eight months after starting with levodopa-benserazid, pramipexole, trihexiphenidyl, vitC, vitE and COQ10, the patient had a complete resolution of all symptoms.
Conclusion: Several cases report post-covid Parkinsonism in previously healthy patients with no family history of parkinson’s disease. The age of patients with post-covid Parkinsonism ranged from 35-74 with mild, moderate, or severe symptoms of covid. The most common complaint of patients was tremor and most of them had a significant response to levodopa. Our patient and those mentioned in the case reports did not have any family history of Parkinson’s disease and used to be healthy. These data obtained from case reports indicate that there might be a possible link between covid infection and acute Parkinsonism.
- Covid19
- Neurological sequel
- Parkinsonism
- Post covid
How to Cite
References
Fishman PS, Gass JS, Swoveland PT, Lavi E, Highkin MK, Weiss SR. Infection of the basal ganglia by a murine coronavirus. Science. 1985; 229(4716):877-9. [DOI: 10.1126/science.2992088]
Guerrero JI, Barragán LA, Martínez JD, Montoya JP, Peña A, Sobrino FE, et al. Central and peripheral nervous system involvement by COVID-19: a systematic review of the pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings. BMC Infect Dis. 2021; 21(1):515. [DOI: 10.1186/s12879-021-06185-6] [PMID] [PMCID]
Kai H, Kai M. Interactions of coronaviruses with ACE2, angiotensin II, and RAS inhibitors-lessons from available evidence and insights into COVID-19. Hypertens Res. 2020; 43(7):648-54. [DOI: 10.1038/s41440-020-0455-8] [PMID] [PMCID]
Wang MY, Zhao R, Gao LJ, Gao XF, Wang DP, Cao JM. SARS-CoV-2: structure, biology, and structure-based therapeutics development. Front Cell Infect Microbiol. 2020; 10:587269. [DOI: 10.3389/fcimb.2020.587269] [PMID] [PMCID]
Yang L, Han Y, Nilsson-Payant BE, Gupta V, Wang P, Duan X, et al. A human pluripotent stem cell-based platform to study SARS-CoV-2 tropism and model virus infection in human cells and organoids. Cell Stem Cell. 2020; 27(1):125-36.e7. [DOI: 10.1016/j.stem.2020.06.015] [PMID] [PMCID]
Beauchamp LC, Finkelstein DI, Bush AI, Evans AH, Barnham KJ. Parkinsonism as a Third wave of the COVID-19 pandemic? J Parkinsons Dis. 2020; 10(4):1343-53. [DOI: 10.3233/JPD-202211] [PMID] [PMCID]
Mahdizade Ari M, Mohamadi MH, Shadab Mehr N, Abbasimoghaddam S, Shekartabar A, Heidary M, et al. Neurological manifestations in patients with COVID-19: a systematic review and meta-analysis. J Clin Lab Anal. 2022; 36(5):e24403. [DOI: 10.1002/jcla.24403] [PMID] [PMCID]
Méndez-Guerrero A, Laespada-García MI, Gómez-Grande A, Ruiz-Ortiz M, Blanco-Palmero VA, Azcarate-Diaz FJ, et al. Acute hypokinetic-rigid syndrome following SARS-CoV-2 infection. Neurology. 2020; 95(15):e2109-18. [DOI: 10.1212/WNL.0000000000010282] [PMID]
Rao AR, Hidayathullah SM, Hegde K, Adhikari P. Parkinsonism: an emerging post COVID sequelae. IDCases. 2022; 27:e01388. [DOI: 10.1016/j.idcr.2022.e01388] [PMID] [PMCID]
Akilli NB, Yosunkaya A. Part of the Covid19 puzzle: acute parkinsonism. Am J Emerg Med. 2021; 47:333.e1-333.e3. [DOI: 10.1016/j.ajem.2021.02.050] [PMID] [PMCID]
Hawkes CH, Del Tredici K, Braak H. Parkinson's disease: a dual-hit hypothesis. Neuropathol Appl Neurobiol. 2007; 33(6):599-614. [DOI: 10.1111/j.1365-2990.2007.00874.x] [PMID] [PMCID]
Tsai HH, Liou HH, Muo CH, Lee CZ, Yen RF, Kao CH. Hepatitis C virus infection as a risk factor for Parkinson disease: a nationwide cohort study. Neurology. 2016; 86(9):840-6. [DOI: 10.1212/WNL.0000000000002307] [PMID]
Simon DK, Tanner CM, Brundin P. Parkinson disease epidemiology, pathology, genetics, and pathophysiology. Clin Geriatr Med. 2020; 36(1):1-12. [DOI: 10.1016/j.cger.2019.08.002] [PMID] [PMCID]
Schapira AH. Etiology and pathogenesis of Parkinson disease. Neurol Clin. 2009; 27(3):583-603. [DOI 10.1016/j.ncl.2009.04.004] [PMID]
Schapira AH. Etiology and pathogenesis of Parkinson disease. Neurol Clin. 2009 Aug;27(3):583-603, v. doi: 10.1016/j.ncl.2009.04.004. PMID: 19555823.
Guan J, Lu Z, Zhou Q. Reversible parkinsonism due to involvement of substantia nigra in Epstein-Barr virus encephalitis. Mov Disord. 2012; 27(1):156-7. [DOI: 10.1002/mds.23935] [PMID]
Barukčić I. Epstein barr virus and
Parkinson’s disease-a causal link? [DOI:10.5281/zenodo.4514014]
Tsivgoulis G, Palaiodimou L, Katsanos AH, Caso V, Köhrmann M, Molina C, et al. Neurological manifestations and implications of COVID-19 pandemic. Ther Adv Neurol
Disord. 2020; 13:1756286420932036. [DOI: 10.1177/1756286420932036] [PMID] [PMCID]
Scherbaum R, Kwon EH, Richter D, Bartig D, Gold R, Krogias C, et al. Clinical profiles and mortality of COVID-19 inpatients with Parkinson's disease in Germany. Mov Disord. 2021; 36(5):1049-57. [DOI: 10.1002/mds.28586] [PMID] [PMCID]
Faber I, Brandão PRP, Menegatti F, de Carvalho Bispo DD, Maluf FB, Cardoso F. Coronavirus disease 2019 and Parkinsonism: a non-post-encephalitic case. Mov Disord. 2020; 35(10):1721-2. [DOI: 10.1002/mds.28277] [PMID] [PMCID]
Méndez-Guerrero, A., et al., Acute hypokinetic-rigid syndrome following SARS-CoV-2 infection. Neurology, 2020. 95(15): p. e2109-e2118.
Cohen ME, Eichel R, Steiner-Birmanns B, Janah A, Ioshpa M, Bar-Shalom R, et al. A case of probable Parkinson's disease after SARS-CoV-2 infection. Lancet Neurol. 2020; 19(10):804-5. [DOI: 10.1016/S1474-4422(20)30305-7] [PMID] [PMCID]
Akilli, N.B. and A. Yosunkaya, Part of the Covid19 puzzle: Acute parkinsonism. The American Journal of Emergency Medicine, 2021. 47: p. 333. e1-333. e3.
Makhoul K, Jankovic J. Parkinson's disease after COVID-19. J Neurol Sci. 2021; 422:117331. [DOI: 10.1016/j.jns.2021.117331] [PMID] [PMCID]
Roy D, Song J, Awad N, Zamudio P. Treatment of unexplained coma and hypokinetic-rigid syndrome in a patient with COVID-19. BMJ Case Rep. 2021; 14(3):e239781. [DOI: 10.1136/bcr-2020-239781] [PMID] [PMCID]
Fearon C, Mikulis DJ, Lang AE. Parkinsonism as a Sequela of SARS-CoV-2 infection: pure hypoxic injury or additional Covid-19-related response? Mov Disord. 2021; 36(7):1483-4. [DOI: 10.1002/mds.28656] [PMID] [PMCID]
Hawkes, C.H., K. Del Tredici, and H. Braak, Parkinson's disease: a dual‐hit hypothesis. Neuropathology and applied neurobiology, 2007. 33(6): p. 599-614.
Ghosh R, Ray A, Roy D, Das S, Dubey S, Benito-León J. Parkinsonism with akinetic mutism following osmotic demyelination syndrome in a SARS-CoV-2 infected elderly diabetic woman: a case report. Neurologia. 2022; 37(8):706-8. [DOI: 10.1016/j.nrl.2021.09.007] [PMID] [PMCID]
Ayele BA, Demissie H, Awraris M, Amogne W, Shalash A, Ali K, et al. SARS-COV-2 induced Parkinsonism: the first case from the sub-Saharan Africa. Clin Park Relat Disord. 2021; 5:100116. [DOI: 10.1016/j.prdoa.2021.100116] [PMID] [PMCID]
Cavallieri F, Fioravanti V, Toschi G, Grisanti S, Napoli M, Moratti C, et al. COVID-19 and Parkinson's disease: a casual association or a possible second hit in neurodegeneration? J Neurol. 2022; 269(1):59-61. [DOI: 10.1007/s00415-021-10694-4] [PMID] [PMCID]
Ong TL, Nor KM, Yusoff Y, Sapuan S. COVID-19 associated acute necrotizing Encephalopathy presenting as Parkinsonism and Myorhythmia. J Mov Disord. 2022; 15(1):89-92. [DOI: 10.14802/jmd.21063] [PMID] [PMCID]
Rao, A.R., et al., Parkinsonism: An emerging post COVID sequelae. IDCases, 2022. 27: p. e01388.
Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A, et al. Neurological associations of COVID-19. Lancet Neurol. 2020; 19(9):767-83. [DOI: 10.1016/S1474-4422(20)30221-0] [PMID] [PMCID]
Boura I, Chaudhuri KR. Coronavirus disease 2019 and related Parkinsonism: the clinical evidence thus far. Mov Disord Clin Pract. 2022; 9(5):584-93. [DOI: 10.1002/mdc3.13461] [PMID] [PMCID]
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