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"COVID 19 and Parkinson's Disease"

"COVID 19 and Parkinson's Disease"

We are all quite familiar with the name of the new Virus COVID-19. We will not discuss all the aspect that how it happened or the source of the virus and all those kinds of stuff. COVID 19 and Parkinson’s Disease.

No need to worry much. It is important to understand that the risk of COVID-19 varies depending on where you live in the country. 

Here we will only discuss the precaution for protecting ourselves from pandemic COVID-19, especially when it comes to Parkinson’s disease.

 

Seniors are the most vulnerable. Since most of Parkinson’s people are senior-most. So we want you to be prepared for COVID-19 and Parkinson’s disease.

COVID-19 is primarily a viral respiratory illness.

It enters the body through the respiratory system. 

This is in a milder form in healthy individuals but becomes more virulent and aggressive in patients with co-morbid diseases, like diabetes, cardiac disease, renal disease, and hypertension.

COVID-19 & Parkinson's Disease

As it is very new, we have very little information about their impact on Parkinson’s disease.

However, we can use some predictive methods, e.g. impact of other viral diseases on PD, the impact of any other illness on PD and make some observations and assumptions.

I have put this blog based on the available scientific data that I could find in this regards,

We can categories in three different parts:

  1. Normal PD people
  2. PD people with other respiratory illnesses
  3. PD people with other chronic diseases and COVID-19

PD people with other respiratory illnesses

Motor and non-motor symptoms of PD people can be worsened by any medical illness, even a viral respiratory illness like COVID-19.

It’s mean that in addition to the respiratory symptoms of the virus, Parkinson’s people may feel slower and stiffer and even their medications don’t seem to be working as well.

Recovery from the illness can be led down. It would be reasonable to understand that anyone with PD who contracts COVID-19 could experience these complications as well.

PD people with other chronic diseases and COVID-19

A wide range of clinical reactions to COVID-19 infection – from very mild to severe. Most people who contract the virus will recover fully.

Older people with underlying health problems, such as asthma, heart disease or diabetes, are more susceptible to COVID-19 (which is in line with what is seen with many other infections).

The age at which susceptibility begins to increase is evolving as we learn more about the disease. Regardless, most people with PD will fit into the demographic of “older adults”.

PD people without any co-morbidities and COVID-19

PD people may be wondering if PD is an underlying medical problem that increases his or her risk beyond that of other people of the same age. 

This is a difficult question to answer since PD is such a variable illness and each person is different.

If you have mild symptoms of Parkinson’s disease and are healthy and fit otherwise, you may not have an increased risk from COVID-19. Practically, however, we do not have enough clinical data yet to be sure of that.

However, we can use the information available to us from other parallel situations. In one research report, Prof. Kailash Bhatia, from London, reviewed the impact of illness on PD.

They found that during the course of any illness, including viral fever, the efficacy of anti PD medications reduces, i.e. the patient requires more medications to achieve the control of the disease.

We have also found this in our clinical practice. Patients who are coming to Jaslok Hospital, are aware, that we insist on them being infection-free (even from infections like dental carries or urinary tract) before we undertake their treatment, Deep brain stimulation surgery or even postoperative programming.

One of the reasons for this phenomenon is the downregulation of dopamine receptors making them less responsive to medications. However, the more common causes (Ummera et al, 2014) are dosing errors due to illness, concomitant antidopaminergic drugs (antiemetics), etc. and this can be easily prevented.

People with more moderate PD may start to experience decreased mobility, with more risk of falls. As advanced PD it can cause additional problems including swallowing difficulties, urinary dysfunction, and weight loss.

All of these points can contribute to general weakness and therefore increased risk of infection, including increased risk from COVID-19.

All things considered, it is very good practice for Parkinson’s people, either because of age or because of their underlying PD, to consider themselves at increased risk from COVID-19. 

Step by step to prevent contracting COVID-19

  • Avoid close contact with people who are sick.
  • Maintain a minimum of 3 feet’ distance between the persons.
  • Frequent hand washing is the best way to stop transmission of this and most other viruses.
  • Stop touching your face by hand, especially your eyes, nose, and mouth.
  • Stay home when you are sick. Now home is the best place to stay safe.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash immediately.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipes.

When to wear a mask

1. If you are healthy, no need to wear a mask. Normally we are not comfortable carrying a mask all the time. You only need to wear a mask, if you are taking care of a person with COVID-19 infection. However, you are at potentially high risk and if you are going to interact with other people or travel in an elevator, public place or public transport, you should protect yourself.

  1. You should wear a mask if you are coughing or sneezing. You should behave, a responsible social person, not to spread infection with others.
  2. If you are wearing a mask then you please know how to use it and the right way to dispose of the proper place.
    4. Know the right way to wear a mask
  • Before using the mask on face, clean your hands with alcohol-based hand rub or soap & water.
  • Cover mouth and nose and make sure that there is no gap between your face and the mask.
  • After using the mask, stop touching the mask again and again for adjusting the mask. If you touch then first rub your hand with alcohol-based sanitizer or clean your hand by soap and water, then adjust your mask. Do not reuse a similar single mask again and again.
  • While removing the mask, remove it from back, do not touch the front part of the mask, and discard at close-bin, please.

What should I take more precautions, because I am Parkinson’s patient?

Whatever the tips are discussed on top, it is wise to consider for Parkinson’s people.

Yes, being a Parkinson’s patient, you have to take extra precautions to reduce the risk of getting sick with the COVID-19.

COVID-19 and Parkinson's Disease

Our suggestions for Especially for Parkinson’s patients or caregiver of PD patient

1) Stock up your medicine for 1 month.

2) Stop going out for a morning walk or evening walk.

3) Stop engaging in Social gathering as of now

4) Maintain a good social distance.

5) Spend some quality time with your family.

6) Kindly avoid non-essential travel.

7) If you are older PD people then strictly stay only at home, do not go outside even not for morning or evening walk.

8) Practice meditation twice or more daily.

9) Practice your hobby at this time

10) Eat only home-made food, avoid outside foods.

11) Avoid reading that news which can affect your mental wellbeing. You have to be smart to take the right precautions to protect ourselves.

12) Before having any food, wash your hand and directly touch your food plate, not anywhere else.

13) Avoid people who have travel -history in recent times.

14) If any person or caregiver is suffering from any sort of cold or cough, please stay in at a separate room, avoid contact with elderly Parkinson’s people.

15) If you feel to touch your face, use with alcohol-based hand rub, then touch your face.

16) Once you have worn any clothes for outside, even for a short distance, after returning home, discard at proper place and wash it. Do not think to re-wear the used clothes again.   

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