Risk of hospitalization and death for COVID-19 in people with Parkinson's disease or parkinsonism.

BACKGROUND The risk of COVID-19 and related death in people with Parkinson's disease or parkinsonism is uncertain. OBJECTIVES The aim of the study was to assess the risk of hospitalization for COVID-19 and death in a cohort of patients with Parkinson's disease or parkinsonism compared to a control population cohort, during the epidemic bout (March-May 2020) in Bologna, northern Italy. METHOD Participants of the ParkLink study with the clinical diagnosis of Parkinson's disease or parkinsonism, and people anonymously matched (ratio 1:10) for sex, age, district, Charlson Index were included. The hospital admission rate for COVID-19 (February 26 - May 31, 2020) and the death rate for any cause were the outcomes of interest. RESULTS The ParkLink cohort included 696 subjects with Parkinson's disease and 184 with parkinsonism; the control cohort 8,590 subjects. The 3-month hospitalization rate for COVID-19 was 0.6% in Parkinson's disease, 3.3% in parkinsonism, 0.7% in controls. The adjusted hazard ratio (age, sex, district, Charlson Index) was 0.8 (95% CI 0.3-2.3, p=0.74) in Parkinson's disease and 3.3 (1.4-7.6, p=0.006) in parkinsonism compared to controls. Twenty-nine of the infected subjects died; 30-day fatality rate was 35.1%, without difference among the three groups. Six out of ten Parkinson's disease/parkinsonism patients had the infection during hospitalization or in nursing home. CONCLUSIONS Parkinson's disease per-se probably is not a risk factor for COVID-19 hospitalization. Conversely, parkinsonism is an independent risk factor probably due to a more severe health status, entailing a higher care dependency and the placement in high infection risk accommodations. This article is protected by copyright. All rights reserved.