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All Studies   Meta Analysis       

COVID-19 in Parkinson’s disease: what holds the key?

Sainz-Amo et al., Journal of Neurology, doi:10.1007/s00415-020-10272-0
Oct 2020  
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Severe case 33% Improvement Relative Risk Case 44% Vitamin D for COVID-19  Sainz-Amo et al.  Prophylaxis Is prophylaxis with vitamin D beneficial for COVID-19? Retrospective 211 patients in Spain Lower severe cases (p=0.45) and fewer cases (p=0.23), not sig. c19early.org Sainz-Amo et al., J. Neurology, October 2020 Favorsvitamin D Favorscontrol 0 0.5 1 1.5 2+
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 122 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
Case control study with 39 COVID+ and 172 COVID- Parkinson's disease patients in Spain, showing positive and severe cases being less likely to use vitamin D supplementation compared to negative or mild/negative cases respectively. These differences were not statistically significant.
This is the 6th of 122 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 587 sextillion).
30 studies are RCTs, which show efficacy with p=0.0000032.
risk of severe case, 32.7% lower, OR 0.67, p = 0.45, treatment 5 of 29 (17.2%) cases, 43 of 182 (23.6%) controls, NNT 23, case control OR.
risk of case, 43.7% lower, OR 0.56, p = 0.23, treatment 6 of 39 (15.4%) cases, 42 of 172 (24.4%) controls, NNT 13, case control OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sainz-Amo et al., 24 Oct 2020, retrospective, Spain, peer-reviewed, mean age 74.5, 13 authors, dosage not specified.
This PaperVitamin DAll
COVID-19 in Parkinson’s disease: what holds the key?
R Sainz-Amo, B Baena-Álvarez, I Pareés, G Sánchez-Díez, P Pérez-Torre, J L López-Sendón, S Fanjul-Arbos, E Monreal, I Corral-Corral, N García-Barragán, J C Martínez-Castrillo, A Fasano, A Alonso-Cánovas
Journal of Neurology, doi:10.1007/s00415-020-10272-0
Introduction Parkinson's disease (PD) is more frequent in the elderly and increases the risk of respiratory infections. Previous data on PD and SARS-CoV-2 are scarce, suggesting a poor prognosis in advanced disease and second-line therapies. Methods A retrospective case-control study comparing patients with PD and COVID-19 and patients with PD without COVID-19 was conducted during the pandemic period in Spain (March 1st-July 31st 2020) in a tertiary university hospital. Results Thirty-nine (COVID-19 +) and 172 (COVID-19-) PD patients were included. Fifty-nine percent were males in both groups, with similar age (75.9 ± 9.0 COVID-19 + , 73.9 ± 10.0 COVID-19-), disease duration (8.9 ± 6.2 COVID-19 + , 8.5 ± 5.6 COVID-19-) and PD treatments. COVID-19 was mild in 10 (26%), required admission in 21 (54%) and caused death in 8 (21%) patients. Dementia was the only comorbidity more frequent in COVID-19 + patients (36% vs. 14%, p = 0.0013). However, in a multivariate analysis, institutionalization was the only variable associated with COVID-19 + (OR 17.0, 95% CI 5.0-60.0, p < 0.001). When considering severe COVID-19 (admission or death) vs. mild or absent COVID-19, institutionalization, neoplasm, dementia and a lower frequency of dopamine agonists were associated with severe COVID-19. In multivariate analysis, only institutionalization [OR 5.17, 95% CI 1.57-17, p = 0.004] and neoplasm [OR 8.0, 95%CI 1.27-49.8, p = 0.027] remained significantly associated. Conclusion In our experience, institutionalization and oncologic comorbidity, rather than PD-related variables, increased the risk of developing COVID-19, and impacted on its severity. These findings suggest that epidemiologic factors and frailty are key factors for COVID-19 morbidity/mortality in PD. Appropriate preventive strategies should be implemented in institutionalized patients to prevent infection and improve prognosis.
Compliance with ethical standards Conflicts of interest On behalf of all authors, the corresponding author states that there is no conflict of interest. Data are available upon request to the authors. Ethical standard The study was approved by the local Ethics Committee.
References
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