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Han C, Zhao ZZ, Chan P, Li F, Chi CL, Zhang X, Zhao Y, Chen J, Ma JH. A large survey on COVID-19 vaccination in patients with Parkinson's disease and healthy population. Vaccine 2023; 41:6483-6494. [PMID: 37726180 DOI: 10.1016/j.vaccine.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/29/2023] [Accepted: 09/02/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND A full rollout of COVID-19 vaccination offers the most promising prospect of bringing the pandemic to an end. This study aimed to compare the coverage, safety, and confidence of COVID-19 vaccination between patients with Parkinson's disease (PD) and healthy individuals so as to give suggestions for future immunization programs. METHODS A web-based, nationwide, multicenter survey was carried out in China from 2021 to 2022. The age and sex-standardized vaccination rate was calculated. Multivariate stepwise logistic regression models were used to estimate the influencing factors of vaccination status. We also investigated vaccination safety, willingness, confidence, and reasons for hesitancy with some ad hoc questions. RESULTS A total of 962 PD patients and 1208 healthy individuals participated in this survey with a vaccination rate of 71.1% vs 94.4% respectively. PD patients living in first-tier cities, with comorbidities, experiencing unstable PD with a longer course and levodopa use were less likely to get vaccinated, while healthy individuals living in first-tier cities and feeling physically poor exhibited a lower vaccination rate. For PD patients, concern about the adverse impact on existing illness and disagreement from doctors were the most common reasons for vaccination hesitancy. Whereas, no evidence was present that they experienced any local or systematic adverse events more frequently or seriously than healthy individuals, or their state of PD and comorbidities was seriously exacerbated after vaccination. A prominent transition from a little concerned to unconcerned about the security and efficacy of vaccines was evident among both two populations from pre-vaccination to post-vaccination. CONCLUSIONS The COVID-19 vaccination rate was remarkably lower in PD patients than healthy individuals in China. The approved vaccines have shown an acceptable safety profile. Our findings would offer a reference to guide future clinical decision-making of COVID-19 vaccination and improve the immunization management of PD patients.
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Affiliation(s)
- Chao Han
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Zhen Zhen Zhao
- Department of Geriatrics Center, The Fourth People's Hospital of Shenyang, Shenyang, Liaoning, China
| | - Piu Chan
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China; Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Fang Li
- Department of Neurology, Yueyang Central Hospital, Yueyang City, China
| | - Chun Ling Chi
- Department of Neurology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xin Zhang
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, China
| | - Yan Zhao
- Department of Neurology, The Third Hospital of Jinan, Jinan, China
| | - Jing Chen
- Department of Neurology, Zhumadian Central Hospital, Zhumadian, China
| | - Jing Hong Ma
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
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Boura I, Qamar MA, Daddoveri F, Leta V, Poplawska-Domaszewicz K, Falup-Pecurariu C, Ray Chaudhuri K. SARS-CoV-2 and Parkinson's Disease: A Review of Where We Are Now. Biomedicines 2023; 11:2524. [PMID: 37760965 PMCID: PMC10526287 DOI: 10.3390/biomedicines11092524] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/16/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has been discussed in the context of Parkinson's disease (PD) over the last three years. Now that we are entering the long-term phase of this pandemic, we are intrigued to look back and see how and why the community of patients with PD was impacted and what knowledge we have collected so far. The relationship between COVID-19 and PD is likely multifactorial in nature. Similar to other systemic infections, a probable worsening of PD symptoms secondary to COVID-19, either transient or persistent (long COVID), has been demonstrated, while the COVID-19-related mortality of PD patients may be increased compared to the general population. These observations could be attributed to direct or indirect damage from SARS-CoV-2 in the central nervous system (CNS) or could result from general infection-related parameters (e.g., hospitalization or drugs) and the sequelae of the COVID-19 pandemic (e.g., quarantine). A growing number of cases of new-onset parkinsonism or PD following SARS-CoV-2 infection have been reported, either closely (post-infectious) or remotely (para-infectious) after a COVID-19 diagnosis, although such a link remains hypothetical. The pathophysiological substrate of these phenomena remains elusive; however, research studies, particularly pathology studies, have suggested various COVID-19-induced degenerative changes with potential associations with PD/parkinsonism. We review the literature to date for answers considering the relationship between SARS-CoV-2 infection and PD/parkinsonism, examining pathophysiology, clinical manifestations, vaccination, and future directions.
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Affiliation(s)
- Iro Boura
- Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London SE5 9RS, UK; (I.B.)
- Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 5 Cutcombe Road, London SE5 9RX, UK
- Medical School, University of Crete, Heraklion, 71003 Iraklion, Greece
| | - Mubasher A. Qamar
- Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London SE5 9RS, UK; (I.B.)
- Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 5 Cutcombe Road, London SE5 9RX, UK
| | - Francesco Daddoveri
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Valentina Leta
- Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London SE5 9RS, UK; (I.B.)
- Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 5 Cutcombe Road, London SE5 9RX, UK
- Parkinson and Movement Disorders Unit, Department of Clinical Neuroscience, Fondazione, IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | | | - Cristian Falup-Pecurariu
- Department of Neurology, County Clinic Hospital, Faculty of Medicine, Transilvania University Brasov, 500019 Brasov, Romania
| | - K. Ray Chaudhuri
- Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London SE5 9RS, UK; (I.B.)
- Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 5 Cutcombe Road, London SE5 9RX, UK
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Chatterjee A, Chakravarty A. Neurological Complications Following COVID-19 Vaccination. Curr Neurol Neurosci Rep 2023; 23:1-14. [PMID: 36445631 PMCID: PMC9707152 DOI: 10.1007/s11910-022-01247-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW A variety of neurological complications have been reported following the widespread use of the COVID-19 vaccines which may lead to vaccine hesitancy and serve as a major barrier to the public health aim of achieving protective herd immunity by vaccination. In this article, we review the available evidence regarding these neurological adverse events reported, to provide clarity regarding the same so that unfounded fears maybe put to rest. RECENT FINDINGS There is a greater than expected occurrence of severe neurological adverse events such as cortical sinus venous thrombosis, Bell's palsy, transverse myelitis, and Guillain-Barré syndromes along with other common effects such as headaches following different kinds of COVID-19 vaccination. Precipitation of new onset demyelinating brain lesions with or without detection of specific antibodies and worsening of pre-existing neurological disorders (like epilepsy, multiple sclerosis) are also a matter of great concern though no conclusive evidence implicating the vaccines is available as of now. The COVID-19 pandemic is far from being over. Till such time that a truly effective anti-viral drug is discovered, or an appropriate therapeutic strategy is developed, COVID-appropriate behavior and highly effective mass vaccination remain the only weapons in our armamentarium to fight this deadly disease. As often occurs with most therapeutic means for the treatment and prevention of any disease, vaccination against COVID-19 has its hazards. These range from the most trivial ones like fever, local pain and myalgias to several potentially serious cardiac and neurological complications. The latter group includes conditions like cerebral venous thrombosis (curiously often with thrombocytopenia), transverse myelitis and acute inflammatory demyelinating polyneuropathy amongst others. Fortunately, the number of reported patients with any of these serious complications is far too low for the total number of people vaccinated. Hence, the current evidence suggests that the benefits of vaccination far outweigh the risk of these events in majority of the patients. As of now, available evidence also does not recommend withholding vaccination in patients with pre-existing neurological disorders like epilepsy and MS, though adenoviral vaccines should be avoided in those with history of thrombotic events.
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Affiliation(s)
| | - Ambar Chakravarty
- Department of Neurology, Vivekananda Institute of Medical Sciences, Kolkata, India.
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Zhou Y, Lin Z, Wan X, Liu J, Ding J, Zhang C, Ren K, Li D, Wu Y. COVID-19 vaccine acceptance and hesitancy in patients with Parkinson's disease. Front Public Health 2022; 10:977940. [PMID: 36304248 PMCID: PMC9595444 DOI: 10.3389/fpubh.2022.977940] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 09/20/2022] [Indexed: 01/25/2023] Open
Abstract
Background As coronavirus disease 2019 (COVID-19) vaccination campaign underway, little is known about the vaccination coverage and the underlying barriers of the vaccination campaign in patients with Parkinson's disease (PD). Objective To investigate the vaccination status and reasons for COVID-19 vaccine acceptance and hesitancy among PD patients. Methods In concordance with the CHERRIES guideline, a web-based, single-center survey was promoted to patients with PD via an online platform from April 2022 and May 2022. Logistic regression models were used to identify factors related to COVID-19 vaccine hesitancy. Results A total of 187 PD cases participated in this online survey (response rate of 23%). COVID-19 vaccination rate was 54.0%. Most participants had a fear of COVID-19 (77.5%) and trusted the efficacy (82.9%) and safety (66.8%) of COVID-19 vaccine. Trust in government (70.3%) and concerns about the impact of vaccine on their disease (67.4%) were the most common reasons for COVID-19 vaccine acceptance and hesitancy, respectively. COVID-19 vaccine hesitancy was independently associated with the history of flu vaccination (OR: 0.09, p < 0.05), trust in vaccine efficacy (OR: 0.15, p < 0.01), male gender (OR: 0.47, p < 0.05), disease duration of PD (OR: 1.08, p < 0.05), and geographic factor (living in Shanghai or not) (OR: 2.87, p < 0.01). Conclusions The COVID-19 vaccination rate remained low in PD patients, however, most individuals understood benefits of vaccination. COVID-19 vaccine hesitancy was affected by multiple factors such as geographic factor, history of flu vaccination, disease duration and trust in efficacy of vaccine. These findings could help government and public health authorities to overcome the barrier to COVID-19 vaccination and improve vaccine roll-out in PD patients.
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Affiliation(s)
- Yifan Zhou
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhengyu Lin
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaonan Wan
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jun Liu
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jianqing Ding
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - ChenCheng Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Kang Ren
- Gyenno Science Co., Ltd., Shenzhen, China
| | - Dianyou Li
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China,*Correspondence: Yiwen Wu
| | - Yiwen Wu
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China,Dianyou Li
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SARS-CoV-2 vaccination, Parkinson's disease, and other movement disorders: case series and short literature review. Neurol Sci 2022; 43:5165-5168. [PMID: 35666352 PMCID: PMC9167915 DOI: 10.1007/s10072-022-06182-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 05/25/2022] [Indexed: 10/25/2022]
Abstract
BACKGROUND Several neurological complications have been reported following SARS-Cov-2 vaccination, without a clear causal relationship ever being verified, including some cases of worsening of Parkinson's disease (PD) symptoms and new onset of movement disorders in non-parkinsonian patients. METHODS We describe two new cases of PD patients treated with device-aided therapy who developed worsening of parkinsonian symptoms after receiving the third vaccine dose (booster). We also conducted a short review of the cases reported in literature of PD symptoms worsening and new onset of movement disorders in non-parkinsonian patients after SARS-Cov-2 vaccination. RESULTS The first patient, a 46-year-old man implanted with bilateral Subthalamic Deep Brain Stimulation, experienced temporary motor and non-motor symptoms worsening after mRNA-1273 booster, improved after stimulation settings modification. The second patient, a 55-year-old man implanted with percutaneous endoscopic transgastric jejunostomy (PEG-J) for levodopa-carbidopa intestinal gel (LCIG) infusion experienced severe temporary worsening of dyskinesia and managed through temporary LCIG dose reduction. Other seven cases of vaccine-related movement disorder are currently reported in literature, four describing PD symptoms worsening and three the onset of new movement disorders in otherwise healthy people. CONCLUSION Both our patients and the cases described so far completely recovered after few days with parkinsonian therapy modification, symptomatic treatment, or even spontaneously, underlining the transient and benign nature of side effects from vaccine. Patients should be reassured about these complications, manageable through a prompt evaluation by the reference neurologist.
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Soldà G, Barvas E, Lenzi J, Di Valerio Z, La Fauci G, Guttmann S, Riccardi R, Fantini MP, Salussolia A, Montalti M, Gori D. Gam-COVID-Vac (Sputnik V) and Pfizer-BioNTech Vaccines Adverse Events following Immunization in Patients Affected by Parkinson’s Disease and Multiple Sclerosis: A Longitudinal Study. Vaccines (Basel) 2022; 10:vaccines10030370. [PMID: 35335001 PMCID: PMC8953464 DOI: 10.3390/vaccines10030370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 01/27/2023] Open
Abstract
The Republic of San Marino COVID-19 vaccination campaign used Gam-COVID-Vac and Pfizer-BioNTech vaccines. To assess adverse events following immunization (AEFIs), approximately 6000 vaccine recipients were monitored by the ROCCA study, including subgroups with Parkinson’s Disease (PD) and Multiple Sclerosis (MS). The purpose of this study is to evaluate short-term AEFIs through a 1-month follow-up. We conducted a longitudinal study, using active surveillance to evaluate the safety profiles of COVID-19 vaccines in PD and MS patients. Participants were actively administered a standardized online questionnaire to collect information on AEFIs. Among all PD and MS assisted by the San Marino hospital, a total of 82 patients completed the questionnaires. One week after administration of the first dose, vaccine recipients reported AEFIs in 26% of cases in the PD group, 67% in the MS group, and 68% in the control group. Participants reported slightly higher rates of AEFIs after dose 2 compared with dose 1, being 29%, 75%, and 78% for PD, MS, control group, respectively. Most of the reported symptoms were mild. Patients with PD and MS reported few AEFIs after administration of the COVID-19 vaccines. The frequency of AEFIs in the PD population was significantly lower than in the control group.
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Affiliation(s)
- Giorgia Soldà
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (G.S.); (Z.D.V.); (A.S.); (M.M.)
| | - Edoardo Barvas
- San Marino Neurological Unit, State Hospital of the Republic of San Marino, 47893 Cailungo, San Marino; (E.B.); (S.G.)
| | - Jacopo Lenzi
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (J.L.); (M.P.F.); (D.G.)
| | - Zeno Di Valerio
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (G.S.); (Z.D.V.); (A.S.); (M.M.)
| | - Giusy La Fauci
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (G.S.); (Z.D.V.); (A.S.); (M.M.)
- Correspondence: ; Tel.: +39-051-209-4802
| | - Susanna Guttmann
- San Marino Neurological Unit, State Hospital of the Republic of San Marino, 47893 Cailungo, San Marino; (E.B.); (S.G.)
| | - Rossano Riccardi
- San Marino Central Pharmacy, San Marino Hospital, 47893 Cailungo, San Marino;
| | - Maria Pia Fantini
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (J.L.); (M.P.F.); (D.G.)
| | - Aurelia Salussolia
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (G.S.); (Z.D.V.); (A.S.); (M.M.)
| | - Marco Montalti
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (G.S.); (Z.D.V.); (A.S.); (M.M.)
| | - Davide Gori
- Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, 40126 Bologna, Italy; (J.L.); (M.P.F.); (D.G.)
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Roszmann A, Podlewska A, Lau YH, Boura I, Hand A. Covid-19 and Parkinson's disease: Nursing care, vaccination and impact on advanced therapies. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 165:173-196. [PMID: 36208900 PMCID: PMC9270873 DOI: 10.1016/bs.irn.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Coronavirus Disease 2019 (Covid-19) pandemic has created many challenges for the Parkinson's Disease (PD) care service delivery, which has been established over the past decades. The need for rapid adjustments to the new conditions has highlighted the role of technology, which can act as an enabler both in patient-facing aspects of care, such as clinical consultations, as well as in professional development and training. The Parkinson's Disease Nurse Specialists (PNSs) play a vital role in the effective management of people with PD (PwP). Maintaining optimum functionality and availability of device aided therapies is essential in order to ensure patients’ quality of life. PwP are particularly recommended to use vaccination as a basic protection from the virus. The long-term consequences of this pandemic on PwP are highly uncertain, and education, support and reassurance of patients and their families may help ease their burden.
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