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Table 1 Published Cases linking Parkinson’s disease with COVID-19

From: Parkinson’s disease following COVID-19: causal link or chance occurrence?

Authors

Cohen ME et al. [2]

Faber I et al. [3]

Méndez-Guerrero et al. [4]

Time of publication

Sep-2020

Aug-2020

Jul-2020

 

Case 1

Case 2

Case 3

Age

45 years old

35 years old

58 years old

Gender

Male

Female

Male

Family history of parkinsonism

Nil

Nil

Nil

Use of drug that can cause parkinsonism

Nil

NIL

Nil

Length of hospital stay for initial COVID-19 infection

3 days

No hospitalization required

 > 47 days

Severity of COVID-19 infection

Mild

Mild

Severe (mechanical ventilation required)

Interval between COVID-19 infection and parkinsonism

20 to 30 days

10 days

32 days

Prodromal parkinsonian symptoms

Nil

Nil

Nil

Parkinsonian features at presentation

Micrographia, hypophonia, hypomimia, tremor, cogwheel rigidity, bradykinesia

Hypomimia, eyelid retraction, slow and hypometric saccades, asymmetric bradykinesia and cogwheel rigidity, stooped posture and parkinsonian gait

Hypomimia, bradykinesia, cogwheel rigidity, postural and rest tremor

Other neurological signs

Nil

Nil

Myoclonus, decreased consciousness, opsoclonus

Cognition

Normal

Normal

Not evaluated

Response to antiparkinson drugs

Good (pramipexole and biperiden)

Good (levodopa/ benserazide)

Poor (trial of apomorphine)

Follow-up period

1 month

Clinical outcome

Improvement observed

Significant improvement observed

Spontaneous significant improvement observed

Routine blood tests

Unremarkable

Unremarkable

Unremarkable at the time when parkinsonism developed (including copper and ceruloplasmin)

CSF studies

6 white blood cells, normal glucose and protein

No evidence of infection

0 cell, normal glucose and protein

No evidence of infection

8 cell, normal glucose and mildly elevated protein 0.82 g/L

No evidence of infection

Common neuronal antibodies

Negative in serum and CSF

Negative in serum and CSF

Anti-SARS-CoV-2 IgG

Detected in serum but not in CSF

RT-PCR of the CSF for SARS-CoV-2

Negative

Negative

MRI brain

Normal

Normal (including nigrosome-1 and neuromelanin imaging)

Normal

DaT scan

Decreased dopamine transporter density on the left putamen

A bilateral decrease in presynaptic dopamine uptake asymmetrically involving both putamina worse on the left side

PET scan

Decreased18F-FDOPA uptake in both putamen and mild decreased uptake in the left caudate

FDG-PET normal

MIBG

No cardiac autonomic denervation

Genetic testing

Negative