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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