A 45-year-old is the first confirmed case of a man developing a Parkinson’s like disease after contracting COVID-19.
A case study, recently published in The Lancet Neurology, reports the first case of Parkinson’s like disease, in a man suffering from COVID-19.
As 2020 comes to an end, there is still a lot to learn about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus with its wide range of symptoms has managed to baffle researchers across the world.
Although respiratory symptoms are most common among those infected, neurological symptoms have been rising among individuals. Neurological complications have been reported in previous pandemics of MERS, SARS, and H1N1 influenza.
First Case of Parkinson’s After COVID-19 Infection
The 45-year-old Ashkenazi-Jewish man reported a dry cough, muscle pain, and loss of smell a few days after returning from a short trip to the USA. A real-time RT PCR test found him to be positive for the virus.
He was then hospitalized at a hospital in Ashdod, Israel where he stayed for 3 days. He was then shifted to a COVID-19 isolation center.
During his isolation period, he started noticing a change in his handwriting. He also reported having difficulty speaking, writing text messages on his cellphone and, started experiencing tremors in his right hand.
Source: The Lancet Neurology
Two months after testing positive for COVID-19, he was hospitalized at the Neurology Department of Shaare Zedek Medical Center.
Doctors found him to be exhibiting symptoms of a Parkinson’s-like disease. These included cogwheel rigidity, bradykinesia, and tremors. A diagnosis of Parkinsonism was made.
Since his diagnosis, the patient has continued to decline. Despite having a normal cognitive function. According to the case report, he now has unreadable handwriting, extreme tremors on his right side, and reduced facial expressions.
Parkinsonism – What is it?
Any condition that causes symptoms similar to those of Parkinson’s such as tremors, slowing of movements, and muscle stiffness, is called Parkinsonism.
Parkinson’s disease itself is a cause of Parkinsonism. However, there are multiple other causes of Parkinsonism including, anti-psychotic drugs, head trauma, brain tumors, Lewy body dementia and, certain metabolic disorders.
While anosmia, loss of smell, commonly precedes Parkinson’s disease, it is still unclear as to what triggered parkinsonism in the patient.
One-Third of Ashkenazi–Jewish are Carriers of LRRK2 Gene
LRRK2 gene mutations are the most common cause of Parkinson’s Disease. Moreover, one-third of Ashkenazi-Jewish people with Parkinson’s disease carry an LRRK2 or GBA gene mutation.
However, no gene related to Parkinson’s disease was found in the patient. Additionally, he had no family history of Parkinson’s, nor did he have any risk factors for the disease.
Researchers hypothesize that the virus could have caused inflammation via microglial activation in the patient, leading to neurodegeneration. Or, the patient’s genetic makeup could have predisposed him to parkinsonism as a result of COVID-19.
However, the most likely explanation remains that multiple factors such as toxic stress and the absence of the body’s neuroprotective responses may have resulted in neuronal death.
Reference:
Cohen, Mikhal E, et al. “A Case of Probable Parkinson’s Disease after SARS-CoV-2 Infection.” The Lancet Neurology, vol. 19, no. 10, 2020, pp. 804–805., doi:10.1016/s1474-4422(20)30305-7.
