Impact of COVID‐19 pandemic on patients with Parkinson's disease: A meta‐analysis of 13,878 patients

BACKGROUND: The clinical, neuropsychological, and socioeconomic factors affecting Parkinson's disease (PD) during COVID‐19 pandemic across different populations have not been systematically studied. To address this, we conducted a meta‐analysis of factors that impact the well‐being of PD patients during the pandemic. METHODS: Medline and Embase were searched for articles published between 2020 and 2022. We conducted random‐effects pooling of estimates and meta‐regression. RESULTS: Twenty‐seven studies involving 13,878 patients from America, Europe, Asia, and Africa were included. There is a high prevalence of decreased physical activity and exercise, and worsening motor and neuropsychiatric symptoms (17–56%). Patients in lower‐income countries more frequently reported worsening anxiety (adjusted OR [aOR] 8.94, 95% confidence interval [CI] 1.62–49.28, p = 0.012), sleep (aOR 5.16, 95% CI 1.15–23.17, p = 0.032), and PD symptoms (aOR 3.57, 95% CI 0.96–13.34, p = 0.058). Lockdown was associated with decreased exercise levels (aOR 0.13, 95% CI 0.02–0.78, p = 0.025) and worsening mood (aOR 0.48, 95% CI 0.24–0.95, p = 0.035). Younger age correlated with decreased physical activity (β −0.30, 95% CI −0.53 to −0.07, p = 0.012), exercise (β −0.11, 95% CI −0.15 to −0.07, p < 0.001), worsening PD symptoms (β −0.08, 95% CI −0.15 to −0.01, p = 0.018), and sleep (β −0.14, 95% CI −0.27 to 0, p = 0.044). Female PD patients reported a greater decrease in physical activity (β 11.94, 95% CI 2.17–21.71, p = 0.017) and worse sleep (β 10.76, 95% CI 2.81–18.70, p = 0.008). CONCLUSION: This large meta‐analysis of PD patients in diverse populations identified a high prevalence of physical and mental worsening during the COVID‐19 pandemic, with patients in lower‐income countries being exceptionally vulnerable.