Seroprevalence of SARS-CoV-2 in Parkinson's Disease Patients: A Case-Control Study.

Abstract

A novel coronavirus, the so-called “Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2),” caused the ongoing pandemic, which was initially identified in Wuhan, China.1 Undefined rates of asymptomatic infections have raised concerns about a possibly high frequency of undiagnosed infections of SARS-CoV-2.2 The impact of the COVID-19 pandemic on patients with Parkinson's disease (PD) is yet to be determined.3 Studies showed diverse prevalence and outcomes among PD patients.4, 5 Assessing a precise approximation of the prevalence of COVID-19 necessitates testing antibodies in people who are not symptomatic.6 Therefore, the aim of this study is to evaluate the seroprevalence of SARS-CoV-2 among PD patients who did not have the symptomatic infection. The Iran National Committee for Ethics in Biomedical Researches approved this cross-sectional, case–control study (IR.SBMU.RETECH.REC.1399.1228) [Correction added on 7 June, 2021 after first online publication: In the preceding sentence, the approval number was updated.]. All PD patients who had visited Shohada-e-Tajrish University Hospital, a referral Movements Disorders center, in December 2020, when Iran had experienced the third wave of COVID-19 pandemic, were enrolled in the study. Patients who had the symptomatic infection with SARS-CoV-2 were excluded, and after signing the informed consent forms, patients completed a questionnaire that included demographics data; PD-related information; comorbid conditions; details regarding having had close contact with SARS-CoV-2-infected individuals; and symptoms such as anosmia, cough, coryza, fever, malaise, and musculoskeletal pain. A blood sample was taken to check IgG antibodies for SARS-CoV-2 IgG. Also, blood serum of healthy controls who did not have the symptomatic infection during the same time was checked for SARS-CoV-2 IgG. All blood samples were tested using the enzyme-linked immunosorbent assay (ELISA) technique, using commercially accessible kits (SARS-CoV-2. IgG 96 Elisa Kit. Ideal, Tehran, Iran), with a sensitivity of 81.82% and a specificity of 94.83%. A total of 90 subjects who were identified with PD and 97 healthy controls were included in the study. Table 1 presents the demographic, disease-associated, and COVID-19-related data. The difference in the proportion of variables is compared using Fisher's exact test, and the difference in mean IgG ratio in different groups is compared using the z score and Mann-Whitney U test depending on the distribution of data. About 25.56% of PD patients and 12.37% of controls tested positive for SARS-CoV-2 IgG antibody, and these proportions were significantly different (P < 0.05). The mean total IgG ratio was 1.53 ± 3.36 and 0.80 ± 2.17 in PD and control groups, respectively, and the difference was statistically significant (P < 0.01). 1.99 ± 4.55 P ≈ 0.067 (proportion comparison) P ≈ 0.91 (positive IgG comparison) There was no statistical difference between the IgG ratio of PD patients and the control group who had direct contact with SARS-CoV-2-positive individuals (P > 0.05). Nevertheless, we found a statistically significant difference between the IgG ratio of PD patients and control group who had not direct contact with SARS-CoV-2-positive individuals (P < 0.00001). Moreover, the proportion of PD patients with positive IgG test who had no direct contact with Covid-19 patients was significantly higher than that of the same individuals in the control group (P < 0.05). A study conducted in the United Kingdom supports our outcome4; nevertheless, another study conducted in Italy showed that PD patients do not pose a higher risk of SARS-CoV2 infection,5 but this study evaluated patients based on having an asymptomatic infection. Therefore, the result of the current study indicates that PD patients can be more susceptible to Covid-19 infection. But more studies with higher sample sizes should be performed to confirm these results. M.S.: conception, design, data acquisition, drafting, editing, revising. M.E.: conception, design, data acquisition, editing, revising. A.Z.: conception, design, editing, revising. A.M.: data acquisition, drafting, editing. S.B.M.: design, data acquisition, drafting. S.T.F.: analysis, design, drafting, editing, revising. Z.A.: analysis, design, drafting, editing, revising. M.S.: 1A, 1B, 1C, 2A, 2C, 2B, 3A, 3B M.E.: 1B, 1C, 3B A.R.: 1A, 1C, 3B A.M.: 2C, 3B S.B.M.: 1B, 2C, 3B S.T.F.: 2A, 2B, 2C Z.A.: 2A, 2B, 2C None.