1. Introduction
Coronavirus disease 2019 (COVID-19) is a novel respiratory illness first reported in December 2019 [1]. The manifestations of COVID-19 may range from mild (or asymptomatic) to severe illness leading to respiratory failure and death [2]. The current literature suggests that the factors associated with worse outcomes include older age (>50 years), male sex, living in long-term care facilities, and medical comorbidities such as cardiovascular disease, hypertension, diabetes, chronic lung disease, renal disease, and immunosuppression [3,4]. Parkinson disease (PD) and other movement disorders have not been reported as particular risk factors for more serious sequelae from COVID-19 to date. However, because the patients cared for at specialized Movement Disorders programs are frequently older, tend to have an increased incidence of physical comorbidities (including identified risk factors for more severe manifestations of COVID-19), have increased frailty, and are more likely to be residents of long-term care facilities [5,6,7,8,9], concerns were raised early in the pandemic that this patient population may be particularly vulnerable to the disease [5,6,10,11].
The first patient with laboratory-confirmed COVID-19 in the State of Connecticut was diagnosed on 8 March 2020, and by 6 June 2020, the time of this reporting, there were 4.3818 × 104 cases in the state [12]. Thus, as the number of cases infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) increased in our region, our team at Hartford HealthCare’s Chase Family Movement Disorders Center implemented immediate initiatives, consistent with the early recommendations published in Movement Disorders journals, to mitigate the risk to our patients [5,7,13], such as early conversion to telemedicine visits, conducting several bilingual virtual educational COVID-19 lectures, providing opportunities to participate in virtual exercise classes and support groups, supplying free face masks to patients and their caregivers if needed, and monitoring for symptoms of COVID-19 infection. Despite these measures, we identified that thirty-six patients of our program tested positive for COVID-19 from 8 March 2020 to 6 June 2020. In this report, we describe the demographic characteristics, presentation, management, and outcome of these patients, with the intent of exploring factors that may influence the clinical course in this patient population.