PwP and coronavirus 2019-nCoV

As the number of cases of coronavirus infection increases it is appropriate to look at some of the purely PD related issues.

I suspect that difficulties of movement caused by PD mean that it is harder for us to wash our hands most effectively. So, if the recommendation to the general public is to spend 20 seconds doing this, we may require 30 to 40 seconds.

Amantadine is a dopamine agonist taken by many PwP. It has anti-viral properties [1]:

"Amantadine and rimantadine appear to work, at least in part, by preventing newly synthesized viruses from being released from the host cell ... Amantadine and rimantadine are effective for reducing the duration of influenza A if given within 24 hours of symptom onset and may prevent the infection in close contacts of affected individuals."

Note: this does not mention coronavirus 2019-nCoV specifically. But [2] points out rimantadine was useful against SARS, a related coronavirus.

The Cochrane review gives a warning [3]:

"Both drugs have adverse gastrointestinal (stomach and gut) effects, but amantadine can also have serious effects on the nervous system. They should only be used in an emergency when all other measures fail."

Rimantadine has been trialed on PD [4]:

"rimantadine may be considered as an alternative to amantadine in patients experiencing amantadine-induced peripheral side effects."

John

References:

[1] Parkinson's Disease, ScienceDirect, 2017 Amantadine - an overview | ScienceDirect Topics

[2] In vitro susceptibility of 1 clinical isolates of SARS coronavirus to selected antiviral compounds. - PubMed - NCBI

[3] Antiviral drugs amantadine and rimantadine for preventing and treating the symptoms of influenza A in adults | Cochrane

[4] Rimantadine in Parkinson's disease patients experiencing peripheral adverse effects from amantadine: Report of a case series | Request PDF

My thanks to Simon Griffith on PRIG for pointing out this paper:

"Rare tendency of catching cold in Parkinson's disease."
Kawaguchi N1, Yamada T, Hattori T.
Parkinsonism and related disorders, 1998
Rare tendency of catching cold in Parkinson's disease. - PubMed - NCBI

"persons with Parkinson's disease (PD) catch relatively fewer colds that are unusually mild. This tendency seems to have no clear relationship to the severity of the PD, the time after the onset of PD, or whether or not the patient is taking antiparkinsonian drugs either as mono therapy or in combination. The study found no similar phenomena among spouses of the PD patients or among patients with cerebrovascular disease. These results suggest that a low frequency of colds is a unique feature in persons with PD."

John

My wife has had PD for about 18 years now. I don't recall her having a cold or flu during all that time. Maybe a sniffle but nothing worse.

Quercetin has been a topic of many posts to this forum over the years. It may have a role to play in the coronavirus epidemic.

Coronavirus (COVID-19) Update 35
Dr Seheult
Coronavirus Pandemic Update 35: New Outbreaks & Travel Restrictions, Possible COVID-19 Treatments - YouTube

Update 34 deals with zinc..

I think of this as combat pharmacology: the situation is so serious that you can't wait for the results of randomised, double blind, placebo controlled trials to be published before acting.

John

Think about taking vitamin D.

Another golden oldie over the years in this forum has been whether vitamin D plays a role in the pathogenesis of PD. I've been skeptical in the past, but I now think it's worth reevaluating given that it might help in the fight against coronavirus.

The Scottish Government have recently revised their advice on vitamin D to reflect the COVID-19 situation (2nd April):

"Since it's difficult for people to get enough vitamin D from food alone, everyone ... should consider taking a daily supplement containing 10 micrograms of vitamin D. ... This advice is especially important for people who are indoors all of the time. ... The current guidance on sun exposure should be followed: 10 to 15 minutes of unprotected Scottish sun exposure is safe for all. Once sunscreen is correctly applied, vitamin D synthesis is blocked. Staying in the sun for prolonged periods without the protection of sunscreen increases the risk of skin cancer."

44 - not found - gov.scot

There is other circumstances that may suggest an negative association between vitamin D and CONVID-19. For example, difference in the infection rates of various ethnic groups has been reported.

"14% of people in England and Wales are from ethnic minority backgrounds ... However, the Intensive Care National Audit and Research Centre found that 34% of more than 3,000 critically ill coronavirus patients identified as black, Asian or minority ethnic."

Coronavirus: Ethnic minorities 'are a third' of patients - BBC News

The differences could be due to noise in the data; or due to differences in social conditions; or, it may be due to physiological differences. Although no proof is given (e.g. a double blind placebo control clinical trial), the following linkages seems plausible:

darker skin -- more melanin -- less vitamin d from sunlight -- weakened immune system

John

This is a very interesting website.



Orthomolecular News


Vitamin C Protects Against Coronavirus



Intravenous Vitamin C Treatment, Coronavirus, hospital, high doses, antiviral, vitamin C, instructions for intravenous vitamin C, Intravenous Therapy, acute viral infections, influenza, herpes zoster, common cold, rubella, mumps, idiopathic sudden he


(OMNS January 26, 2020) The coronavirus pandemic can be dramatically slowed, or stopped, with the immediate widespread use of high doses of vitamin C. Physicians have demonstrated the powerful antiviral action of vitamin C for decades. There has been a lack of media coverage of this effective and successful approach against viruses in general, and coronavirus in particular.
It is very important to maximize the body's anti-oxidative capacity and natural immunity to prevent and minimize symptoms when a virus attacks the human body. The host environment is crucial. Preventing is obviously easier than treating severe illness. But treat serious illness seriously. Do not hesitate to seek medical attention. It is not an either-or choice. Vitamin C can be used right along with medicines when they are indicated.
"I have not seen any flu yet that was not cured or markedly ameliorated by massive doses of vitamin C."