Abstract
The last couple of months have witnessed the world in a state of virtual standstill. The
SARS-CoV-2 virus has overtaken the globe to economic and social lockdown. Many patients with
COVID-19 have compromised immunity, especially in an aged population suffering from Parkinson's
disease (PD).
Alteration in dopaminergic neurons and deficiency of dopamine in PD patients are the most common
symptoms affecting 1% population above the age of 60 years. The compromised immune system
and inflammatory manifestation in PD patients make them an easy target. The most common
drugs under trial for COVID-19 are remdesivir, favipiravir, chloroquine and hydroxychloroquine,
azithromycin along with adjunct drugs like amantadine with some monoclonal antibodies.
Presently, clinically US FDA approved drugs in PD include Levodopa, catechol-O-methyl transferase
(COMT) inhibitors, (Entacapone and Tolcapone), dopamine agonists (Bromocriptine,
Ropinirole, Pramipexole, and Rotigotine), monoamine oxidase B (MAO-B) inhibitors (Selegiline
and Rasagiline), amantadine and antimuscarinic drugs. The drugs have established mechanisms of
action on PD patients with known pharmacodynamics and pharmacokinetic properties along with
dose and adverse effects.
Conclusion and relevance of this review focus on the drugs that can be tried on PD patients with
SAR CoV-2 infection, in particular, amantadine that has been approved by all the developed countries
as a common drug possessing both antiviral properties by downregulation of CTSL, lysosomal
pathway disturbance and change in pH necessary to uncoat the viral proteins and anti-
Parkinson properties. To deal with the significant prognostic adverse effect of SARS-CoV-2 on
PD, the present-day treatment options, clinical presentation and various mechanisms are the need
of the hour.
Keywords:
COVID-19, Parkinson disease, amantadine, SARS-CoV-2, treatment, pH disturbance.
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