Impact of COVID-19 on Movement Disorders Patients in the Outpatient Setting

Introduction The coronavirus disease 2019 (COVID-19) pandemic may have been the only worldwide infectious outbreak that many patients have experienced in their lifetime. The impact of COVID-19 on patients with chronic neurodegenerative disease, including movement disorders, is largely unknown. Since patients with movement disorders rely heavily on inpatient therapies and are closely followed by their medical team, it would be reasonable to see an increase in stress during a period of prolonged isolation. This study aimed to determine the emotional impact, stress, and burden of the COVID-19 pandemic on patients with movement disorders in an academic practice. Methods Over four months during the COVID-19 pandemic, from May 2021 to August 2021, patients with movement disorders were screened for eligibility to participate in the study conducted at a single academic center. Patients must be at least 18 years of age, diagnosed with a movement disorder by an academic physician who specializes in movement disorders, and score ≥ 24 on the mini-mental state exam (MMSE). Patients would be excluded if they were not able to speak or read English or scored <24 on the MMSE, indicating cognitive impairment. Study participants were asked to fill out a subjective questionnaire (the COVID-19 and Movement Disorders Questionnaire [CMDQ]) asking whether neurological symptoms, relationships, mental health care, finances, or healthcare delays worsened during the COVID-19 pandemic. Patients were also tested on the Pandemic Emotional Impact Scale (PEIS), a validated instrument designed to measure the emotional impact of a worldwide pandemic on populations within the United States, and the Patient Health Questionnaire (PHQ-4). Results The mean PEIS score for the cohort was 32.52 ± 12.61 (range 16-80). Higher (worse) PEIS scores were significantly associated with "personal financial loss" (p=0.0077), "worsening neurological symptoms" (p=0.0006), "strained relationships" (p=0.0021), "friends/family experiencing financial loss" (p=0.0006), "friends/family hospitalized" (p=0.0178), "delay in healthcare" (p < 0.0001), and "masks impacting health" (p = 0.0064). The mean PHQ-4 score was 3.18 (mild distress), and over 30% of the population were positive for symptoms of anxiety. Conclusion Although the emotional burden of COVID-19 was low in this cohort, patients were affected by financial burdens, strained relationships, delays in healthcare, and mask-wearing. More research is needed to assess the potential long-term effects of COVID-19 on these individuals.