Background Comprehensive, nationwide data regarding Parkinson's disease (PD) hospitalizations, coronavirus disease 2019 (COVID‐19) in‐hospital frequency, and COVID‐19‐associated inpatient mortality during the first wave of the COVID‐19 pandemic are not available. Objective To provide a nationwide analysis on hospitalized PD patients in Germany and evaluate the impact of the COVID‐19 pandemic. Methods We conducted a cross‐sectional study using an administrative claims database covering 1468 hospitals and 5,210,432 patient hospitalizations including a total of 30,872 COVID‐19+ cases between January 16 and May 15, 2020. Results Compared to 2019, hospitalizations for PD transiently decreased by up to 72.7% in 2020. COVID‐19 frequency was significantly higher in the population of 64,434 PD patients (693 being COVID‐19+) than in non‐PD patients (1.1% vs. 0.6%, P < 0.001), especially in subjects with advanced age (≥ 65 years). Regarding established COVID‐19 risk comorbidities, COVID‐19+ inpatients with PD showed higher incidences than non‐PD COVID‐19+ subjects, particularly hypertension and chronic kidney disease. Advanced age and male sex were significantly more frequent in COVID‐19+ than in COVID‐19− PD patients. The COVID‐19 inpatient mortality rate was much higher in PD patients than in non‐PD patients (35.4% vs. 20.7%, P < 0.001), especially in patients aged 75–79 years. Of note, overall inpatient mortality of PD patients was significantly higher in 2020 than in 2019 (5.7% vs. 4.9%, P < 0.001). Conclusions PD inpatients are more frequently affected by COVID‐19 and suffer from increased COVID‐19‐associated mortality in comparison to non‐PD patients. More comprehensive studies are needed to assess the significance of associated comorbidities for COVID‐19 risk and mortality in PD. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

Parkinson’s disease (PD) is currently the world’s fastest-growing neurological disorder. It is characterized by motor and non-motor symptoms which progressively lead to significant clinical impairment, causing a high burden of disease. In addition to pharmacological therapies, various non-pharmacological treatment options are available. A well established and frequently used multiprofessional inpatient treatment concept in Germany is “Parkinson’s disease multimodal complex treatment” (PD-MCT) which involves physiotherapists, occupational therapists, speech therapists, and other specializations for the optimization of treatment in PD (ICD G20) and other Parkinsonian syndromes (ICD G21 and G23). In this study we analyze the PD-MCT characteristics of 55,141 PD inpatients who have been integrated into this therapy concept in Germany in the years 2010–2016. We demonstrate that PD-MCT is increasingly applied over this time period. Predominately, PD patients with advanced disease stage and motor fluctuations in age groups between 45 and 69 years were hospitalized. In terms of gender, more male than female patients were treated. PD-MCT is provided primarily in specialized hospitals with high patient numbers but a minor part of all therapies is performed in a rather large number of hospitals with each one treating only a few patients. Access to PD-MCT differs widely across regions, leading to significant migration of patients from underserved areas to PD-MCT centers – a development that should be considered when implementing such therapies in other countries. Furthermore, our data imply that despite the overall increase in PD-MCT treatments during the observational period, the restricted treatment accessibility may not adequately satisfy current patient´s need.

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