Clinical Profiles and Mortality of COVID‐19 Inpatients with Parkinson's Disease in Germany

Abstract

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

Mental and neurological disorders and risk of COVID-19 susceptibility, illness severity and mortality: A systematic review, meta-analysis and call for action

“…Among the 149 eligible articles, 227,351,954 participants were included in our meta-analysis; and 89,235,737 were COVID-19 patients. We included 27 studies (132,727,798 participants) for susceptibility [ [20] , [21] , [22] , [23] , [24] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [108] , [109] , [110] , [111] , [112] , [113] , [114] , [115] , [116] , [117] , [118] , [119] , 132 , 166 ], 56 studies (83,097,968 participants) for illness severity [ 21 , 24 , 28 , 31 , 32 , 34 , [38] , [39] , [40] , [41] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , 83 , 108 , 110 , 116 , 117 ...…”

Hospital Admissions for Neurodegenerative Diseases during the First Wave of the COVID-19 Pandemic: A Nationwide Cross-Sectional Study from Germany

“…We conducted a cross-sectional study using the nationwide administrative claims database covering 1468 hospitals and 11,464,523 patient admissions between 16 January and 15 May 2020 (5,210,432) and 2019 (6,254,091), respectively. The high-quality and validated diagnosis-related group (DRG) database has been described in detail previously for this purpose [7]. No informed consent or ethical approval was required, as this analysis of anonymized secondary data was provided by the German Federal Statistical Office complying with the German data protection regulations.…”

“…Overall hospital admissions were used as a reference. According to the dynamic of COVID-19 cases [ 7 ], we divided the course of the first wave of the pandemic into four phases of a one-month duration each, including a prodromal, an early, a peak, and a late phase with corresponding inpatient numbers of COVID-19 ( Figure 1 b, Table 1 ). Secondary outcomes included year-to-year relative changes during the predefined four-week peak phase.…”

“…The COVID-19 pandemic thus impacts healthcare delivery and utilization, which has been shown to occur across all care settings and health conditions [ 5 , 6 ] including neurological diseases [ 7 , 8 ]. Rather than by COVID-19 itself, this impact is mediated by responses of society and individuals to COVID-19.…”

“…Various publications have shown that the COVID-19 pandemic significantly affects the lives of people living with NDD, for example, amyotrophic lateral sclerosis (ALS) [ 10 , 11 ], multiple system atrophy (MSA) [ 12 ] or Parkinson’s disease (PD) [ 13 , 14 ]. For PD, a recent analysis showed reductions of hospital admissions by up to 72.7% during the first pandemic wave [ 7 ]. Nevertheless, there is a lack of data on changes in inpatient care utilization for the broad spectrum of further NDD including movement disorders such as MSA and progressive supranuclear palsy (PSP).…”