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

Abstract

(1) Background: The COVID-19 pandemic impacts healthcare utilization across all care settings and health conditions. The objective of this study was to determine changes in hospital admissions for neurodegenerative diseases (NDD) during the first COVID-19 wave in Germany; (2) Methods: This cross-sectional study used nationwide administrative claims data covering 1468 hospitals. The primary outcome was the year-to-year relative change in case numbers during a four-month study period (16 January–15 May 2020 vs. 2019) during the first pandemic wave. Secondary outcomes included year-to-year relative changes during a four-week peak phase (16 March–15 April) and changes between differential phases of the wave. The analyzed NDD comprised progressive supranuclear palsy (PSP), multiple system atrophy (MSA), Parkinson’s disease, amyotrophic lateral sclerosis (ALS) and Huntington’s disease; (3) Results: Hospital admissions for any reason decreased by 16.7% in 2020 during the study period and by 36.6% during the peak phase, whereas admissions for NDD decreased by 27.6% and 65.0%, respectively. PSP cases decreased during the study period (−34.7%) and the peak phase (−68.1%) and stayed reduced in a late phase with falling COVID-19 numbers. MSA and ALS cases increased strongest after the peak, with ALS cases being comparatively weakly reduced during the study period (−17.3%) and peak phase (−51.7%); (4) Conclusions: Inpatient care utilization for NDD changed differentially during the first wave of the COVID-19 pandemic in Germany and showed a greater reduction than overall and general neurological admissions. Mitigating long-term health deterioration of this vulnerable subgroup is important to reduce morbidity and mortality in the future.

The Cause and Duration of Emergency Admissions to Hospital in People with Idiopathic Parkinson’s Disease, Under the Care of a UK Service, During the First Year of the COVID-19 Pandemic

“…In the UK admissions decreased by 25.5% from 2019-2020 to 2020-2021 [14]. Data from Germany shows that, during the peak of COVID-19, admissions for any cause decreased by 36.6%, but in people with PD admissions decreased by 66.6% [15]. However, there are no data looking at the cause and duration of admissions in people with PD during the COVID-19 pandemic.…”

Impact of the COVID-19 Pandemic on Inpatient Utilization for Acute Neurologic Disease

“…The literature regarding admission for other neurologic conditions is nascent; studies have largely been conducted in small US samples, 23,24 international cohorts, [25][26][27][28][29] or focused on survey-based methods. 30,31 Similar to our findings, these studies found decrements in admissions for neurotrauma, 23,24 neuro-oncologic surgical cases, 31 epilepsy, 25 headache, 26 neurodegenerative, 28 and neuro-inflammatory disorders 29 during the initial phase of the pandemic. Among the various categories of neurologic disease, we found headache hospitalizations to be most impacted, falling 66.7% in April and still being down by 20.5% by the October rebound period.…”

COVID-19 outcomes in hospitalized Parkinson’s disease patients in two pandemic waves in 2020: a nationwide cross-sectional study from Germany

“…As to indirect health effects, the COVID-19 pandemic disrupted health care delivery and utilization across all care settings and non-COVID-19 health conditions [ 3 , 24 ] including neurological diseases [ 23 , 25 – 28 ]. In people with PD, public health measures such as lockdowns and social distancing are associated with decreases in physical activity and quality of life and increases in anxiety and depression [ 1 , 4 , 14 , 29 – 32 ].…”