The impact of the COVID-19 pandemic on hospitalizations and plasmapheresis therapy in multiple sclerosis and neuromyelitis optica spectrum disorder: a nationwide analysis from Germany.

BACKGROUND

Many countries worldwide reported side effects of the coronavirus disease 2019 (COVID-19) pandemic that have influenced the care of patients with other diseases in both acute and elective settings. Patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) represent the major patient population suffering from an autoimmune inflammatory demyelinating disease of the central nervous system. We aimed to analyze MS and NMOSD hospitalizations, the application of plasmapheresis therapy, and the dynamic during different periods of the COVID-19 pandemic in Germany.

METHODS

We conducted a nationwide retrospective cross-sectional study using the administrative database of all hospitalized patients with the main diagnosis of MS and NMOSD, including the information on the application of plasmapheresis therapy. We included full-year data from 1463 hospitals of all MS and NMOSD patients hospitalized in 2019 and 2020 in Germany (

RESULTS

We observed a substantial decline of MS and NMOSD patients' hospitalizations during the different pandemic periods, with the most remarkable decline during the first wave of the pandemic (First diagnosis of MS: -16.8%; relapsing-remitting MS: -34.0%; secondary progressive MS: -48.9%; primary progressive MS: -43.8%; NMOSD: -19.2%). Treatment rates with plasmapheresis increased for MS and NMOSD patients in 2020 compared to 2019 (1.8%

CONCLUSION

There was a marked decline of MS and NMOSD patients' hospitalizations during the different pandemic periods in 2020, with the most substantial reduction during the pandemic's first wave and in progressive MS patients. MS and NMOSD patients who needed rescue relapse treatment continued to receive plasmapheresis therapy in Germany.

Informations de copyright

© The Author(s), 2021.

Déclaration de conflit d'intérêts

Conflict of interest statement: Daniel Richter: receives support from the Medical Faculty of Ruhr-University Bochum (FoRUM grant K136-20). Simon Faissner: received speaker’s and/or board honoraria from Biogen, BMS, Celgene, Novartis and Roche and grant support from Ruhr-University Bochum, DMSG, Stiftung für therapeutische Forschung and Novartis, none related to this work. Dirk Bartig: received orders for analysis of the German Diagnosis-Related Groups system from Boehringer Ingelheim and Sanofi Aventis. Lars Tönges: LT has received travel funding and/or speaker honoraria from Abbvie, Bayer, Bial, Desitin, GE, UCB, Zambon and consulted for Abbvie, Bayer, Bial, Desitin, Stadapharm, UCB, Zambon in the last three years. Kerstin Hellwig: received speaker’s and/or research support from Biogen, Bayer, Teva, Sanofi Genzyme, Novartis, and Roche and grant support from the Innovation Fond, DMSG and DFG, all not related to this work. Ilya Ayzenberg: has received travel grants and speaker honoraria from Biogen Idec and Guthy-Jackson Charitable Foundation, Alexion, Santhera, Merck, served on scientific advisory boards for Roche and Alexion, and received research support from Diamed, none related to this study. Christos Krogias: received speaker honoraria or travel grants for scientific meetings from Bayer Vital and Daichii Sankyo. Ralf Gold: serves on scientific advisory boards for Teva Pharmaceutical Industries Ltd., Biogen Idec, Bayer Schering Pharma, and Novartis; has received speaker honoraria from Biogen Idec, Teva Pharmaceutical Industries Ltd., Bayer Schering Pharma, and Novartis; serves as editor for Therapeutic Advances in Neurological Diseases and on the editorial boards of Experimental Neurology and the Journal of Neuroimmunology; and receives research support from Teva Pharmaceutical Industries Ltd., Biogen Idec, Bayer Schering Pharma, Genzyme, Merck Serono, and Novartis, none related to this manuscript. Ralf Gold is the Editor-in-Chief of Therapeutic Advances in Neurological Disorders; therefore, the peer review process was managed by alternative members of the Board and the submitting Editor was not involved in the decision-making process.