Richter Daniel, Faissner Simon, Bartig Dirk, Tönges Lars, Hellwig Kerstin, Ayzenberg Ilya, Krogias Christos, Gold Ralf
Department of Neurology, Ruhr University Bochum, St. Josef-Hospital Bochum, Gudrunstrasse 56, Bochum, 44791 Germany.
Ther Adv Neurol Disord. 2021 Jul 7;14:17562864211030656. doi: 10.1177/17562864211030656. eCollection 2021.
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.
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 ( = 87,453). We compared case numbers and plasmapheresis therapy rates of the different pandemic periods in 2020 with the corresponding periods in 2019.
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% 1.6%, = 0.003; 14.0% 9.3%, < 0.001), with a substantial increase during the first wave of the pandemic, especially in NMOSD patients (19.7% 8.4%, < 0.001).
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.
全球许多国家报告了2019冠状病毒病(COVID-19)大流行的副作用,这些副作用在急性和择期情况下影响了其他疾病患者的护理。多发性硬化症(MS)和视神经脊髓炎谱系障碍(NMOSD)患者是患有中枢神经系统自身免疫性炎性脱髓鞘疾病的主要患者群体。我们旨在分析德国COVID-19大流行不同时期MS和NMOSD的住院情况、血浆置换疗法的应用及其动态变化。
我们使用所有主要诊断为MS和NMOSD的住院患者的行政数据库进行了一项全国性回顾性横断面研究,包括血浆置换疗法的应用信息。我们纳入了德国1463家医院2019年和2020年所有MS和NMOSD住院患者的全年数据(n = 87453)。我们将2020年不同大流行时期的病例数和血浆置换治疗率与2019年的相应时期进行了比较。
我们观察到在不同大流行时期,MS和NMOSD患者的住院人数大幅下降,在大流行的第一波期间下降最为显著(MS首次诊断:-16.8%;复发缓解型MS:-34.0%;继发进展型MS:-48.9%;原发进展型MS:-43.8%;NMOSD:-19.2%)。与2019年相比,2020年MS和NMOSD患者的血浆置换治疗率有所增加(1.8%对1.6%,P = 0.003;14.0%对9.3%,P < 0.001),在大流行的第一波期间大幅增加,尤其是在NMOSD患者中(19.7%对8.4%,P < 0.001)。
2020年不同大流行时期MS和NMOSD患者的住院人数显著下降,在大流行的第一波期间以及进展型MS患者中下降最为明显。在德国,需要抢救性复发治疗的MS和NMOSD患者继续接受血浆置换治疗。