Background: Motor neuron disease (MND) is a progressive neurological disorder affecting the upper and lower neurons with no known cure. The purpose of this study is to examine the place of death for MND patients in the United States (U.S.) during the coronavirus pandemic and to investigate the extent specific comorbidities.
Methods: A population-based cross-sectional analysis was conducted of all U.S. MND deaths from 2018-2019 (pre-COVID), then expanded to include 2020 and 2021 (COVID) deaths to evaluate how COVID-19 might have affected place of death for MND patients. Death certificate data were obtained for all MND deaths among persons aged 20 years and older from 2018-2021 along with the associated comorbidities.
Results: A total of 30,067 MND deaths were analyzed, 14,563 pre-COVID and 15,504 during COVID. During COVID, an increased likelihood of dying at home compared to a nursing home/hospice was found for the Hispanic population (OR [95% CI]), (1.57 [1.22-2.02]) and current or former smokers (1.42 [1.21-1.68]) but a decreased likelihood of dying at home compared to a hospital (0.61 [0.51-0.72]) and (0.72 [0.63-0.83]). Comparing the top comorbidities listed in the underlying or contributing cause of death for MND deaths pre-COVID and during COVID, there was a 27.8% increase in diabetes mellitus and 20.2% increase in essential hypertension. Sepsis was more likely to be listed as a comorbidity in a hospital during COVID compared to pre-COVID (2.36 [1.37-4.07]). Diabetes mellitus was more likely to listed in a hospital (1.40 [1.03-1.89]) and decedent’s home (1.26 [1.03-1.55]). Essential hypertension was more likely to be listed when place of death was the decedent’s home (1.17 [1.01-1.36]) during COVID compared to pre-COVID years.
Conclusion: Data analyzed for MND deaths during COVID shows an increase in decedent’s home as place of death. Certain comorbidities also saw an increase during the COVID years, suggesting MND patients had a higher risk of death in other comorbidities than COVID-19 itself.