Triage of amyotrophic lateral sclerosis patients during the COVID-19 pandemic: An application of the D50 model

Robert Steinbach*, Tino Prell, Nayana Gaur, Beatrice Stubendorff, Annekathrin Roediger, Benjamin Ilse, Otto W. Witte, Julian Grosskreutz

*Corresponding author for this work
4 Citations (Scopus)


Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease, the management of which requires the continuous provision of multidisciplinary therapies. Owing to the novel coronavirus disease (COVID-19) pandemic, regular contact with ALS patients at our center was severely restricted and patient care was at risk by delay of supportive therapies. We established a triage system based on the D50 disease progression model and were thus able to identify a prospective cohort with high disease aggressiveness (D50 < 30). Thirty-seven patients with highly aggressive disease were actively offered follow-up, either via telephone or on-site, depending on their disease-specific needs and abilities. We describe here the procedures, obstacles, and results of these prescient efforts during the restrictions caused by COVID-19 in the period between March and June 2020. In conclusion, four patients with highly aggressive disease were initiated with non-invasive ventilation and two received a gastrostomy. We could show that a comparable amount of advanced care was induced in a retrospective cohort within a similar time period one year prior to the COVID-19 outbreak. Our workflow to identify high-risk patients via D50 model metrics can be easily implemented and integrated within existing centers. It helped to maintain a high quality of advanced care planning for our ALS patients.

Original languageEnglish
Article number2873
JournalJournal of Clinical Medicine
Issue number9
Pages (from-to)1-14
Number of pages14
Publication statusPublished - 09.2020
Externally publishedYes

Research Areas and Centers

  • Centers: Center for Neuromuscular Diseases


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