Impact of COVID-19 Vaccine Rollout on Mental Health, Social Determinants of Health, and Attitudes Among Individuals With COPD

Overview

Journal Chronic Obstr Pulm Dis

Date 2024 Aug 13

PMID 39137254

Authors

Ashraf Fawzy

Jing Gennie Wang

James G Krings

Jiaxian He

Obiageli Offor

Michelle N Eakin

Janet T Holbrook

Robert A Wise

Affiliations

Soon will be listed here.

Abstract

Background: Social distancing early in the COVID-19 pandemic helped mitigate viral spread and protect vulnerable populations. Broad availability of vaccines allowed social re-integration, but effects on mental health, social determinants of health, and attitudes among individuals with chronic obstructive pulmonary disease (COPD), who are high risk for adverse outcomes following COVID-19 infection, are unknown.

Methods: Participants in the Losartan Effects on Emphysema Progression trial were recruited into an ancillary study from May to November 2020. Study coordinators administered telephone questionnaires to evaluate respiratory symptoms (COPD Assessment Test [CAT]), anxiety (Generalized Anxiety Disorder-7 [GAD-7]) and depressive (Patient Health Questionnaire [PHQ-8]) symptoms, social isolation, instrumental support, and attitudes and actions related to the COVID-19 pandemic. Generalized estimating equation models evaluated changes in patient-reported scores from the period before vaccine availability (prevaccine, May to December 2020) to the postvaccine period (May 2021 to September 2022).

Results: Of 157 enrolled participants, 138 were interviewed during both periods. Compared with the prevaccine period, severe respiratory symptoms (CAT>20) were higher in the postvaccine period (odds ratio [OR] 1.36, 95% confidence interval [CI] 95%: 1.00-1.85), as were moderate anxiety symptoms (GAD-7≥10; OR 1.65, 95%CI: 1.11-2.46) and moderate depressive symptoms (PHQ-8≥10; OR 1.77, 95%CI: 1.22-2.55). Social isolation improved, though not significantly, and instrumental support was unchanged. In the postvaccine period compliance with COVID-19 mitigation strategies remained high and governmental health care entities were viewed as trustworthy by fewer respondents.

Conclusion: Despite a trend towards less social isolation following broad availability of COVID-19 vaccines, individuals with COPD reported worse symptoms, and greater anxiety and depressive symptoms compared to the prevaccine period.

References

Toussaint A, Husing P, Gumz A, Wingenfeld K, Harter M, Schramm E . Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7). J Affect Disord. 2020; 265:395-401. DOI: 10.1016/j.jad.2020.01.032. View

Zareifopoulos N, Bellou A, Spiropoulou A, Spiropoulos K . Prevalence, Contribution to Disease Burden and Management of Comorbid Depression and Anxiety in Chronic Obstructive Pulmonary Disease: A Narrative Review. COPD. 2019; 16(5-6):406-417. DOI: 10.1080/15412555.2019.1679102. View

Fettes L, Bayly J, de Bruin L, Patel M, Ashford S, Higginson I . Relationships between prolonged physical and social isolation during the COVID-19 pandemic, reduced physical activity and disability in activities of daily living among people with advanced respiratory disease. Chron Respir Dis. 2021; 18:14799731211035822. PMC: 8370888. DOI: 10.1177/14799731211035822. View

Andersson O, Campos-Mercade P, Meier A, Wengstrom E . Anticipation of COVID-19 vaccines reduces willingness to socially distance. J Health Econ. 2021; 80:102530. PMC: 8442531. DOI: 10.1016/j.jhealeco.2021.102530. View

Williamson E, Walker A, Bhaskaran K, Bacon S, Bates C, Morton C . Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020; 584(7821):430-436. PMC: 7611074. DOI: 10.1038/s41586-020-2521-4. View

Czeisler M, Marynak K, Clarke K, Salah Z, Shakya I, Thierry J . Delay or Avoidance of Medical Care Because of COVID-19-Related Concerns - United States, June 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(36):1250-1257. PMC: 7499838. DOI: 10.15585/mmwr.mm6936a4. View

Moreland A, Herlihy C, Tynan M, Sunshine G, McCord R, Hilton C . Timing of State and Territorial COVID-19 Stay-at-Home Orders and Changes in Population Movement - United States, March 1-May 31, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(35):1198-1203. PMC: 7470456. DOI: 10.15585/mmwr.mm6935a2. View

Peng S, Roth A . Social Isolation and Loneliness Before and During the COVID-19 Pandemic: A Longitudinal Study of U.S. Adults Older Than 50. J Gerontol B Psychol Sci Soc Sci. 2021; 77(7):e185-e190. PMC: 8083229. DOI: 10.1093/geronb/gbab068. View

Zava T, Zava D . Validation of dried blood spot sample modifications to two commercially available COVID-19 IgG antibody immunoassays. Bioanalysis. 2020; 13(1):13-28. PMC: 7739400. DOI: 10.4155/bio-2020-0289. View

10.

Jones P, Harding G, Berry P, Wiklund I, Chen W, Leidy N . Development and first validation of the COPD Assessment Test. Eur Respir J. 2009; 34(3):648-54. DOI: 10.1183/09031936.00102509. View

11.

Bu F, Philip K, Fancourt D . Social isolation and loneliness as risk factors for hospital admissions for respiratory disease among older adults. Thorax. 2020; 75(7):597-599. PMC: 7361022. DOI: 10.1136/thoraxjnl-2019-214445. View

12.

Wise R, Holbrook J, Brown R, Criner G, Dransfield M, He J . Clinical Trial of Losartan for Pulmonary Emphysema: Pulmonary Trials Cooperative Losartan Effects on Emphysema Progression Clinical Trial. Am J Respir Crit Care Med. 2022; 206(7):838-845. PMC: 9799269. DOI: 10.1164/rccm.202201-0206OC. View

13.

Bauer-Staeb C, Kounali D, Welton N, Griffith E, Wiles N, Lewis G . Effective dose 50 method as the minimal clinically important difference: Evidence from depression trials. J Clin Epidemiol. 2021; 137:200-208. PMC: 8485844. DOI: 10.1016/j.jclinepi.2021.04.002. View

14.

Garuti G, Cilione C, DellOrso D, Gorini P, Lorenzi M, Totaro L . Impact of comprehensive pulmonary rehabilitation on anxiety and depression in hospitalized COPD patients. Monaldi Arch Chest Dis. 2003; 59(1):56-61. View

15.

Spitzer R, Kroenke K, Williams J, Lowe B . A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. View

16.

Suen A, Iyer A, Cenzer I, Farrand E, White D, Singer J . National Prevalence of Social Isolation and Loneliness in Adults with Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc. 2023; 20(12):1709-1717. PMC: 10704233. DOI: 10.1513/AnnalsATS.202304-288OC. View

17.

Zhang M, Ho R, Cheung M, Fu E, Mak A . Prevalence of depressive symptoms in patients with chronic obstructive pulmonary disease: a systematic review, meta-analysis and meta-regression. Gen Hosp Psychiatry. 2011; 33(3):217-23. DOI: 10.1016/j.genhosppsych.2011.03.009. View

18.

Hacker K, Briss P, Richardson L, Wright J, Petersen R . COVID-19 and Chronic Disease: The Impact Now and in the Future. Prev Chronic Dis. 2021; 18:E62. PMC: 8220960. DOI: 10.5888/pcd18.210086. View

19.

Kounali D, Button K, Lewis G, Gilbody S, Kessler D, Araya R . How much change is enough? Evidence from a longitudinal study on depression in UK primary care. Psychol Med. 2020; 52(10):1875-1882. PMC: 9340848. DOI: 10.1017/S0033291720003700. View

20.

Liu J, Gou R, Jones R, Schmitt E, Metzger E, Tabloski P . Association of Loneliness With Change in Physical and Emotional Health of Older Adults During the COVID-19 Shutdown. Am J Geriatr Psychiatry. 2023; 31(12):1102-1113. PMC: 10797604. DOI: 10.1016/j.jagp.2023.07.015. View