Abstract 223: Association Between Covid-19 Pandemic Related Anxiety and Advanced Care Planning Desire in Cardiac Arrest Survivors

Abstract

Introduction: Patients with cardiovascular disease conditions are at high risk for direct and indirect impacts of COVID-19 on morbidity and mortality. In light of this, we aimed to assess the extent to which COVID-19-related anxiety in patients with a history of cardiac arrest (CA) correlates with the desire to change or discuss advanced directives. Methods: Between May 15-28, 2020, a month after the New York City (NYC) COVID-19 pandemic peak, CA survivors from a prospective cohort were invited to participate in a telephone-based assessment of the pandemic’s impact on psychological and other survivorship dimensions. COVID-19-related anxiety was measured by the Generalized Anxiety Disorder-3 scale, which asks how often respondents felt (1) anxious, (2) unable to stop worrying, and (3) excessively worried over two weeks, and was keyed to the COVID-19 pandemic. Desire to discuss or to change financial and/or health-related advanced directives were reported on a yes-or-no basis. Results: 100 approached, 69 CA survivors participated (53% male; age 61±15 years; 44% White, 20% Black, and 31% Latinx). A majority, 58 of 69 (84%), had no COVID-19 symptoms and/or were not tested. Only 12 of the 69 respondents (17%) showed interest in discussing or changing advanced directives. There were no significant differences in the age, sex, race, or COVID-19 symptoms status between those who showed desire versus those who did not. Desire to change advance directives was significantly associated with increased COVID-19-related anxiety (OR 1.5, CI 95% [1.2-1.9] p<0.002). Conclusions: In CA survivors, a desire to change financial or healthcare-related advanced directives during the COVID-19 outbreak was associated with increased pandemic-related anxiety. The causality and directionality of this relationship require further, qualitative study.