Coronavirus-related stress, anxiety, and obsessive thinking in patients undergoing cardiac rehabilitation during the COVID19 pandemic

Abstract

Funding AcknowledgementsType of funding sources: Public grant(s) – National budget only. Main funding source(s): Slovenian Research Agency and Ministry of Health of the Republic of SloveniaBackgroundThe coronavirus (COVID19) pandemic has disrupted the provision of health care, including cardiac rehabilitation. Reduced healthcare provision has been associated with reduced accessibility, wheares patients’ perspectives – such as COVID19-related anxiety, stress and obsessive thinking – have been less thouroghly addressed.MethodsThis was a cross-sectional study of COVID19-related anxiety, stress and obsessive thinking in consecutive patients undergoing outpatient cardiac rehabilitation after myocardial infarction at two centres — a general hospital catering a predominantly rural area and a university hospital in an urban area. From April to October 2021 we captured patients’ clinical and socio-economic characteristics, and resposes to the Hospital Anxiety and Depression Scale (HADS) as well as to three dedicated COVID19-related questionnaires – the Coronavirus Anxiety Scale, the Obsession with COVID-19 Scale and a customized COVID-19 Stress Scale.ResultsWe included 109 patients (mean age 59±10 years, 20% women). Fifteen (13.8%) and eleven (11%) patients reached a HADS treshold for depression and anxiety, respectively. Pateints expressed most concenrs regarding the safety of COVID19 vaccinces (60.6%) on the COVID19 Stress Scale, sleeping disturbances (14.8%) on the Coronavirus Anxiety Scale, and fear of interacting with infected people (30.3%) on the Obsession with COVID-19 Scale. No significant differences were observed between respondents from the general and the university hospital. HADS score and social status—but not age, sex and clinical characteristics—were associated with scores on the COVID-19-specific questionnaires; HADS-anxiety domain score remained an independent predictor of COVID19-related stress (p=0.009), obsessive thinking (p<0.001) and anxiety (p=0.009) after multivariate adjustment.ConclusionsPatients undergoing cardiac rehabilitation expressed relatively low levels of COVID19-related stress and anxiety. Higher levels of COVID19-related stress, anxiety, and obsessive thinking were observed in patients with higher levels of anxiety, but not in association with demographic or clinical characteristics.