Impact of COVID-19 on hospital care, employment and mental health of people with Cystic Fibrosis

Abstract

BackgroundThe COVID-19 pandemic has been challenging for many but especially for people with pre-existing co-morbidities such as people with cystic fibrosis (PWCF). The aim of this study was to examine the impact of COVID-19 pandemic on hospital services access to essential medication, employment, and mental health of PWCF.MethodsA cross-sectional survey developed by University College Dublin and Cystic Fibrosis Ireland was uploaded on SmartSurvey UK and advertised by CF Ireland to CF community via CFI website and social media in October 2020. Logistic Regression was used for analysis.Results119 PWCF participated. 56 (47.5%) deferred hospital visits for CF care from 1-6 months: (57.4%) to 3 months; 42.6% 4 months-over 6 months), due to hospital closure (11.5%) & fear (69.8%). When adjusted for gender and location, PWCF aged <35 years were twice as likely to defer hospital visits as compared to those >35 years (P = 0.048). Online consultation and prescription via email was new for >50% of PWCF and >80% found it useful. Amongst those who worked (46.2%), 87.2% (n = 48) worked from home during COVID19. More PWCF <35 years (9.6%) worked onsite as compared to those >35 years (1.9%). 95% of employers were sympathetic for PWCF who cocooned while working from home (41.7%), however, overall, approximately 1/3rd of all employers were considered unsympathetic. 24.4% found access to CF medications challenging and 7 (5.9%) had to find alternative. After adjustment for gender and working, PWCF < 35 years were more likely to feel “nervous” (OR: 3.28; P = 0.017), “nothing could cheer them up” (OR: 3.24; P = 0.038) and “tired” (OR: 2.76; P = 0.016) compared to those >35 years.ConclusionsFear was a strong reason for essential hospital visit deferrals in COVID19, but hospital closures played an important part also. Prescription by email was novel and popular. There has been a serious impact on the mental health of this vulnerable group.Key messages COVID-19 impacted hospital visits due to fear and hospital closures; younger PWCF deferred more and for longer.The negative impact of COVID-19 on mental health was more pronounced in older PWCF.