Physical Activity and Mental Health of Patients with Pulmonary Hypertension during the COVID-19 Pandemic.

Khodr Tello,Britta Krüger,Hossein Ardeschir Ghofrani,Karsten Krüger,Natascha Sommer,Kristina Gebhardt,Jana Strahler,Christopher Weyh,Henning Gall,Carolin Leoni Dobler,Manuel Jonas Richter

doi:10.3390/jcm9124023

Abstract

The aim of the study was to analyze the effect of personal restrictions on physical activity, mental health, stress experience, resilience, and sleep quality in patients with pulmonary hypertension (PH) during the “lockdown” period of the COVID-19 pandemic. In total, 112 PH patients and 52 age-matched healthy control subjects completed a questionnaire on the topics of physical activity, mental health, resilience, and sleep quality. PH patients had significantly lower physical activity, mental health, and sleep quality compared to age-matched healthy controls. Physical activity positively correlated with mental health and sleep quality in the PH group. Mental wellbeing and life satisfaction could be predicted by total physical activity, sleep, stress level, and resilience. PH patients appeared as an especially vulnerable group, demanding interventions to promote an active lifestyle and protect mental health in these patients. This could be helpful in counseling on how to carry out physical activity while maintaining infection control.

Highlights

Pulmonary hypertension (PH) is a multifactorial chronic pulmonary disease which is defined by an elevated mean pulmonary arterial pressure, which untreated eventually can lead to right heart failure and death [1]
For the PH group, the level of mental health was represented through the WHO-5 scoring 11.9 ± 5.6, the Patient Health Questionnaire-4 (PHQ-4) being 3.9 ± 3.0, and the L-1 being 5.6 ± 2.7 on average
A prevalence of depression ranged from 36.4% and 53.6% derived from the WHO-5 score, the Patient Health Questionnaire-2 (PHQ-2) yellow flag, and PHQ-2 red flag

Summary

Introduction

Pulmonary hypertension (PH) is a multifactorial chronic pulmonary disease which is defined by an elevated mean pulmonary arterial pressure, which untreated eventually can lead to right heart failure and death [1]. Patients with PH experience symptoms such as shortness of breath, exertion, fatigue, chest pain that restrict physical activity, which in turn impairs quality of life and favors mental disorders such as depression [3,4,5,6]. On January 27th, the first COVID-19 infection in Germany was detected. Since “socio-physical distancing” is seen as one of the most effective strategies to reduce the number of infections, Robert-Koch Institute (RKI) called on the population in Germany to keep their distance from other people [8]. As elderly and patients with specific risk factors and pre-existing diseases are at a higher risk of severe COVID-19 course of disease and mortality [8], these groups, including PH patients, were prompted to be careful to reduce individual infection risks. One can assume that many persons at risk stayed at home, reduced their physical activity, and performed a social distancing to protect themselves

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