Abstract
Cancer patients are a population at high risk of contracting COVID-19 and, also of developing severe complications due to the infection, which is especially true when they are undergoing immunosuppressive treatment. Despite this, they had still to go to hospital to receive chemotherapy during lockdown. In this context, we have evaluated the psychological status of onco-hematological outpatients receiving infusion and not deferrable anti-neoplastic treatment for lymphoproliferative neoplasms, with the aim of both measuring the levels of post-traumatic symptoms, depression, and anxiety during the pandemic and also of investigating the perception of risk of potential nosocomial infection. The Impact of Event Scale-Revised (IES-R) and the Hospital Anxiety and Depression Scale (HADS) were administered to all patients. Moreover, patients were investigated about their worries regarding the impact of COVID-19 on their lives as onco-hematologic patients. Since the 2nd to the 29th April 2020 (during the first phase of the lockdown period in Italy), 77 outpatients were prospectively evaluated. They were diagnosed with non-Hodgkin's lymphoma, classical Hodgkin lymphoma, and Chronic lymphocytic leukemia/Small lymphocytic lymphoma. The mean age was 56.6 (range 22–85). We found that 36% of patients had anxiety (HADS-A), 31% depression (HADS-D), and 43% were above the cut-off for the HADS-General Scale; 36% fulfilled the diagnostic criteria for post-traumatic stress disorder (PTSD). Women and younger patients were found to be more vulnerable to anxiety and PTSD. The study firstly analyzes the psychological impact of the COVID-19 pandemic on the frail population of patients affected by lymphoproliferative neoplasms, to underly the importance of screening patients for emotional and distress conditions and then offering them psychological support.
Highlights
Coronavirus Disease 2019 (COVID-19), the disease caused by SARS-CoV-2, was firstly diagnosed in Wuhan, China, in late October 2019, and rapidly spread all over the world, causing a severe pandemic1
COVID-19 and Psychological Distress in Lymphoma contagions and deaths were observed in the northern part of the Country (Lombardia 55.8%, Emilia Romagna 13.8%, Piemonte 7.5%, Veneto 5.2%), but every region was affected, with the virus affecting large cities
Consecutive outpatients diagnosed with a lymphoproliferative neoplasm were prospectively enrolled in the study as they arrived in our clinic to receive infusion chemo- or immunotherapy
Summary
Coronavirus Disease 2019 (COVID-19), the disease caused by SARS-CoV-2, was firstly diagnosed in Wuhan, China, in late October 2019, and rapidly spread all over the world, causing a severe pandemic. In Italy, the first patient was identified on the 18th February, and since that time to the 24th April 192,994 positive cases were identified and 25,969 deaths occurred. The psychological effects of the COVID-19 quarantine on the general population in China showed a high prevalence of symptoms of posttraumatic stress. In Italy, a survey 18,147 people during the epidemic peak found the presence of high levels of post-traumatic stress disorder, depression, anxiety, insomnia, and perceived stress [5]. Being of a younger age and female were factors constantly associated with an increased risk of developing major mental health disorders [5]. The mean age of infected people in Italy was 79 years, with a slight prevalence of males (63.3%), and with more than 80% of cases presenting with two or more comorbidities
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