Fawzy Ashraf, Wang Jing Gennie, Krings James G, He Jiaxian, Offor Obiageli, Eakin Michelle N, Holbrook Janet T, Wise Robert A
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States.
Division of Pulmonary, Critical Care and Sleep Medicine, Ohio State University, Columbus, Ohio, United States.
Chronic Obstr Pulm Dis. 2024 Sep 27;11(5):496-506. doi: 10.15326/jcopdf.2024.0537.
Social distancing early in the COVID-19 pandemic helped mitigate viral spread and protect vulnerable populations. Broad availability of vaccines allowed social re-integration, but effects on mental health, social determinants of health, and attitudes among individuals with chronic obstructive pulmonary disease (COPD), who are high risk for adverse outcomes following COVID-19 infection, are unknown.
Participants in the Losartan Effects on Emphysema Progression trial were recruited into an ancillary study from May to November 2020. Study coordinators administered telephone questionnaires to evaluate respiratory symptoms (COPD Assessment Test [CAT]), anxiety (Generalized Anxiety Disorder-7 [GAD-7]) and depressive (Patient Health Questionnaire [PHQ-8]) symptoms, social isolation, instrumental support, and attitudes and actions related to the COVID-19 pandemic. Generalized estimating equation models evaluated changes in patient-reported scores from the period before vaccine availability (prevaccine, May to December 2020) to the postvaccine period (May 2021 to September 2022).
Of 157 enrolled participants, 138 were interviewed during both periods. Compared with the prevaccine period, severe respiratory symptoms (CAT>20) were higher in the postvaccine period (odds ratio [OR] 1.36, 95% confidence interval [CI] 95%: 1.00-1.85), as were moderate anxiety symptoms (GAD-7≥10; OR 1.65, 95%CI: 1.11-2.46) and moderate depressive symptoms (PHQ-8≥10; OR 1.77, 95%CI: 1.22-2.55). Social isolation improved, though not significantly, and instrumental support was unchanged. In the postvaccine period compliance with COVID-19 mitigation strategies remained high and governmental health care entities were viewed as trustworthy by fewer respondents.
Despite a trend towards less social isolation following broad availability of COVID-19 vaccines, individuals with COPD reported worse symptoms, and greater anxiety and depressive symptoms compared to the prevaccine period.
在新冠疫情早期实施社交距离措施有助于减缓病毒传播并保护弱势群体。广泛可得的疫苗使得社会能够重新融合，但对于慢性阻塞性肺疾病（COPD）患者（他们在感染新冠病毒后出现不良后果的风险较高）的心理健康、健康的社会决定因素以及态度的影响尚不清楚。
2020年5月至11月，将参加氯沙坦对肺气肿进展影响试验的参与者纳入一项辅助研究。研究协调员通过电话问卷来评估呼吸症状（慢性阻塞性肺疾病评估测试[CAT]）、焦虑症状（广泛性焦虑障碍量表[GAD - 7]）和抑郁症状（患者健康问卷[PHQ - 8]）、社会隔离情况、工具性支持以及与新冠疫情相关的态度和行为。广义估计方程模型评估了患者报告的分数从疫苗可用之前的时期（预接种期，2020年5月至12月）到接种疫苗后的时期（2021年5月至2022年9月）的变化。
在157名登记参与者中，138人在两个时期都接受了访谈。与预接种期相比，接种疫苗后的时期严重呼吸症状（CAT>20）更多（优势比[OR]为1.36，95%置信区间[CI]：1.00 - 1.85），中度焦虑症状（GAD - 7≥10；OR为1.65，95%CI：1.11 - 2.46）和中度抑郁症状（PHQ - 8≥10；OR为1.77，95%CI：1.22 - 2.55）也是如此。社会隔离情况有所改善，尽管不显著，且工具性支持没有变化。在接种疫苗后的时期，对新冠疫情缓解策略的依从性仍然很高，但认为政府医疗保健实体值得信赖的受访者减少了。
尽管在广泛提供新冠疫苗后社会隔离有减少的趋势，但与预接种期相比，慢性阻塞性肺疾病患者报告的症状更严重，焦虑和抑郁症状更明显。
