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Wieteska-Miłek M, Witowicz A, Szmit S, Florczyk M, Peller M, Dzienisiewicz M, Kurzyna M. Anxiety and Depression in Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension after the Removal of COVID-19 Pandemic Restrictions. J Clin Med 2024; 13:3532. [PMID: 38930062 PMCID: PMC11204547 DOI: 10.3390/jcm13123532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Background: There was increased risk of mental disturbances during the COVID-19 pandemic. Patients with chronic diseases, including pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH), were particularly vulnerable. Our previous study showed high levels of fear of COVID-19 (FCV-19S), anxiety (HADS-A), and depression (HADS-D) in the second year of the pandemic among PAH/CTEPH patients. The aim of the present study was to assess changes in the levels of FCV-19S, HADS-A, and HADS-D after removing restrictions related to the COVID-19 pandemic. Methods: In this prospective, single-center study, 141 patients (62% females, 64% PAH) with a median age of 60 (range 42-72) years were included. Patients completed appropriate surveys in the second year of the pandemic, and then, after the restrictions were lifted in Poland (after 28 March 2022). Results: FVC-19S decreased significantly from 18 (12-23) to 14 (9-21), p < 0.001. The levels of anxiety (HADS-A ≥ 8 points) and depression (HADS-D ≥ 8 points) were abnormal in 26% and 16% of patients, respectively; these did not change at follow-up (p = 0.34 for HADS-A and p = 0.39 for HADS-D). Conclusions: Among PAH/CTEPH patients, fear of COVID-19 decreased significantly after the COVID-19 pandemic restrictions were removed, but anxiety and depression remained high, indicating that the COVID-19 pandemic was not a major factor in causing these disorders.
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Affiliation(s)
- Maria Wieteska-Miłek
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre, ERN-LUNG Member, ul. Borowa 14/18, 05-400 Otwock, Poland; (A.W.); (M.F.); (M.K.)
| | - Anna Witowicz
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre, ERN-LUNG Member, ul. Borowa 14/18, 05-400 Otwock, Poland; (A.W.); (M.F.); (M.K.)
- Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland
| | - Sebastian Szmit
- Department of Cardio-Oncology, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland;
| | - Michał Florczyk
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre, ERN-LUNG Member, ul. Borowa 14/18, 05-400 Otwock, Poland; (A.W.); (M.F.); (M.K.)
| | - Michał Peller
- 1st Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland;
| | | | - Marcin Kurzyna
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre, ERN-LUNG Member, ul. Borowa 14/18, 05-400 Otwock, Poland; (A.W.); (M.F.); (M.K.)
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Zybarth D, Brandt M, Mundlos C, Inhestern L. [Consequences of a pandemic for people living with rare diseases and recommendations for maintaining healthcare and participation]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:57-65. [PMID: 38019314 PMCID: PMC10776713 DOI: 10.1007/s00103-023-03810-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 11/17/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Rare diseases are often characterized by complex symptoms and usually require coordination of multiprofessional treatment during the diagnostic and healthcare processes. In the wake of the COVID-19 pandemic, the healthcare situation and daily life of people with rare diseases and the caregivers of children with rare diseases changed drastically. The aim of the research project RESILIENT-SE-PAN was to assess the situation of people with rare diseases and caregivers during COVID-19 and to develop recommendations based on the findings. METHODS We conducted a mixed methods study including the perspective of people with rare diseases, caregivers and representatives from patient organizations and conducted a concluding workshop. RESULTS The findings indicate an impact on healthcare and daily life of participants. Moreover, mental burden, supportive needs, COVID-19-specific aspects but also positive aspects were mentioned. Based on the findings from our mixed methods study, we developed 21 recommendations referring to the following topics: medical diagnostics and healthcare of the rare diseases, additional therapies and aids, access to COVID-19 information and vaccination, psychosocial support, participation and activities, patient organisations and others. DISCUSSION The recommendations can provide an orientation for the organisation of healthcare in future crises or pandemics in order to adequately take the situations of people with rare diseases into account and consider the needs of this patient group.
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Affiliation(s)
- David Zybarth
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - Maja Brandt
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - Christine Mundlos
- Allianz Chronischer Seltener Erkrankungen (ACHSE) e. V., Berlin, Deutschland
| | - Laura Inhestern
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
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Dörner M, von Känel R, Pazhenkottil AP, Altwegg R, Nager L, Attanasio V, Guth L, Zirngast S, Menzi A, Princip M, Hackl-Zuccarella C. Fear of COVID-19 Predicts Depression, Anxiety and Post-Traumatic Stress Disorders in Patients with Implantable Cardioverter Defibrillators and Is Mediated by Positive and Negative Affects-A Cross-Sectional Study. J Clin Med 2023; 12:6884. [PMID: 37959349 PMCID: PMC10648893 DOI: 10.3390/jcm12216884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
The COVID-19 pandemic affected both the physical and mental health of the general population. People with cardiac diseases seem to be particularly vulnerable to the implications of the pandemic. However, studies on the mental health impact of the COVID-19 pandemic on people with implantable cardioverter defibrillator (ICDs) are lacking. Thus, we aimed to explore the level of fear of COVID-19 and the prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) in ICD patients. Furthermore, we aimed to identify novel predictors for anxiety, depression and PTSD, including COVID-19-related variables, and to assess whether positive affects (PAs) and negative affects (NAs) mediate the relationship between the level of fear of COVID-19 and anxiety, depression and PTSD, respectively. The data of 363 patients with ICDS who had been prospectively included in this study between 2020 and 2023, were analyzed. Potential predictors for anxiety, depression, and PTSD were identified using logistic regression. To identify indirect mediating effects of PAs and NAs, we applied the PROCESS regression path analysis modeling tool. The prevalence of anxiety was 9.19%, of depression 10.85%, and of PTSD 12.99%. Being unemployed was the strongest predictor for anxiety (OR = 10.39) and depression (OR = 6.54). Younger age predicted anxiety (OR = 0.95) and PTSD (OR = 0.92). Receiving low social support was associated with anxiety (OR = 0.91), depression (OR = 0.88) and PTSD (OR = 0.91). Patients with a history of COVID-19 (OR = 3.58) and those who did not feel well-informed about COVID-19 (OR = 0.29) were more likely to be depressed. Higher levels of fear of COVID-19 predicted anxiety (OR = 1.10), depression (OR = 1.12) and PTSD (OR = 1.14). The relationship between fear of COVID-19 and anxiety or depression was fully mediated by PAs and NAs, while NAs partially mediated the relationship between fear of COVID-19 and PTSD. Vulnerable subgroups of ICD patients may need additional psychological and educational interventions due to fear of COVID-19, anxiety, depression and PTSD during the pandemic.
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Affiliation(s)
- Marc Dörner
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
- German Center for Neurodegenerative Diseases (DZNE) within the Helmholtz Association, 39120 Magdeburg, Germany
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Aju P. Pazhenkottil
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Rahel Altwegg
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Ladina Nager
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Veronica Attanasio
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Lisa Guth
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Sina Zirngast
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Anna Menzi
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Mary Princip
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Claudia Hackl-Zuccarella
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
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Yao Y, Lin M, Ni J, Ni J. Hope Buffers the Effect of Fear of COVID-19 on Depression among College Students: Insomnia as a Mediator. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3245. [PMID: 36833940 PMCID: PMC9966876 DOI: 10.3390/ijerph20043245] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/07/2023] [Accepted: 02/11/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND In the period of the global pandemic, psychophysical problems induced by the fear of COVID-19 among college students deserve attention since the dormitory environment in college greatly increases the possibility of COVID-19 infection. METHODS A hypothesized mediated moderation model was to be verified using a cross-sectional study among 2453 college students. Fear of COVID-19, insomnia, hope, and depression were assessed by using the relevant scales. RESULTS (1) The fear of COVID-19 was positively correlated to depression (β = 0.365, t = 5.553, 95% CI = [0.236, 0.494]); (2) hope moderated the influence of the fear of COVID-19 on depression (β = -0.093, t = -4.066, 95% CI = [-0.137, -0.048]), as well as on insomnia (β = -0.095, t = -4.841, 95% CI = [-0.133, -0.056]); and (3) the mediated moderation model with hope as the moderator and insomnia as the full mediating variable between fear of COVID-19 and depression was verified (β = -0.060, 95% CI = [-0.093, -0.028]). CONCLUSIONS The findings suggest that hope is a vital mechanism to explain the relationship between the fear of COVID-19 and depression in early adulthood. In practical application, mental health practitioners should focus on boosting hope and alleviating insomnia when addressing COVID-19-related depression issues among college students.
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Affiliation(s)
- Yingying Yao
- Counseling and Education Center, Xiamen University, Xiamen 361005, China
| | - Min Lin
- Institute of Education, Xiamen University, Xiamen 361005, China
| | - Jianchao Ni
- School of Aerospace Engineering, Xiamen University, Xiamen 361005, China
| | - Jing Ni
- Faculty of Nursing, Jiujiang University, Jiujiang 332005, China
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Chu Y, Wang X, Dai H. Prevalence and risk factors for anxiety and depression among community dwelling patients with cervical spondylosis during the COVID-19 pandemic. Heliyon 2023; 9:e13497. [PMID: 36776911 PMCID: PMC9899124 DOI: 10.1016/j.heliyon.2023.e13497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/06/2023] Open
Abstract
Background The emergence of COVID-19 and its unfavorable consequences lead to disease fear and other related mental health problems for individuals worldwide. This study aimed to analyze the prevalence and relevant factors of anxiety and depression among community dwelling cervical spondylosis (CS) patients, and to explore the relationship between fear of COVID-19 and anxiety and depression, so as to provide scientific basis for improving their mental health. Methods A community-based cross-sectional study was conducted among a cohort of 556 CS patients by using convenient sampling. These participants were asked to complete a demographic questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Fear of COVID-19 Scale (FCV-19S). The Chi-square test was used to determine the differences among categorical variables. Binary stepwise logistic regression was used to determine predictors of anxiety and depression. Results The median HADS-A score was 5 (interquartile interval 2-7), and the median HADS-D score was 4 (interquartile interval 2-8). In this study, the prevalence of anxiety and depression was 25.0% and 26.6%, respectively. Gender and comorbid chronic diseases were predictors of depressive symptoms. In addition, fear of COVID-19 was related to depression and anxiety among community dwelling CS patients. Conclusion Approximately one quarter of community dwelling CS patients were suffering depression or anxiety. Our findings could provide a basis for the development of psychological crisis intervention strategies for CS patients under public health emergencies in the future.
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Affiliation(s)
| | | | - Hongliang Dai
- Corresponding author. School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Jinzhou, Liaoning, China.
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Farmakis IT, Giannakoulas G. Management of COVID-19 in Patients with Pulmonary Arterial Hypertension. Heart Fail Clin 2023; 19:107-114. [PMID: 36435565 PMCID: PMC9364740 DOI: 10.1016/j.hfc.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In this review, we discuss the evidence regarding the course and management of COVID-19 in patients with pulmonary arterial hypertension (PAH), the challenges in PAH management during the pandemic and, lastly, the long-term complications of COVID-19 in relation to pulmonary vascular disease. The inherent PAH disease characteristics, as well as age, comorbidities, and the patient's functional status act synergistically to define the prognosis of COVID-19 in patients with PAH. Management of COVID-19 should follow the general guidelines, while PAH-targeted therapies should be continued. The pandemic has caused a shift toward telemedicine in the chronic care of patients with PAH. Whether COVID-19 could predispose to the development of chronic pulmonary hypertension is a subject of future investigation.
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Affiliation(s)
- Ioannis T. Farmakis
- Department of Cardiology, AHEPA University Hospital, Stilp. Kiriakidi 1, Thessaloniki 54637, Greece,Center for Thrombosis and Hemostasis, University Medical Center Mainz, Langebeckstr. 1, 55131, Mainz, Germany
| | - George Giannakoulas
- Department of Cardiology, AHEPA University Hospital, Stilp. Kiriakidi 1, Thessaloniki 54637, Greece,Corresponding author. Aristotle University of Thessaloniki, AHEPA Hospital, Cardiology Department, Stilp. Kiriakidi 1, Thessaloniki 54637, Greece
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Rawlings GH, Thompson AR, Armstrong I, Beail N. What is the psychosocial burden of COVID-19 on people with pulmonary hypertension? THE CLINICAL RESPIRATORY JOURNAL 2022; 17:124-126. [PMID: 36539347 PMCID: PMC9880613 DOI: 10.1111/crj.13570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Affiliation(s)
| | - Andrew R. Thompson
- South Wales Clinical Psychology Training ProgrammeCardiff UniversityCardiffUK
| | - Iain Armstrong
- Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire HospitalSheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
| | - Nigel Beail
- Clinical and Applied Psychology UnitUniversity of SheffieldSheffieldUK
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BAŞKAYA E, KAYA Ç. Bireylerin Aşılara Yönelik Tutumları Üzerine COVID-19 Korkusunun Etkisi. DOKUZ EYLÜL ÜNIVERSITESI HEMŞIRELIK FAKÜLTESI ELEKTRONIK DERGISI 2022. [DOI: 10.46483/deuhfed.1013479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Giriş: Covid-19 hastalığının psikolojik etkileri devam etmektedir. Hastalığa ilişkin yaşanılan korku bireylerin Covid-19 aşılarına yönelik tutumlarını etkilemektedir.
Amaç: Bireylerin Covid-19 aşısına yönelik tutumları üzerine Covid-19 korkusunun etkisini belirlemektir.
Yöntem: Niceliksel araştırma yöntemlerinden tanımlayıcı tipte bir araştırmadır. Çalışmanın verileri 1 Temmuz- 31 Ağustos 2021 tarihleri arasında kartopu örnekleme tekniği kullanılarak online olarak toplanmıştır. Belirtilen süre içerisinde araştırmaya gönüllü olarak katılmayı kabul eden ve formu eksiksiz dolduran 221 kişi araştırmanın örneklemini oluşturmuştur. Veri toplama araçları “Katılımcı Bilgi Formu”, “Covid-19 Korku Ölçeği” ve “Covid-19 Aşısına Yönelik Tutumlar Ölçeği” dir.
Bulgular: Araştırmaya katılan bireylerin Covid-19 korku ölçeği puan ortalaması 17.84 ± 6.65; Covid-19 aşısına yönelik olumlu tutum alt boyut puan ortalaması 3.79 ± 1.12; Covid-19 aşısına yönelik olumsuz tutum alt boyut puan ortalaması 3.57 ± 1.23 olarak tespit edilmiştir. Covid-19 korku ve Covid-19 aşısına yönelik olumlu tutum değişkenleri arasında pozitif yönde, anlamlı (r = .28; p = .000) bir ilişki saptanmıştır. Ayrıca, Covid-19 korkusunun bireylerin Covid-19 aşına yönelik olumlu tutum düzeyi üzerinde anlamlı bir etkiye sahip olduğu görülmüştür (t = 4.396; p = .000).
Sonuç: Covid-19 korkusu bireylerin Covid-19 aşısına yönelik tutumunu olumlu şekilde etkilemiştir
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Mickael C, Lee MH, Graham BB. The COVID-19 pandemic and pulmonary arterial hypertension in Italy: adaptation, outcomes and valuable lessons learned. Eur Respir J 2022; 60:2200796. [PMID: 36202406 PMCID: PMC9924355 DOI: 10.1183/13993003.00796-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 04/29/2022] [Indexed: 11/05/2022]
Abstract
This editorial summarises the key findings of R. Badagliacca and co-workers regarding the changes in care and clinical outcomes of PAH patients during the initial COVID-19 pandemic in Italy https://bit.ly/3ytgIjk
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Affiliation(s)
- Claudia Mickael
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Michael H Lee
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Brian B Graham
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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A Retrospective Study of Diaphragmatic Breathing Training Combined with Discharge Care Bundles in Patients with Chronic Obstructive Pulmonary Disease. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9649986. [PMID: 36159577 PMCID: PMC9492362 DOI: 10.1155/2022/9649986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/16/2022] [Accepted: 08/20/2022] [Indexed: 11/18/2022]
Abstract
Objective. Both physical exercise and discharge care bundles can improve patient outcomes and reduce hospitalization rates among subjects with chronic obstructive pulmonary disease (COPD). The retrospective analysis aims to determine the advantages of care bundles combined with diaphragmatic breathing training (DBT) in COPD patients after discharge. Methods. Of the 110 COPD patients, 55 patients received DBT alone (DBT group) and 55 participants received the combined intervention (care bundle + DBT group). Three months after discharge, we assessed the outcomes of patients using Bristol COPD Knowledge Questionnaire (BCKQ), Hospital Anxiety and Depression Scale (HADS), COPD Assessment Test (CAT), and St. George’s Respiratory Questionnaire (SGRQ). Meanwhile, COPD-related hospital readmissions were also recorded. Results. The BCKQ score for assessing the disease knowledge level was increased in patients at 3 months after the combined interventions as compared to the baseline values, which was higher in the care bundle + DBT group than the DBT group at 3 months. Moreover, improvements in negative emotion and clinical symptoms from baseline to 3-month follow-up were seen in both the two groups. Besides, the care bundle + DBT group showed the mitigation of depression and anxiety and the alleviation of clinical symptoms in comparison with the DBT group at 3 months. Participants who received combined interventions had lower SGRQ scores than those who received DBT alone. The time to first COPD-related readmission was shorter for patients in the care bundle + DBT group compared with the DBT group. Conclusions. DBT combined with discharge care bundles for COPD patients resulted in improvements in disease-specific knowledge, negative emotions, and clinical symptoms with better HRQOL and lower readmission rate.
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Montani D, Certain MC, Weatherald J, Jaïs X, Bulifon S, Noel-Savina E, Nieves A, Renard S, Traclet J, Bouvaist H, Riou M, de Groote P, Moceri P, Bertoletti L, Favrolt N, Guillaumot A, Jutant EM, Beurnier A, Boucly A, Ebstein N, Jevnikar M, Pichon J, Keddache S, Preda M, Roche A, Solinas S, Seferian A, Reynaud-Gaubert M, Cottin V, Savale L, Humbert M, Sitbon O. COVID-19 in Patients with Pulmonary Hypertension: A National Prospective Cohort Study. Am J Respir Crit Care Med 2022; 206:573-583. [PMID: 35549842 PMCID: PMC9716894 DOI: 10.1164/rccm.202112-2761oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Rationale: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with pulmonary endothelial dysfunction. There are limited data available on the outcomes of coronavirus disease (COVID-19) in patients with pulmonary hypertension (PH), a disease characterized by pulmonary endothelial dysfunction. Objectives: To describe characteristics and outcomes of patients with precapillary PH and COVID-19. Methods: We prospectively collected characteristics, management, and outcomes of adult patients with precapillary PH in the French PH network who had COVID-19 between February 1, 2020, and April 30, 2021. Clinical, functional, and hemodynamic characteristics of PH before COVID-19 were collected from the French PH registry. Measurements and Main Results: A total of 211 patients with PH (including 123 with pulmonary arterial hypertension, 47 with chronic thromboembolic PH, and 41 with other types of PH) experienced COVID-19, and 40.3% of them were outpatients, 32.2% were hospitalized in a conventional ward, and 27.5% were in an ICU. Among hospitalized patients (n = 126), 54.0% received corticosteroids, 37.3% high-flow oxygen, and 11.1% invasive ventilation. Right ventricular and acute renal failure occurred in 30.2% and 19.8% of patients, respectively. Fifty-two patients (all hospitalized) died from COVID-19. Overall mortality was 24.6% (95% CI [confidence interval], 18.8-30.5) and in-hospital mortality 41.3% (95% CI, 32.7-49.9). Nonsurvivors were significantly older, more frequently male and suffering comorbidities (diabetes, chronic respiratory diseases, systemic hypertension, chronic cardiac diseases, and/or chronic renal failure), and had more severe PH at their most recent evaluation preceding COVID-19 diagnosis (in terms of functional class and 6-minute-walk distance; all P < 0.05). Use of pulmonary arterial hypertension therapy was similar between survivors and nonsurvivors. Conclusions: COVID-19 in patients with precapillary PH was associated with a high in-hospital mortality. The typical risk factors for severe COVID-19 and severity of PH were associated with mortality in this population.
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Affiliation(s)
- David Montani
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Marie-Caroline Certain
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Jason Weatherald
- Division of Respirology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada;,Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Xavier Jaïs
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Sophie Bulifon
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | | | - Ana Nieves
- Service de Pneumologie Centre Hospitalier Universitaire Nord, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Sébastien Renard
- Service de Cardiologie, Centre Régional de Compétences de l'Hypertension Pulmonaire, Hôpital La Timone, Marseille, France
| | - Julie Traclet
- Université Lyon-1, Hospices Civils de Lyon, Centre de Référence des Maladies Pulmonaires Rares, Centre de Compétences de l'Hypertension Pulmonaire, Hôpital Louis Pradel, Lyon, France
| | - Hélène Bouvaist
- Service de Cardiologie, Hôpital Universitaire Grenoble-Alpes, Grenoble, France
| | - Marianne Riou
- Département de Pneumologie, Nouvel Hôpital Civil, Strasbourg, France
| | - Pascal de Groote
- Hôpital Cardiologique de Lille, Centre de Compétences de l'Hypertension Pulmonaire, Lille, France
| | - Pamela Moceri
- Unité de Recherche Clinique Côte d'Azur, Service de Cardiologie, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Laurent Bertoletti
- Service de Médecine Vasculaire et Thérapeutique, Institut National de la Santé et de la Recherche Médicale Unité 1059 et Centre d'Investigation Clinique 1408, Centre Hospitalier Universitaire de Saint-Etienne, Université Jean-Monnet, Saint-Etienne, France
| | - Nicolas Favrolt
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Anne Guillaumot
- Université de Lorraine, Centre Hospitalo-Universitaire Nancy, Pôle des Spécialités Médicales, Département de Pneumologie, Vandoeuvre-lès-Nancy, France; and
| | - Etienne-Marie Jutant
- Université de Poitiers, Centre Hospitalo-Universitaire de Poitiers, Service de pneumologie, Institut National de la Santé et de la Recherche Médicale Centre d'Investigation Clinique 1402, Poitiers, France
| | - Antoine Beurnier
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Physiology – Pulmonary Function Testing, Assistance Publique – Hôpitaux de Paris, Hôpital Bicêtre, Département Médico-Universitaire 5 Thorinno, Le Kremlin-Bicêtre, France
| | - Athénaïs Boucly
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Nathan Ebstein
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Mitja Jevnikar
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Jérémie Pichon
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Sophia Keddache
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Mariana Preda
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Anne Roche
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Sabina Solinas
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Andrei Seferian
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Martine Reynaud-Gaubert
- Service de Pneumologie Centre Hospitalier Universitaire Nord, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Vincent Cottin
- Université Lyon-1, Hospices Civils de Lyon, Centre de Référence des Maladies Pulmonaires Rares, Centre de Compétences de l'Hypertension Pulmonaire, Hôpital Louis Pradel, Lyon, France
| | - Laurent Savale
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Marc Humbert
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
| | - Olivier Sitbon
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France;,Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche _S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France;,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, and
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12
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Wieteska-Miłek M, Szmit S, Florczyk M, Witowicz A, Kurzyna M. Physical Activity in Pulmonary Arterial Hypertension during Pandemic COVID-19 and the Potential Impact of Mental Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148343. [PMID: 35886194 PMCID: PMC9323217 DOI: 10.3390/ijerph19148343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/01/2022] [Accepted: 07/06/2022] [Indexed: 02/01/2023]
Abstract
One of the non-pharmacological recommendations for stable patients with pulmonary arterial hypertension (PAH) is to increase physical activity. The study aimed to analyze the degree of physical activity of PAH patients and check if mental factors may have a potential negative impact during the COVID-19 pandemic. Forty patients with stable PAH were included in the study. Physical activity was assessed by pedometer (Omron HJ-321-E) for four weeks. At baseline, in addition to the 6 min walk test (6MWT) and functional assessment, patients completed the quality-of-life questionnaire SF-36, fear of COVID-19 scale, and hospital anxiety and depression scale (HADS). The mean age of the study group was 45.5 years, 80% were women, and 62.5% had idiopathic/heritable PAH. Low physical activity defined as <5000 steps/day had 19 (47.5%), and moderate/high physical activity (≥5000 steps/day) had 21 (52.5%) patients. Patients with low physical activity less frequently worked compared with the moderate−high-activity sub-group, 42% vs. 81%, p = 0.03, and had the shorter distance in 6-6MWT, p = 0.03. There was no significant correlation between steps/day and different mental factors. Almost half of the study group had low activity during the pandemic. Mental factors did not impact physical activity in PAH patients during the pandemic.
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13
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Dering MR, Lepsy N, Fuge J, Meltendorf T, Hoeper MM, Heitland I, Kamp JC, Park DH, Richter MJ, Gall H, Ghofrani HA, Ellermeier D, Kulla HD, Kahl KG, Olsson KM. Prevalence of Mental Disorders in Patients With Chronic Thromboembolic Pulmonary Hypertension. Front Psychiatry 2022; 13:821466. [PMID: 35308878 PMCID: PMC8925996 DOI: 10.3389/fpsyt.2022.821466] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/24/2022] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE Pulmonary hypertension (PH) is a chronic and progressive pulmonary vascular disease resulting in symptoms such as shortness of breath and fatigue and leading to death from right heart failure if not adequately treated. Chronic thromboembolic pulmonary hypertension (CTEPH) is a subgroup of PH characterized by obstruction or occlusion of pulmonary arteries by post-embolic fibrotic material. To date, few studies examined symptoms of depression and anxiety in patients with CTEPH, showing depression levels as high as 37.5%. However, none of the former studies used structured expert interviews. METHODS Mental disorders were diagnosed using the Structured Clinical Interview for DSM-5 (SCID). The prevalence of mental disorders in patients with CTEPH were compared to the prevalence in patients with pulmonary arterial hypertension (PAH) and the general German population. Quality of life (QoL) was measured with World Health Organization (WHO) Quality of Life questionnaire (short form). Factors associated with QoL were analyzed with linear regression and the diagnostic value of the Hospital Anxiety and Depression Scale (HADS) was evaluated using receiver operating characteristics (ROC) curve analysis. RESULTS Hundred and seven patients with CTEPH were included. Almost one-third of the patients (31.8%) had current psychological disorders. Panic disorder (8.4%), specific phobia (8.4%), and major depressive disorder (6.5%) were the most prevalent mental illnesses. The prevalence of panic disorders was higher in CTEPH compared to the German population while major depressive disorder was fewer in CTEPH compared to PAH. The presence of mental disorders had a major impact on QoL. Hospital Anxiety and Depression Scale discriminated depression and panic disorder reliably. CONCLUSION Mental disorders are common in patients with CTEPH and associated with an impaired QoL. The HADS may be a useful screening tool for panic and depression disorders in patients with CTEPH. Further research on therapeutic strategies targeting mental disorders in patients with CTEPH is needed.
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Affiliation(s)
- Madelaine-Rachel Dering
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Nicole Lepsy
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Jan Fuge
- Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany
| | - Tanja Meltendorf
- Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany
| | - Marius M Hoeper
- Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany
| | - Ivo Heitland
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Jan C Kamp
- Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany
| | - Da-Hee Park
- Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany
| | - Manuel J Richter
- Department of Internal Medicine, Justus Liebig University Giessen, Universities of Giessen and Marburg Lung Center, German Center for Lung Research (DZL), Giessen, Germany
| | - Henning Gall
- Department of Internal Medicine, Justus Liebig University Giessen, Universities of Giessen and Marburg Lung Center, German Center for Lung Research (DZL), Giessen, Germany
| | - Hossein A Ghofrani
- Department of Internal Medicine, Justus Liebig University Giessen, Universities of Giessen and Marburg Lung Center, German Center for Lung Research (DZL), Giessen, Germany.,Department of Pneumology, Kerckhoff Heart, Rheuma and Thoracic Center, Universities of Giessen and Marburg Lung Center, German Center for Lung Research, Bad Nauheim, Germany
| | | | | | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Karen M Olsson
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.,Department of Respiratory Medicine, Hannover Medical School, German Center for Lung Research (DZL/BREATH), Hannover, Germany
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14
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Wieteska-Miłek M, Szmit S, Florczyk M, Kuśmierczyk-Droszcz B, Ryczek R, Kurzyna M. COVID-19 Vaccination in Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension: Safety Profile and Reasons for Opting against Vaccination. Vaccines (Basel) 2021; 9:vaccines9121395. [PMID: 34960141 PMCID: PMC8706780 DOI: 10.3390/vaccines9121395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 01/30/2023] Open
Abstract
The incidence of COVID-19 infection in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) is similar to that in the general population, but the mortality rate is much higher. COVID-19 vaccination is strongly recommended for PAH/CTEPH patients. The aim of our cross-sectional study was to identify reasons why PAH/CTEPH patients refused vaccination against COVID-19. Moreover, we assessed the safety profile of approved COVID-19 vaccines in PAH/CTEPH patients. We examined 261 patients (164 PAH patients and 97CTEPH patients) with a median age of 60 (18–92) years, 62% of which were female. Sixty-one patients (23%) refused to be vaccinated. The main reason for unwillingness to be vaccinated was anxiety about adverse events (AEs, 61%). Age and fear of COVID-19 in the univariate analysis and age ≥60 years in the multivariate regression analysis were factors that impacted willingness to be vaccinated (OR = 2.5; p = 0.005). AEs were reported in 61% of vaccinated patients after the first dose and in 40.5% after the second dose (p = 0.01). The most common reported AEs were pain at the injection site (54.5%), fever (22%), fatigue (21%), myalgia (10.5%), and headache (10%). A lower percentage of AEs was reported in older patients (OR = 0.3; p = 0.001). The COVID-19 vaccines are safe for PAH/CTEPH patients. The results obtained in this study may encourage patients of these rare but severe cardio-pulmonary diseases to get vaccinated against COVID-19.
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Affiliation(s)
- Maria Wieteska-Miłek
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Center, 05-400 Otwock, Poland; (S.S.); (M.F.); (M.K.)
- Correspondence:
| | - Sebastian Szmit
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Center, 05-400 Otwock, Poland; (S.S.); (M.F.); (M.K.)
| | - Michał Florczyk
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Center, 05-400 Otwock, Poland; (S.S.); (M.F.); (M.K.)
| | | | - Robert Ryczek
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-349 Warsaw, Poland;
| | - Marcin Kurzyna
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Center, 05-400 Otwock, Poland; (S.S.); (M.F.); (M.K.)
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