Smoking and associated unhealthy lifestyle behaviours in patients with chronic cardiac diseases during COVID-19 related lockdown

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Dijon University Hospital France

OnBehalf

CLEO-CD

Background

  Lockdown can affect tobacco smoking (TS) behaviours. 

Purpose

To evaluate the impact of lockdown on (TS) and associated lifestyle behaviours in patients with Chronic coronary syndrome (CCS) and congestive heart failure (CHF)

Methods

CCS and CHF patients were invited to answer to a phone-call questionnaire during the 1st COVID-19 lockdown start 

Results

(Table) 343 questionnaires were fit for analysis, 43 (12.5%) were current smokers (CS). CS were younger (p < 0.001), none stopped and 13 increased their consumption (main reasons were stress and boredom). CS felt more often cramped (p = 0.023). CS who increased their TS consumption showed a trend toward a higher rate of unhealthy lifestyle behaviours

Conclusions

During the lockdown, more than ¼ of CS with CCS or CHF increased their TS consumption and none quitted. Moreover, TS was often associated with other deleterious behaviours increasing their risk for short and long term

Impact of lockdown in patients with congestive heart failure during the Covid-19 pandemic

Funding Acknowledgements

Type of funding sources: Private company. Main funding source(s): Dijon Football Côte d"Or

OnBehalf

CLEO-CD

Background

Congestive heart failure (CHF) can be destabilized by Covid-19 (C19) lockdown.

Purpose

To evaluate the impact of lockdown in CHF patients.

Methods

150 out-patients from the HF Clinic of our hospital were invited to answer to a phone-call interview during the 7th week of first C19 lockdown .

Results

From 124 questionnaires, more than 1/5 felt worse and almost 1/4 declared a psychologic distress. CHF medications were modified in 10%. Decrease in physical activity was observed in 2/5. Almost 1/2 declared increased screen time;  smokers often increased consumption. Adherence to dietary counselling was reduced by 1/6, increase in weight and HF symptoms were common. Some patients benefitted from a teleconsultation.

Conclusions

Our patients exhibited well-being impairment and unhealthy behaviours. Medication adherence was not diminished and the reduction in care access was counterbalanced by a switch toward telehealth.

Main results

	124 patients	75 Male (M)	49 Female (F)	p value between M and F
Age, years	71.0 ± 14.0	68.9 ± 13.7	74.3 ± 14.0	0.03
Urban/Rural	82/42	49/26	33/16	0.84
HFrEF*	87	62	25	<0.001
Dilated cardiomyopathy	50	37	13	0.02
Ischemic	23	18	5	0.06
Other	51	20	31	<0.0001
Current NYHA class I/II/III/IV	39/48/28/9	29/29/14/3	10/19/14/6	0.66
History of NYHA III-IV class	94	62	32	0.03
Electronic device/Telemonitoring	77/28	54/18	23/10	<0.001/0.66
Increase in dyspnea or edema or fatigue	27	13	14	0.07
Decrease in well-being	27	12	15	0.07
Psychological distress (#)	23	15 (20.0)	8	0.64
Weight gain > 2 kg	34	22 (29.3)	12	0.68
Switch for teleconsultation (##)	16	11 (34.4)	5	1
Teleconsultation (total)	23	14	9	1
Decrease in physical activity	52	25 (33.3)	27	0.02
Increase in screen time	57	31 (41.3)	26	0.27
Increase in cigarette consumption (9 smokers)	4	3	1	1
Decrease in dietary adherence (###)	22 (17.7)	15 (20.0)	7 (14.3)	0.47

*HFrEF; # Kessler-6 score ≥ 5; ## from planned physical examination; ### salt, water, alcohol

During the Covid-19 lockdown, rural residence is associated to healthier lifestyle behaviours in patients with chronic coronary syndrom

Funding Acknowledgements

Type of funding sources: Private company. Main funding source(s): Dijon Football Côte d"Or

OnBehalf

CLEO-CD

Background

Lifestyle behaviours (LB) are keystones of coronary prevention and might be impacted during Covid-19 (C19) lockdown.

Purpose

To compare the LB in urban and rural patients suffering from chronic coronary syndrom (CCS)

Methods

250 outpatients suffering from CCS were invited during the 6th week of the 1st C19 lockdown to answer to a phone-call questionnaire.

Results

220 questionnaires were fit for analysis, of whom about 1/4 declared a psychologic impairment; people staying at home in urban zones trended to be more impacted. Unhealthier behaviours including cigarette smoking, decrease in physical activity and increase in screentime were common, especially in patients from urban zones. Telehealth partially counterbalanced limitation in care access and none declared discontinuation of medications.

Conclusion

The lockdown impacted wellbeing of CCS patients; living in rural zone was associated with a healthier LB.

Main results

	TOTAL	URBAN	RURAL
N (%)	220	107	113	p *
Age (years, SD)	66.4+/-12.0	64.5+/-14.0	68.2+/-9.5	0.02
Male/Female	154/66	76/31	78/35	0.77
Alone at home	47(21.7)	28(26.2)	19(17.3)	0.13
Feeling cramped	16(7.6)	13(12.5)	3(2.8)	0.008
Feeling less well	50(22.9)	29(27.1)	21(18.9)	0.19
Kessler-6 score ≥ 5	57(26.8)	33(32.0)	24(21.8))	0.12
Sleep impairment	53(24.5)	30(28.6)	23(20.7)	0.20
Angina pectorisdestabilization	13(6.6)	8(7.9)	5(5.3)	0.57
Cancelled physical examination**	67(63.8)	40(65.6)	27(61.4)	0.68
Switched to Telehealth***	16(17.0)	7(17.5)	9(16.7)	1
Coronavirus testing	7(3.2)	3(2.8)	4(3.6)	1
Lifestyle behaviours
Cigarette smoking	36(16.4)	26(23.3)	10(9.3)	0.006
Cigarette smoking increase	11(30.6)	8(40.0)	3(18.8)	0.27
Decreased physical activity	96(44.2)	56(53.3)	40(35.7)	0.009
Screentime increase	98(45.0)	59(55.1)	39(35.1)	0.004
Alcohol intake increase	10(5.2)	5(5.3)	5(5.2)	1
Weight increase ≥ 2 kg	52(24.5)	28(26.9)	24(22.2)	0.52

* between Urban and Rural

**from scheduled physical examination

***from cancelled scheduled physical examination

Impact of lockdown on patients with congestive heart failure during the coronavirus disease 2019 pandemic

AIMS

Cardiovascular co-morbidities like congestive heart failure (CHF) alter the course of coronavirus disease 2019. Factors associated with the outbreak and lockdown can exacerbate CHF.

METHODS AND RESULTS

We analysed the answers of 124 randomly selected CHF outpatients (mean age 71.0 ± 14.0 years, 60.5% male) interviewed by phone during the sixth and seventh weeks of the lockdown. Most patients were treated for New York Heart Association class II (38.7%) and reduced ejection fraction HF (70.2%). Psychological distress (Kessler 6 score ≥ 5) was common (18.5%), and 21.8% felt worse than before the lockdown. Few patients (n = 10) adjusted their intake of HF medications, always on medical prescription. Decreased physical activity was common (41.9%) and more frequent in women (P = 0.025) and urban dwellers (P = 0.009). Almost half of respondents (46.0%) declared increased screen time, but only few declared more alcohol intake (4.0%). Weight gain was common (27.4%), and 44.4% of current smokers increased tobacco consumption. Adherence to recommended salt or fluid intake restrictions was reduced in 14.5%. Increase in HF symptoms was commonly reported (21.8%) and tended to be higher in women than in men (P = 0.074). Of the 23 patients who had a phone teleconsultation during the pandemic, 16 had initially planned an in-person consultation that they switched for teleconsultation.

CONCLUSIONS

During the lockdown, psychological distress and decreased well-being were common in CHF outpatients, and there was an increase in unhealthy lifestyle behaviours. These changes may negatively impact short-term and long-term prognoses. Medication adherence was maintained, and limitations in access to care were partly counterbalanced by use of telehealth.