ABSTRACT
BACKGROUND: The health and financial burdens faced by cancer survivors, compounded by the significant disruption in care and their increased risk for morbidity and mortality during the COVID-19 pandemic, emphasize the need to assess the mental health impact of the pandemic in this population. We examined the association between beliefs about COVID and posttraumatic stress disorder (PTSD) symptoms among breast and prostate cancer survivors. METHODS: Participants from two longitudinal cohort studies completed surveys assessing their beliefs about COVID- 19, as well as stress and PTSD symptoms. COVID beliefs were assessed using questions adapted from a previous coronavirus survey developed through an iterative process. PTSD symptoms were assessed using the PTSD Checklist (PCL-5). Participants with PCL-5 scores ≥ 33 were classified as having COVID-related PTSD symptoms. Surveys were completed between May 2020 and June 2021 and were categorized into four time points: season 1 from May 2020 to August 2020, season 2 from September 2020 to November 2020, season 3 from December 2020 to February 2021 and season 4 from March 2021 to June 2021. Chi-square, Fisher, Signed Rank Wilcoxon tests and general linear models were performed to assess the relationships between COVID beliefs and PTSD symptoms. RESULTS: Participants were 276 older cancer survivors (mean age 67 years), of whom 157 (57%) were female and had breast cancer and 118 (43%) were male with prostate cancer. Seventy (25%) self-identified as Black, 147 (53%) as White, and 36 (13%) identified as Latinx. Twenty-four participants (7%) had COVID-related PTSD symptoms. Participants with PTSD symptoms were more likely to be very worried about getting COVID (65% vs. 33%, p=0.007), more likely to think that ≥10% of people with COVID would die (75% vs. 40%, p=0.006), and that it was very likely that they or someone they know will get sick from COVID (64% vs. 23%, p=0.006). As the pandemic drew on, cancer survivors' beliefs about COVID changed such that fewer respondents reported that COVID changed their daily routine a lot in season 4 compared to season 1 (88% vs 65%, p <0.001), and fewer were very worried about getting COVID (38% vs. 19%, p=0.056). Temporality was also significantly associated with a decrease in PTSD symptoms with average PCL-5 scores decreasing from 14.2 to 8.9 in season 1 compared to season 4 (p <0.0001). CONCLUSIONS: As the pandemic progressed, cancer survivors tended to have decreased levels of PTSD symptoms, were less likely to have their routines disrupted and were less worried about getting COVID. However, among participants who had PTSD symptoms, concerns about COVID were significantly higher than among those without PTSD symptoms, emphasizing the need for mental health screening and counseling to better support survivors' coping with the impacts of the pandemic.
ABSTRACT
Background: COVID-19, the disease caused by SARS CoV2, causes severe respiratory disease, and rarely multisystem inflammatory syndrome, in some pediatric patients. Little is known about the disease course among patients with pediatric-onset multiple sclerosis. Objectives: To describe the demographic and clinical characteristics of a subgroup of pediatric-onset multiple sclerosis (POMS) patients infected with SARS CoV2. Methods: The Network of Pediatric Multiple Sclerosis Centers (NPMSC), a consortium of 10 US pediatric multiple sclerosis (MS) centers contributes clinical information about POMS patients and demyelinating disorders to a centralized database, the Pediatric Demyelinating Disease Database (PeMSDD), to facilitate research for this rare disorder. In addition to collecting clinical data on clinical course, comorbidities, disease modifying therapy use, and functional status, the NPMSC developed a screening questionnaire to administer to patients during standard of care visits to further evaluate their COVID- 19 status. Additionally POMS patients with confirmed or highly suspected COVID-19, will be assessed for risk factors including smoking use, recent glucocorticoid use, comorbidities;clinical presentation, including symptoms, radiological and laboratory data;COVID-19 treatments and outcomes. POMS patients will also complete the COViMS (COVID-19 Infections in MS & Related Diseases) database, a joint effort of the US National MS Society and the Consortium of MS Centers to capture information on outcomes of people with MS and other central nervous system (CNS) demyelinating diseases (Neuromyelitis Optica Spectrum Disease, or MOG antibody disease) who have developed COVID- 19. Together with data collected from the PeMSDD, we will present comprehensive data on the POMS patient experience with COVID- 19 and compare it to POMS patients without known or suspected COVID-19. Results: Data collection continues. Results available by the meeting due date will describe the demographics, risk factors, treatments and outcomes of POMS with COVID-19. Conclusions: will be drawn pending results of data analysis. We anticipate reporting on demographic data, risk factors, outcomes and any associations with disease modifying therapy.