The differentiating effect of COVID-19-associated stress on the morbidity of blood donors with symptoms of hidradenitis suppurativa, hyperhidrosis, or psoriasis.

PURPOSE: The burden of different skin diseases may vary leading individuals to have different sensitivity to stress. Therefore, we compared the health-related quality of life (HRQoL) and stress before and during the universal stress from the severe acute respiratory syndrome coronavirus-2-pandemic in individuals with and without hyperhidrosis, hidradenitis suppurativa, or psoriasis. METHODS: The study cohort was the Danish Blood Donor Study. Overall, 12,798 participants completed a baseline questionnaire before the pandemic, in 2018-2019, and a follow-up questionnaire during the pandemic, in 2020. Regression determined the association between the skin diseases and outcomes. Outcomes were the physical and mental component summary (MCS, PCS, respectively), which assess the mental and physical HRQoL, and the perceived stress scale, which assesses stress in the past four weeks. RESULTS: Overall, 1168 (9.1%) participants had hyperhidrosis, 363 (2.8%) had hidradenitis suppurativa, and 402 (3.1%) had psoriasis. At follow-up, the participants with hyperhidrosis had worse MCS (coefficient -0.59 [95% confidence interval (CI) -1.05, -0.13]) and higher odds of moderate-to-severe stress (odds ratio 1.37 [95% CI 1.13, 1.65]) and the participants with hidradenitis suppurativa worse PCS (coefficient -0.74 [95% CI -1.21, -0.27]) than the control groups. The associations were independent of baseline HRQoL, stress, the Connor-Davidson Resilience scale, and other covariables. Psoriasis was not associated with the outcomes. CONCLUSION: Individuals with hyperhidrosis or hidradenitis suppurativa experienced worse mental or physical well-being and individuals with hyperhidrosis also had higher stress during the pandemic compared to healthy individuals. This suggests that individuals with these skin diseases are particularly susceptible to external stress.

THE EFFECT OF COVID-19-ASSOCIATED STRESS ON THE HEALTH OF BLOOD DONORS WITH SYMPTOMS OF HIDRADENITIS SUPPURATIVA, HYPERHIDROSIS OR PSORIASIS

Purpose: The burden of different dermatoses may vary with ensuing different degrees of sensitivity to stress. Thus, we compared the stress and health-related quality of life (HRQoL) before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and the subsequent societal lockdown. Methods: The study cohort was the Danish Blood Donor Study. Overall, 12,798 participants completed a baseline questionnaire before the pandemic, between June 2018 and December 2019, and a follow-up questionnaire during the pandemic, between May and July of 2020. The classification of dermatoses was based on responses in the baseline questionnaire and hospital diagnoses. Logistic and linear regression determined the association between the dermatoses and the outcomes. Results: Overall, 1,168 (9.1%) participants had hyperhidrosis, 363 (2.8%) hidradenitis suppurativa and 402 (3.1%) psoriasis. At follow-up, hyperhidrosis was associated with a worse mental HRQoL (adjusted coefficient -0.59 [95% confidence interval -1.05, -0.13]) and hidradenitis suppurativa with a worse physical HRQoL (adjusted coefficient -0.74 [95% confidence interval -1.21, -0.27]) independent of the baseline HRQoL. Hyperhidrosis was also associated with moderate-to-severe stress (adjusted odds ratio 1.37 [95% confidence interval 1.13, 1.65]) independent of the baseline stress level. No association with psoriasis was observed. Conclusions: Individuals with hyperhidrosis and hidradenitis suppurativa may have been particularly affected during the SARSCoV- 2 pandemic and the societal lockdown. This indicates that individuals with these dermatoses may be especially susceptible to external stress in general.

The healthy donor effect: Mental health among blood donors in the midst of the pandemic

Aims: The COVID-19 pandemic has affected lives of Danish citizens in different ways, for example, through social distancing and other public health measures introduced to mitigate SARS-CoV-2 spread or through economic consequences. We assessed changes in self-reported measures of physical and mental health-related quality of life (MCS, PCS), stress levels, quality of sleep and loneliness during the COVID-19 pandemic in Denmark, and identified factors influencing such changes. Methods: This is a nation-wide prospective cohort study including 50,968 participants in the Danish Blood Donor Study, who answered health questionnaires before and during the COVID-19 pandemic. The questionnaires included the 12-Item Short Form Health Survey, Cohen's Perceived Stress Scale 10-item version, the 3-item UCLA loneliness scale, and three selected questions evaluating insomnia. During the pandemic, the questionnaire also contained items on the personality trait stamina, behaviours undertaken to avoid infection, and changes in experienced changes in job situation during the pandemic. Finally, information on socio-demographic factors and previous use of anti-depressive medication was collected for all study participants from national registers. Descriptive statistics, multivariable linear and multinomial logistic regression analyses were applied. Results: Comparing measurements from before March 2020 with those after May 2020, MCS and quality of sleep both worsened, while the overall stress levels decreased. PCS decreased in men and increased in women. The mean level of loneliness increased by 14%. The degree of health changes varied by age, type of job, changes in job situation during the pandemic, previous use of anti-depressive medication and by level of personal stamina. Conclusions: Living under the unusual circumstances that persisted during the COVID-19 pandemic negatively impacted the health of Danish blood donors.Our observations may herald an emerging public health problem.