ABSTRACT
Background: Individuals with underlying cardiovascular disease (CVD) have an increased vulnerability to COVID-19 and poorer outcomes. Little is known about the impact social distancing guidelines have had on the health behaviors of this population. Objective: The purpose of this study was to examine levels of social isolation, anxiety, depression, loneliness, stress, cognitive function, alcohol use, substance use and health appointment engagement pre-pandemic and after social distancing guidelines were initiated among individuals with CVD. Methods: A secondary analysis was completed of a cross-sectional study that utilized a web-based survey. The parent sample included 184 participants recruited using social media. Forty-nine participants (27%) reported a history of CVD that included hypertension, heart failure, myocardial infarction and/or peripheral artery disease. Descriptive statistics and Wilcoxon signed-rank tests with Bonferroni correction were used to compare levels of social isolation, anxiety, depression, loneliness, stress, cognitive function, alcohol use, substance use, and delay/canceled healthcare appointments before and during social distancing recommendations. Results: The majority of participants with CVD were female (92%), white (94%), college graduates (92 %), working full-time (45%), and living with two or more people (71%). There were significant differences (p<0.001) between pre- and during COVID-19 restrictions for levels of social isolation, anxiety, cognitive function, and loneliness, while depression (p=0.006), perceived stress (p=0.108), alcohol use (p=0.056), and substance use (p=0.141) were not significantly different. About half of the participants (45%) delayed or canceled healthcare appointments because they were afraid to be exposed to COVID-19. One-third (37%) of participants had a healthcare provider delay an appointment, 27% of participants' healthcare providers canceled, and 67% of respondents had a healthcare provider change to telehealth appointments. Conclusions: The COVID-19 pandemic has concerning repercussions on the mental health of individuals with CVD. A heightened awareness by healthcare providers regarding the psychosocial needs of patients with CVD during the COVID-19 pandemic is warranted. The sample in this study is homogenous, limiting generalization, however, telehealth appointments with the above sample emerged as a viable mechanism for providers to interact with individuals with CVD. Psychosocial and biophysical outcomes from telehealth engagements are areas for further investigation.