Characterizing COVID-19 pandemic-related anxiety and its impact on cardioprotective health behaviors among racially and ethnically diverse cardiac arrest survivors in New York City

ABSTRACT

Objective: We assessed the association of COVID-19 anxiety with physical activity (PA), sleep, and likelihood of seeking medical care among cardiac arrest (CA) survivors. Background: The COVID-19 pandemic has caused significant changes in the types of routine daily activities that can be safely performed, particularly for vulnerable patient populations. CA survivors' fear of contracting COVID-19 may limit their ability or willingness to perform cardio-protective health behaviors. Design/Methods: Between 5/15/20 and 7/31/20, CA survivors from a prospective cohort participated in a telephone-based assessment of COVID-19's impact on psychological and behavioral dimensions. COVID-19 anxiety was assessed using the 7-item Perceived Coronavirus Threat Questionnaire (PCTQ;range 1-42). PA in 7 days both pre- and during COVID-19 was categorized into International Physical Activity Questionnaire-based low, moderate, or high activity levels. Self-reported poor sleep quality and sleep duration were assessed via the Pittsburgh Sleep Quality Index. Participants self-reported their likelihood of delay in seeking care for non-COVID conditions. Results: Of 130 approached, 105 CA survivors participated (57% men;mean age 58.5±17 years;41% non-Hispanic White, 18% Black, 35% Latinx). The majority (75%) had negative COVID-19 test results and/or lacked symptoms. The median COVID-19 anxiety score was 29 (IQR 20-32), indicating substantial fear. Black and Latinx participants reported greater anxiety than Whites(34±6 vs 31±8 vs 23±8 respectively, p<0.01). COVID-19 anxiety was highest for those withpreviously high PA and now had low PA (high-high26±9, low-low 28±9, high-low32±9,ANOVA p=0.03). For every 1 SD increase in COVID-19 anxiety, participants reported 30 minutes less sleep per night (b=0.06, p=0.01) and poorer sleep quality (OR=1.07, 95% CI [1.0,1.1], p=0.01). Participants (42%) reporting "moderately-extremely" likely to delay seeking care for non-COVID conditions had greater COVID-19 anxiety (31±8 vs 26±9, p<0.01).Conclusions: COVID-19 anxiety was more frequent in Black and Latinx participants and wasassociated with poorer health behaviors.