Associations of positive and negative psychological factors with fear of COVID-19 among racially and ethnically diverse cardiac arrest survivors

ABSTRACT

Objective: To examine the association between psychological factors and fear of COVID-19. Background: Psychological distress due to the COVID-19 pandemic is pronounced in cardiovascular disease patients. Cardiac arrest (CA) survivors may be especially fearful due to recent public health policies (e.g. paramedics' policy of not taking CA patients to hospital if revival fails in-field). Positive psychological well-being has been associated with improved health and recovery, but its impact on fear of COVID-19 is unknown. Design/Methods: In May 2020, a month after the NYC COVID-19 pandemic peak, CA survivors participated in a telephone-based assessment of the pandemic's impact. Positive well-being was measured by the Life Orientation Test-Revised "Overall, I expect more good things to happen to me than bad." Ill-being was measured by the 4-item Perceived Stress Scale. Fear of COVID-19 was measured by the Perceived Coronavirus Threat Questionnaire (range 1-42). Results: Of 130 approached, 105 CA survivors participated (53% male;mean±SD age 61±15 years;42% non-Hispanic White, 17% Black, 35% Latinx). The majority (75%) denied positive COVID-19 testing or symptoms. The median COVID-19 anxiety score was 28 (interquartile range [IQR] 21-35). The median perceived stress score was 7.5 (IQR 7-8). Participants [N=68/105;66% (56-74)] reporting higher optimism (agree or strongly agree) had significantly lower fear of COVID-19 than those with lower optimism (mean±SD 26±8 vs 31±8, p = 0.003). In a multivariable model, higher optimism (β = -4, 95% CI [-7, -1.0];p = 0.04) and lower perceived stress (β = 0.6, 95% CI [0.1, 1.2];p = 0.05) were independently associated with reduced fear of COVID-19, adjusting for age, sex, race/ethnicity, and COVID-19 symptom status. Conclusions: Measures of positive psychological well-being were independently associated with reduced fear of COVID-19 in CA survivors. Future studies should take these measures into account while assessing the impact of COVID-19 anxiety on medical outcomes and quality of life.