Impact of the COVID-19 outbreak on the level of distress in patients with breast cancer

ABSTRACT

Goals In a very short period of time, during the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the coronavirus disease 2019 (COVID-19) became a great threat worldwide in terms of health, as well as social and economic aspects. From the beginning of the outbreak, patients with cancer were considered a high-risk population with regard to the COVID- 19 infection. Epidemiological measures imposed during the pandemic, such as social distancing and lockdowns, additionally burdened patients with cancer. Psychological distress is common in such patients. The prevalence of distress in patients with breast cancer ranges approximately 20–40%. The aim of this study was to examine the impact of the COVID-19 outbreak on the level of distress among patients with breast cancer in Croatia, during extreme epidemiological measures. We also sought to examine whether disease or socio-demographic characteristics were predictors for distress. Methods: A total of 545 patients with breast cancer were approached to participate in the study;201 patients completed the questionnaire with disease and socio-demographic characteristics. All patients were actively receiving systemic oncological treatment (neoadjuvant, adjuvant, or metastatic setting), with disease stages ranging I–IV. The level of distress was measured using the Distress Thermometer with a cut-off value of 4, followed by a problem list. The study was conducted from April 20, 2020 to May 24, 2020, while all extreme epidemiological measures (lockdown and strict social distancing) were ongoing and equally applied to all regions in Croatia. Results: High distress level was reported in 54.2% of patients. The most prominent problems were worry, fatigue, sleep, nervousness, fear, and child care. Highly distressed patients had more practical problems (child care, housing, and work/school) and emotional problems (depression, fear, nervousness, sadness, worry, and loss of interest for usual activities), than those in the low distress group. None of the socio-demographic or disease characteristics of the patients were linked to the level of distress. Conclusion(s) Even in a country with a favorable epidemiological situation, at the beginning of the COVID-19 pandemic, every second patient with breast cancer had a high level of distress. COVID-19- induced distress should be promptly addressed and additional psychological and social support, targeting specific practical and emotional problems, should be provided for those patients. Conflict of Interest No significant relationships.