COVID-RELATED DISTRESS AND DISRUPTIONS IN OVARIAN CANCER SURVIVORS

ABSTRACT

Background: The objective of this study was to determine how levels of distress and disruption during the COVID-19 pandemic compared between ovarian cancer survivors and a community sample;how clinical and demographic characteristics of survivors were related to COVID-related distress and disruption;and if perceived stress, depression, and emotional well-being at cancer diagnosis predicted COVID-related distress during the first year of the pandemic. Methods: Ovarian cancer patients (N=90) who were part of 3 ongoing studies completed COVID surveys through mail and on REDCAP between 6/20 and 12/20. Responses were compared to those of community females (N=1110) who participated in a COVID survey mailed to an Iowa Statewide Voter Registration-based sample between 8/20 and 12/20. Pre-COVID data on perceived stress, depression, and emotional well-being (EWB) from ovarian cancer patients at the time of diagnosis was available for 30 long-term (≥4 yrs) and 60 shorter-term (<4 yrs) survivors. Hierarchical regressions examined whether psychosocial features at diagnosis, controlling for age, stage, total COVID disruption (healthcare, financial, and daily-life), and time since diagnosis, predicted COVID-related distress. Results: Compared to the community sample, ovarian cancer survivors reported lower levels of healthcare disruption (p=.016), financial hardship (p<.001), and distress (p=.009), but no difference in disruption of daily activities (p=.089). Among survivors, there were no differences in distress or total COVID-related disruptions based on stage or time since diagnosis (all p values ≥0.10). Younger survivors (<63 yr median) showed significantly greater distress (p=.009) and disruption (p=.001) than older survivors. Adjusting for covariates, perceived stress (β=.237, p=.006) and EWB (β= -.338, p<.001) at diagnosis were significant predictors of total COVID-related distress, whereas depression was not. Conclusions: Surprisingly, cancer survivors reported fewer COVID-related disruptions and distress compared to a community sample. Older patients reported less distress and disruptions during COVID, but stage and time since diagnosis were not associated with these factors. The relationship between distress and well-being at diagnosis and COVID-related distress suggests the possibility of identifying patients particularly at-risk during environmental challenges.