Comparison of anxiety and depressive symptoms of head and neck cancer patients in a closed-loop management system before and during the 2019 coronavirus pandemic: a comparative study.

ABSTRACT

BACKGROUND: The coronavirus disease of 2019 (COVID-19) poses an unprecedented challenge to health and the financial system, especially the healthcare of patients with cancer. However, the research on the negative effect of the pandemic on the anxiety and depressive symptoms of cancer patients in closed-loop is rarely reported at present. In view of the limitations of previous studies. In this study, we compared the anxiety and depressive symptoms of head and neck cancer patients in the closed-loop management system before and during the 2019 coronavirus pandemic. METHODS: In this comparative study, a total of 526 head and neck cancer patients (269 and 257 patients before and during the COVID-19 pandemic) were enrolled in the present study. The two groups of patients' median age (53 years, 52 years), female distribution (70.26%, 66.15%) and male distribution (29.74%, 33.85%) were analyzed before and after the COVID-19 epidemic. They received questionnaires using the standardized data forms of Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) to collect the relevant data of patients for retrospective investigation. For data analysis, either the chi-squared test or Fisher's exact test was employed for categorical variables, and we described the time trend of psychological states before and after the outbreak with Cochran-Armitage trend (CAT) test. RESULTS: A total of 526 head and neck cancer patients were included in the final analysis; 26.85% and 50.19% of cases experienced anxiety and depression during the COVID-19 epidemic. In contrast, 18.22% and 33.46% of cases had experienced anxiety and depression before the pandemic. According to the statistical results, the prevalence of anxiety and depression in patients during the COVID-19 epidemic was higher compared to that of patients prior to the pandemic (P=0.018). More importantly, both anxiety and depression incidence trends increased significantly before and after the outbreak of COVID-19 (P=0.000). CONCLUSIONS: The present study demonstrates the significant impact of COVID-19 on the psychological states of cancer patients in the case of closed-loop management system, effectively indicating the need for appropriate changes in treatment decisions, enhanced psychotherapy, and interventions to reduce the incidence of anxiety, depression, and even suicide during this pandemic.