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Being a Myeloproliferative Patient in COVID-19 Era: The Mytico Study
Fabrizio Cavalca1,2, Rossella Renso2, Giovanni Paolo Maria Zambrotta1,2
1Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Insights
The COVID-19 quarantine negatively impacted anxiety and symptoms in myeloproliferative neoplasm (MPN) patients. Female gender, lack of physical activity, and healthcare access issues were linked to worse outcomes.
Area of Science:
- Oncology
- Hematology
- Public Health
Background:
- The COVID-19 pandemic led to social distancing, impacting patient care and quality of life (QoL).
- Patients with chronic myeloproliferative neoplasms (MPN) faced heightened anxiety due to SARS-CoV-2 concerns, exacerbating their existing symptom burden (BS).
Purpose of the Study:
- To investigate the impact of COVID-19 pandemic restrictions on anxiety, BS, and QoL in MPN patients.
- To identify factors associated with increased anxiety and symptom burden during the pandemic.
Main Methods:
- A cross-sectional survey was conducted with 132 MPN patients.
- Anxiety levels were assessed using the Zung Self-Rating Anxiety Scale (SAS).
- Symptom burden modifications were evaluated using the Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF).
Main Results:
- 20.4% of patients reported moderate to marked anxiety, with greater symptom worsening (p <0.0001).
- Women reported higher anxiety (p = 0.01), while physical activity showed a trend towards lower anxiety (p = 0.06).
- 74.2% experienced symptom worsening during quarantine, and 71.2% had postponed appointments, correlating with significant BS worsening (p = 0.01).
Conclusions:
- COVID-19 quarantine significantly increased anxiety and symptom burden in MPN patients.
- Factors associated with higher anxiety and worse symptoms included female gender, lack of physical activity, frequent hospital visits, and limited direct healthcare access.
Introduction:
The Coronavirus disease 2019 (COVID-19) pandemic and the resulting social distancing, determined a reduction in access to care and limitations of individual freedom, with a consequent strong impact on quality of life (QoL), anxiety levels and medical management of onco-hematological people. In particular, in the case of patients with chronic myeloproliferative neoplasm (MPN), concern about SARS-CoV-2 infection added to the burden of symptoms (BS) which already weights on the QoL of these patients. We designed a cross-sectional survey in order to investigate the impact of the COVID-19 pandemic on status of anxiety, BS and QoL in MPN patients.
Methods:
We analyzed the anxiety levels using the Zung Self-Rating Anxiety Scale (SAS); BS modifications were studied using the 18 items of the Myeloproliferative Neoplasm Symptom Assessment Form [MPN-SAF].
Results:
132 people answered to the survey: 27 (20.4%) patients achieved a moderate to marked anxiety index value: this group described a greater worsening of symptoms than the rest of the cohort (p <0.0001). Women showed a higher level of anxiety than men (p = 0.01). A trend for lower level of anxiety was reported by patients who performed habitual physical activity (p = 0.06). A total of 98 (74.2%) patients described worsening of their symptoms during the quarantine period; 94 (71.2%) patients had postponed appointments or visits: they showed a significant worsening of their BS (p =0.01).
Conclusion:
This study first showed that the COVID-19 quarantine had a significant negative impact on the level of anxiety and BS in MPN patients. We identified female gender, absence of physical activity, the need for frequent visit to the hospital and the absence of a direct access to healthcare staff as the main factors associated to a higher anxiety index and worst BS.
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