Impact on mental health, disease management, and socioeconomic modifications in hematological patients during the COVID-19 pandemic in Italy

Marianna De Muro; Annelot Julia Janssen; Sergio Amadori; Paolo de Fabritiis; Dante Sabatino; Pasquale Niscola; Lorenza Torti; Malgorzata Monika Trawinska; Cristiano Tesei; Felice Bombaci; Mario Tarricone; Monica Bocchia; Carmen Fava; Sara Galimberti; Alessandra Iurlo; Luigia Luciano; Elisabetta Abruzzese

doi:10.1177/20406207231190683

Impact on mental health, disease management, and socioeconomic modifications in hematological patients during the COVID-19 pandemic in Italy

Ther Adv Hematol. 2023 Sep 6:14:20406207231190683. doi: 10.1177/20406207231190683. eCollection 2023.

Authors

Marianna De Muro¹, Annelot Julia Janssen², Sergio Amadori³, Paolo de Fabritiis⁴, Dante Sabatino⁵, Pasquale Niscola⁴, Lorenza Torti⁴, Malgorzata Monika Trawinska⁴, Cristiano Tesei⁶, Felice Bombaci⁷, Mario Tarricone⁷, Monica Bocchia⁸, Carmen Fava⁹, Sara Galimberti¹⁰, Alessandra Iurlo¹¹, Luigia Luciano¹², Elisabetta Abruzzese¹³

Affiliations

¹ Department of Hematology and Stem Cell Transplantation, Campus Bio-Medico University Hospital, Rome, Italy.
² Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
³ GIMEMA Foundation, Rome, Italy.
⁴ Hematology S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy.
⁵ Institute for Research on Population and Social Policies, National Research Council (CNR), Rome, Italy.
⁶ Hematology Unit, Tor Vergata University Hospital, Rome, Italy.
⁷ Italian Association against Leukemia (AIL) Onlus, Rome, Italy.
⁸ Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy.
⁹ Department of Clinical and Biological Sciences, University of Turin, Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Italy.
¹⁰ Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
¹¹ Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
¹² Hematology, Federico II University, Napoli, Italy.
¹³ Hematology, S. Eugenio Hospital, Tor Vergata University, ASL Roma2. Piazzale dell'Umanesimo 10, 00144 Rome, Italy.

Abstract

Background: Hematological patients are a highly vulnerable population with an increased risk of developing severe COVID-19 symptoms due to their immunocompromised status. COVID-19 has proven to cause serious mental health issues, such as stress, anxiety, and depression in the general population. However, data on the psycho-social impact of COVID-19 on hematological patients are lacking.

Objectives: This study aims to examine the psychological well-being of hematological patients in Italy during the initial period of the COVID-19 pandemic. Furthermore, it seeks to explore the association between modifications in the management of hematological diseases and employment status of these patients during the COVID-19 pandemic and the resulting mental health outcomes.

Design and methods: A survey using the DASS-21 questionnaire was administered to 1105 hematological patients. Data analysis was conducted using the R software, and logistic regression analysis was performed to predict the association between hematological patient/general population and employment status with DASS scores.

Results: The hematological patient population reported significantly higher levels of depression (OR 0.947, 95% CI 0.966-0.982, p < 0.001), anxiety (OR 0.948, 95% CI 0.939-0.958, p < 0.001), and stress (OR 0.984, 95% CI 0.977-0.992, p < 0.001) compared with the general population. A significant relationship has been found in stress between employed and unemployed patients (OR 1.015, 95% CI 1.000-1.030, p = 0.044), as well as in the control group (OR 1.024, 95% CI 1.010-1.039, p = 0.001). In addition, employment status is significantly related to depression, anxiety, and stress in both the hematological patient group and the general population.

Conclusion: During the initial phase of the COVID-19 pandemic, hematological patients had elevated levels of depression, anxiety, and stress compared with the general population. The delay in their treatment and employment status played a role in their mental health outcomes. These findings emphasize the importance of further research to gain deeper insight into the long-term psychological effects and explore effective strategies for managing mental health in similar crises.

Keywords: COVID-19; anxiety; depression; disease management; hematological patients; mental health; stress.