Distress in a Pandemic: Association of the Coronavirus Disease-2019 Pandemic with Distress and Quality of Life in Hematopoietic Stem Cell Transplantation

•The coronoavirus disease 19 (COVID-19) pandemic has not worsened pre-hematopoietic stem cell transplantation (HSCT) distress, fatigue, or quality of life.•However, it has had negative and positive implications in the recovery following HSCT.•The COVID-19 pandemic has been a barrier to needed social...

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Published in:Transplantation and cellular therapy 2021-12, Vol.27 (12), p.1015.e1-1015.e7
Main Authors: Amonoo, Hermioni L., Topping, Carlisle E.W., Clay, Madison A., Reynolds, Matthew J., Rice, Julia, Harnedy, Lauren E., Longley, Regina M., LeBlanc, Thomas W., Greer, Joseph A., Chen, Yi-Bin, DeFilipp, Zachariah, Lee, Stephanie J., Temel, Jennifer S., El-Jawahri, Areej
Format: Article
Language:English
Subjects:
Coronavirus
COVID-19
Cross-Sectional Studies
Distress
Full Length
Hematopoietic Stem Cell Transplantation
Humans
Pandemics
Patient-reported outcomes
Quality of Life
SARS-CoV-2
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Summary:•The coronoavirus disease 19 (COVID-19) pandemic has not worsened pre-hematopoietic stem cell transplantation (HSCT) distress, fatigue, or quality of life.•However, it has had negative and positive implications in the recovery following HSCT.•The COVID-19 pandemic has been a barrier to needed social support for HSCT recipients. The global coronavirus disease 2019 (COVID-19) pandemic has drastically disrupted cancer care, potentially exacerbating patients’ distress levels. Patients undergoing hematopoietic stem cell transplantation (HSCT) may be especially vulnerable to this pandemic stress. However, the associations of the COVID-19 pandemic with distress, fatigue, and quality of life (QoL) are not well understood in this population. In a cross-sectional analysis of data from 205 patients undergoing HSCT enrolled in a supportive care trial, we compared baseline pre-HSCT distress symptoms (depression, anxiety, and posttraumatic stress disorder [PTSD]), fatigue, and QoL between enrollees before (ie, March 2019-January 2020) and during (ie, March 2020-January 2021) the COVID-19 pandemic. We used linear regression models adjusting for sociodemographics and cancer diagnosis to examine the associations between enrollment period and patient-reported outcomes. We used semistructured qualitative interviews in 20 allogeneic HSCT recipients who were ≥3-months post-HSCT to understand the impact of the COVID-19 pandemic on their recovery post-HSCT. One hundred twenty-four participants enrolled before COVID-19, and 81 participants enrolled during the pandemic. The 2 cohorts had similar baseline demographics and disease risk factors. In multivariate regression models, enrollment during COVID-19 was not associated with pre-HSCT symptoms of depression, anxiety, PTSD, fatigue, or QoL impairment. COVID-19-era participants reported themes of negative (eg, increased isolation) and positive (eg, engagement with meaningful activities) implications of the pandemic on HSCT recovery. We found no differences in pre-HSCT distress, fatigue, or QoL in patients undergoing HSCT before or during the COVID-19 pandemic; however, patients in early recovery post-HSCT report both negative and positive implications of the COVID-19 pandemic in their lives.
ISSN:2666-6367
2666-6375
2666-6367
DOI:10.1016/j.jtct.2021.09.001