Abstract
Individuals with underlying cardiovascular disease (CVD) have an increased vulnerability to COVID-19 and poorer outcomes. Little is known about the impact social distancing guidelines have had on the health behaviors of this population.
The purpose of this study was to examine levels of social isolation, anxiety, depression, loneliness, stress, cognitive function, alcohol use, substance use and health appointment engagement pre-pandemic and after social distancing guidelines were initiated among individuals with CVD.
A secondary analysis was completed of a cross-sectional study that utilized a web-based survey. The parent sample included 184 participants recruited using social media. Forty-nine participants (27%) reported a history of CVD that included hypertension, heart failure, myocardial infarction and/or peripheral artery disease. Descriptive statistics and Wilcoxon signed-rank tests with Bonferroni correction were used to compare levels of social isolation, anxiety, depression, loneliness, stress, cognitive function, alcohol use, substance use, and delay/canceled healthcare appointments before and during social distancing recommendations.
The majority of participants with CVD were female (92%), white (94%), college graduates (92 %), working full-time (45%), and living with two or more people (71%). There were significant differences (p<0.001) between pre- and during COVID-19 restrictions for levels of social isolation, anxiety, cognitive function, and loneliness, while depression (p=0.006), perceived stress (p=0.108), alcohol use (p=0.056), and substance use (p=0.141) were not significantly different. About half of the participants (45%) delayed or canceled healthcare appointments because they were afraid to be exposed to COVID-19. One-third (37%) of participants had a healthcare provider delay an appointment, 27% of participants' healthcare providers canceled, and 67% of respondents had a healthcare provider change to telehealth appointments.
The COVID-19 pandemic has concerning repercussions on the mental health of individuals with CVD. A heightened awareness by healthcare providers regarding the psychosocial needs of patients with CVD during the COVID-19 pandemic is warranted. The sample in this study is homogenous, limiting generalization, however, telehealth appointments with the above sample emerged as a viable mechanism for providers to interact with individuals with CVD. Psychosocial and biophysical outcomes from telehealth engagements are areas for further investigation.