Impact of COVID-19 Pandemic on Mental Health and Quality of Healthcare: Findings From the Joslin COVID-19 Study

ABSTRACT

The COVID-19 pandemic limited health care access for individuals with multiple chronic medical conditions. Our aim was to evaluate the impact of COVID-19 on mental health and quality of health care in patients with chronic comorbidities such as DM, HTN and CKD. An online survey was sent to patients over the age of 18 years who have been seen at Joslin during the last 24 months. Surveys were sent to participants by Redcap or conducted through telephone. The survey consisted of 92 items that included COVID diagnosis, General Health, Home self-care, Vaccines, Exposure to COVID, Health- care access and delivery, Perceptions of healthcare quality during the COVID-19 Pandemic, Pregnancy, Mental well-being, Diet and lifestyle, and demographics. Anxiety and depression symptoms were assessed using the Patient Health Questionnaire-4 (PHQ-4). As of November 1, 2021, 1189 had completed the survey. The mean age of participants was 54.2 ± 17.3 years. Half were women, and 89.2% were White. One hundred-six reported to have had COVID-19 infection;94% had diabetes, 36% had HTN, and 8% had CKD. An income of < $50,000 was reported in 9% and 39% were college graduates. While half of the CKD participants felt COVID-19 made their quality of healthcare “worse or a lot worse”, 81% of the participants with CKD felt that their doctors were available to meet their healthcare needs. In addition, the majority of the CKD participants reported to have access to all of their medications during the pandemic. About 48% reported COVID-19 outbreak has negatively affected their mental health with 21% and 11% screened positive for anxiety and depression respectively. Results were similar in patients with CKD. Individuals with depression and anxiety were, more likely to be women and obese. Fifteen percent of the participants with depression and 10.6% with anxiety responded that COVID-19 made the quality of healthcare a lot worse compared to 3.6% in individuals with no depression and 3.3% with no anxiety respectively (p<0.001). The COVID-19 pandemic has made an impact on mental health and quality of healthcare in individuals with CKD.