Impact of COVID-19 Vaccine Rollout on Mental Health, Social Determinants of Health, and Attitudes Among Individuals With COPD.

BACKGROUND: Social distancing early in the COVID-19 pandemic helped mitigate viral spread and protect vulnerable populations. Broad availability of vaccines allowed social re-integration, but effects on mental health, social determinants of health, and attitudes among individuals with COPD, who are high-risk for adverse outcomes following COVID-19 infection, are unknown.

METHODS: Participants in the Losartan Effects on Emphysema Progression (LEEP) trial were recruited into an ancillary study from May-November 2020. Study coordinators administered telephone questionnaires to evaluate respiratory symptoms (COPD Assessment Test [CAT]), anxiety (Generalized Anxiety Disorder-7 [GAD-7]) and depressive (Patient Health Questionnaire [PHQ-8]) symptoms, social isolation, instrumental support, and attitudes and actions related to the COVID-19 pandemic. Generalized estimating equation models evaluated changes in patient-reported scores from the period before vaccine availability (pre-vaccine, May-December 2020) to the post-vaccine period (May 2021-September 2022).

RESULTS: Of 157 enrolled participants, 138 were interviewed during both periods. Compared with the pre-vaccine period, severe respiratory symptoms (CAT>20) were higher in the post-vaccine period (odds ratio [OR] 1.36, 95% confidence interval [95%CI]: 1.00-1.85), as were moderate anxiety symptoms (GAD-7≥10; OR 1.65, 95%CI: 1.11-2.46) and moderate depressive symptoms (PHQ-8≥10; OR 1.77, 95%CI: 1.22-2.55). Social isolation improved, though not significantly, and instrumental support was unchanged. In the post-vaccine period compliance with COVID-19 mitigation strategies remained high and governmental healthcare entities were viewed as trustworthy by fewer respondents.

CONCLUSION: Despite a trend towards less social isolation following broad availability of COVID-19 vaccines, individuals with COPD reported worse symptoms, and greater anxiety and depressive symptoms compared to the pre-vaccine period.