Psychological Impact of Covid-19 on Immuno Compromised Patients

Abstract

Background: COVID-19 pandemic has had a global impact. Patients with HIV, cancer, on immunosuppressants, and renal transplants due to CKD need to balance the challenges associated with COVID-19 while ensuring that continued care cannot be compromised, stress beyond the coping mechanisms of patients may result in major depressive disorder and anxiety in chronic illness. The possible link between the chronic stress response, patients have an altered peripheral immune system, with impaired cellular immunity and increased levels of proinflammatory cytokines which may predispose patients to depression, and anxiety.  Thus, Depression and anxiety is a common comorbidity in immunocompromised patients. This study aimed to evaluate the psychological effect of COVID-19 on these groups of patients. Methods: A Cross sectional Study on Patients with immune compromised states infected by COVID-19was the main aim. The study includes 10200 covid infected patient admitted to Victoria hospital, a specialized covid hospital.  Patients taken into study were aged above 18years, of both sexes, with a history of immunocompromised state like HIV, cancer, on Immunosuppressants drugs and renal transplants due to CKD and infected by the COVID-19 (Confirmed by RT-PCR). Patients who were excluded were on life support, prisoners, patients were with pre-existing Psychiatric illness, neurodegenerative disorders, congenital or acquired brain damage, hepatic coma, drug dependence (Except ADS and NDS). Of 71 patients who fulfilled the above criteria found to have immunocompromised state were taken in study and 40 of them were found to have depression and anxiety. The tools used to assess were Patient Health Questionnaire, 9-item version (PHQ-9) and Generalized Anxiety Disorder Assessment 7-item version (GAD-7) was used to assess the anxiety and depression respectively. All the data obtained was entered into excel sheets (SPSS data sheets) and analysed using SPSS 24th version. Results: More than half (n =40; 50.4%) of the patients had psychiatric morbidity either in the form of depressive disorder or in the form of anxiety. Depression was slightly more prevalent (n=21; 29%) than anxiety (n=19; 26%). Conclusion: The results show that patients with immunocompromised states have the high prevalence of anxiety and depression.