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Patient-reported Outcomes of Patients With Breast Cancer During the COVID-19 Outbreak in the Epicenter of China: A Cross-sectional Survey Study.
Clin Breast Cancer. 2020 10; 20(5):e651-e662.CB

Abstract

INTRODUCTION

We aimed to analyze the psychological status in patients with breast cancer (BC) in the epicenter of the coronavirus disease 2019 (COVID-19) pandemic.

PATIENTS AND METHODS

A total of 658 individuals were recruited from multiple BC centers in Hubei Province. Online questionnaires were conducted, and these included demographic information, clinical features, and 4 patient-reported outcome scales (Generalized Anxiety Disorder Questionnaire [GAD-7], Patient Health Questionnaire [PHQ-9], Insomnia Severity Index [ISI], and Impact of Events Scale-Revised [IES-R]). Multivariable logistic regression analysis was designed to identify potential factors on mental health outcomes.

RESULTS

Questionnaires were collected from February 16, 2020 to February 19, 2020, the peak time point of the COVID-19 outbreak in China. Of patients with BC, 46.2% had to modify planned necessary anti-cancer treatment during the outbreak. Severe anxiety and severe depression were reported by 8.9% and 9.3% of patients, respectively. Severe distress and insomnia were reported by 20.8% and 4.0% of patients, respectively. Multivariable logistic regression analysis demonstrated poor general condition, shorter duration after BC diagnosis, aggressive BC molecular subtypes, and close contact with patients with COVID-19 as independent factors associated with anxiety. Poor general condition and central venous catheter flushing delay were factors that were independently associated with depression. In terms of insomnia, poor generation condition was the only associated independent factor. Poor physical condition and treatment discontinuation were underlying risk factors for distress based on multivariable analysis.

CONCLUSION

High rates of anxiety, depression, distress, and insomnia were observed in patients with BC during the COVID-19 outbreak. Special attention should be paid to the psychological status of patients with BC, especially those with poor general condition, treatment discontinuation, aggressive molecular subtypes, and metastatic BC.

Authors+Show Affiliations

Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China.Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD.Department of Breast Surgery, Thyroid Surgery, Huangshi Central Hospital of Edong Healthcare Group, Hubei Polytechnic University, Huangshi, Hubei, PR China.Department of Thyroid and Breast and Vascular Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, PR China.Department of Breast Thyroid Surgery, Xiangyang No.1 People's Hospital of Hubei University of Medicine, Xiangyang, Hubei, PR China.Department of Thyroid Breast Surgery, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, Xiaogan, Hubei, PR China.Department of Thyroid and Breast Surgery, Yichang Central People's Hospital, Yichang, Hubei, PR China.Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China.School of Computer Science, Wuhan University, Wuhan, Hubei, PR China; School of Computer Science, and Institute of Artificial Intelligence, Wuhan University, Wuhan, Hubei, PR China.School of Computer Science, Wuhan University, Wuhan, Hubei, PR China; School of Computer Science, and Institute of Artificial Intelligence, Wuhan University, Wuhan, Hubei, PR China.Department of Breast Disease, East Campus of Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China.Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China.Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China.Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China.Department of Breast and Thyroid Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, PR China. Electronic address: lixingrui07@126.com.Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China. Electronic address: chenc2469@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32709505

Citation

Juanjuan, Li, et al. "Patient-reported Outcomes of Patients With Breast Cancer During the COVID-19 Outbreak in the Epicenter of China: a Cross-sectional Survey Study." Clinical Breast Cancer, vol. 20, no. 5, 2020, pp. e651-e662.
Juanjuan L, Santa-Maria CA, Hongfang F, et al. Patient-reported Outcomes of Patients With Breast Cancer During the COVID-19 Outbreak in the Epicenter of China: A Cross-sectional Survey Study. Clin Breast Cancer. 2020;20(5):e651-e662.
Juanjuan, L., Santa-Maria, C. A., Hongfang, F., Lingcheng, W., Pengcheng, Z., Yuanbing, X., Yuyan, T., Zhongchun, L., Bo, D., Meng, L., Qingfeng, Y., Feng, Y., Yi, T., Shengrong, S., Xingrui, L., & Chuang, C. (2020). Patient-reported Outcomes of Patients With Breast Cancer During the COVID-19 Outbreak in the Epicenter of China: A Cross-sectional Survey Study. Clinical Breast Cancer, 20(5), e651-e662. https://doi.org/10.1016/j.clbc.2020.06.003
Juanjuan L, et al. Patient-reported Outcomes of Patients With Breast Cancer During the COVID-19 Outbreak in the Epicenter of China: a Cross-sectional Survey Study. Clin Breast Cancer. 2020;20(5):e651-e662. PubMed PMID: 32709505.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patient-reported Outcomes of Patients With Breast Cancer During the COVID-19 Outbreak in the Epicenter of China: A Cross-sectional Survey Study. AU - Juanjuan,Li, AU - Santa-Maria,Cesar Augusto, AU - Hongfang,Feng, AU - Lingcheng,Wang, AU - Pengcheng,Zhang, AU - Yuanbing,Xu, AU - Yuyan,Tan, AU - Zhongchun,Liu, AU - Bo,Du, AU - Meng,Lan, AU - Qingfeng,Yang, AU - Feng,Yao, AU - Yi,Tu, AU - Shengrong,Sun, AU - Xingrui,Li, AU - Chuang,Chen, Y1 - 2020/06/07/ PY - 2020/04/06/received PY - 2020/05/13/revised PY - 2020/06/03/accepted PY - 2020/7/28/pubmed PY - 2020/10/21/medline PY - 2020/7/26/entrez KW - Breast cancer KW - COVID-19 KW - Epicenter KW - Psychological status SP - e651 EP - e662 JF - Clinical breast cancer JO - Clin Breast Cancer VL - 20 IS - 5 N2 - INTRODUCTION: We aimed to analyze the psychological status in patients with breast cancer (BC) in the epicenter of the coronavirus disease 2019 (COVID-19) pandemic. PATIENTS AND METHODS: A total of 658 individuals were recruited from multiple BC centers in Hubei Province. Online questionnaires were conducted, and these included demographic information, clinical features, and 4 patient-reported outcome scales (Generalized Anxiety Disorder Questionnaire [GAD-7], Patient Health Questionnaire [PHQ-9], Insomnia Severity Index [ISI], and Impact of Events Scale-Revised [IES-R]). Multivariable logistic regression analysis was designed to identify potential factors on mental health outcomes. RESULTS: Questionnaires were collected from February 16, 2020 to February 19, 2020, the peak time point of the COVID-19 outbreak in China. Of patients with BC, 46.2% had to modify planned necessary anti-cancer treatment during the outbreak. Severe anxiety and severe depression were reported by 8.9% and 9.3% of patients, respectively. Severe distress and insomnia were reported by 20.8% and 4.0% of patients, respectively. Multivariable logistic regression analysis demonstrated poor general condition, shorter duration after BC diagnosis, aggressive BC molecular subtypes, and close contact with patients with COVID-19 as independent factors associated with anxiety. Poor general condition and central venous catheter flushing delay were factors that were independently associated with depression. In terms of insomnia, poor generation condition was the only associated independent factor. Poor physical condition and treatment discontinuation were underlying risk factors for distress based on multivariable analysis. CONCLUSION: High rates of anxiety, depression, distress, and insomnia were observed in patients with BC during the COVID-19 outbreak. Special attention should be paid to the psychological status of patients with BC, especially those with poor general condition, treatment discontinuation, aggressive molecular subtypes, and metastatic BC. SN - 1938-0666 UR - https://www.unboundmedicine.com/medline/citation/32709505/Patient_reported_Outcomes_of_Patients_With_Breast_Cancer_During_the_COVID_19_Outbreak_in_the_Epicenter_of_China:_A_Cross_sectional_Survey_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1526-8209(20)30147-6 DB - PRIME DP - Unbound Medicine ER -