Background: Coronavirus disease 2019 (COVID-19) has significantly the delivery of healthcare all around the world. In part, an abnormal and unexplained high non-COVID-related cardiovascular mortality rate was reported during the outbreak. We assess the correlation between anxiety level and decision to seek medical care (DSMC) during the COVID-19 pandemic. Materials and methods: We recruited patients with cardiovascular complaints admitted to the emergency department in a single institute in Israel between February and September 2020. Anxiety level was measured using available questionnaires. DSMC was assessed with a newly designed questionnaire . Results: Two-hundreds seventy patients were included in the study. The mean age was 52.6 ± 14.9 (females represent 36.2%). 23.6% of the patients had at least moderate cardiovascular risk. High anxiety levels were (HAL) reported in nearly half of the patients (57.1% and 49.8% for General Anxiety Disorder Assessment [GAD-7] and Beck Anxiety Inventory [BAI], respectively). It was more prevalent in old, married, and unemployed patients (significant p-value for all in both questionnaires). Age was an independent factor (χ 2 = 6.33, p < 0.001, odds-ratio: 4.8) and had a positive correlation on anxiety level (r = 0.81, p < 0.001 and r = 0.62, p < 0.001, for GAD-7 and BAI, respectively). The DM-19 revealed a strong and positive correlation of seeking medical care with anxiety level (R 2 linear = 0.44, r = 0.70, p < 0.001 and R 2 linear = 0.30, r = 0.58, p < 0.001 for GAD-7 and BAI, respectively) and results in deferring medical care for several days than patient with low anxiety level (p = 0.02). Conclusions: We observed an abnormal prevalence of a high level of anxiety among non-COVID patients with cardiovascular complaints, which affected the patient's likelihood to seek medical care and resulted in an unreasonable postponement of medical treatment. Our results may explain cardiovascular mortality trends during the outbreak and should be considered in health crisis management. Future studies will involve multi-institutional efforts to address reproducibility of our findings across geographic regions in the state of the global impact. Additionally, it is imperative to understand the effects of the coronavirus vaccine on patient consideration to seek medical care.
Background High anxiety levels (HAL) were widely reported in patients during the COVID outbreak. We assess whether HAL influenced medical decision-making (MDM) of Non-COVID patients. Method We prospectively recruited patients with cardiovascular complaints during February and September 2020. We assessed anxiety levels using the GAD-7, Beck Inventory, the cardiac anxiety questionnaires, and a newly designed MDM questionnaire. Results We recruit 287 patients. The mean age was 52.6±14.9 (females represent 36.2%). HAL was reported in 261 (90.3) patients and was more prevalent in old (p<0.001 for all questionnaires), married, and unemployed patients (significant p-value for all). Cardiovascular comorbidities and a history of anxiety, depression, and psychiatric disorder were independent factors for HAL (p<0.001 for all). Coronary catheterization was performed more in HAL (p<0.001 for all), yet the rate of significant coronary artery disease was lower than in patients with low anxiety level (LAL) (p<0.001 for all). 161 (56.9) patients reported that their MDM was affected (<0.001), and 149 (76.8) patients indicated that they would have gone earlier to the hospital if not the pandemic (p=0.03 for high DM-19 score). Patients with HAL seek medical care longer than LAL patients (p=0.02). Correlation analysis revealed a positive correlation between MDM and HAL (p<0.001 for all). Conclusion Our study shows a strong and positive correlation between anxiety level and MDM. Old patients with cardiovascular comorbidities and a history of mental disorders were at particularly high risk for HAL and sought medical treatment significantly longer than LAL patients. FUNDunding Acknowledgement Type of funding sources: None.
Background We intend to examine whether the COVID-19 outbreak influences medical decision-making (MDM) among Non-COVID patients. Method We recruit 287 patients who admit to ER department due to cardiovascular complaints. Anxiety level was measured using three questionnaires (GAD-7, Beck Inventory, and the cardiac anxiety questionnaire). A fourth survey was designed to assess MDM considerations. Results 64% of patients were male (median age 54). Almost half of the patients were found to have moderate to severe levels of anxiety.79.3% of patients reported that the outbreak influenced their MDM. 44.5% of patients sought medical care 2-3 from the onset of symptoms. Coronary artery disease was found in only 26 patients (9.1%). Almost half of the patients stated that they would have gone earlier if not for the current pandemic. Conclusion Non-COVID patients seeking medical care had a high anxiety level that directly affected decision-making and put them at unnecessary risk.
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