Does COVID-19 Impact Less on Post-stroke Aphasia? This Is Not the Case

Abstract

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has greatly affected people’s mental health resulting in severe psychological consequences. One of the leading causes of long-term disability worldwide is aphasia. The language changes experienced by a person with aphasia (PWA) often have a sudden and long-lasting negative impact on social interaction, quality of life, and emotional wellbeing. The main aim of this study was to investigate the impact of COVID-19 on the different psychosocial dimensions which affect PWA.MethodsThis retrospective study included 73 PWA and 81 elderly matched controls. All patients were in the chronic phase. They were all discharged from rehabilitation services, which left them with different degrees of language deficits (i.e., severe vs. mild vs. moderate). All participants were administered the hospital anxiety and depression scale (HADS) through an online survey. PWA also took part in the stroke and aphasia quality of life scale questionnaire (SAQOL-39).ResultsAlthough the comparison between two different time points [one month before (T0) and one month after the lockdown (T1)] led to a significant increase in depression and anxiety symptoms in both groups (PWA vs. control), lower rates of depression and anxiety were found in PWA compared to the healthy group. Significant deterioration was also present in PWA in the communication and psychosocial scales of the SAQOL-39 test, which correlated with the observed changes in the psychological domains. Interestingly, the results were not significantly influenced by the degree of aphasia severity. Similarly, in both groups, none of the demographic variables (gender, age, and educational level) significantly affected the scores in the different subscales.ConclusionsThis evidence which, at first glance, seems to suggest that PWA have been partially spared from the impact of COVID-19, actually masks a dramatic situation that has always characterized this population. Indeed, given that PWA already live in a state of social isolation and emotional instability, these conditions might have, paradoxically, limited the effects of the coronavirus. However, as our results showed a deterioration in the emotional state and communication skills of our patients, possible solutions are discussed in order to prevent further decline of their cognitive abilities.

The impact of the UK COVID-19 pandemic on patient-reported health outcomes after stroke: a retrospective sequential comparison

“…Ahmed et al [25] reported significant increase in post-stroke anxiety and depression related to social deprivation, but the study did not include a comparator group, was limited to small study cohort (n = 52) and included a large proportion of patients of Arab origin. Pisano et al [26] also found increased anxiety in aphasic stroke survivors during the pandemic, but this study cohort was not representative of the full stroke population. By contrast, we included a well-phenotyped and ethnically diverse population of stroke survivors with a control group drawn from the same geographical population.…”

Mental Health of Persons with Aphasia during the COVID-19 Pandemic: Challenges and Opportunities for Addressing Emotional Distress

“…One of the very few reports was a recent retrospective interview-based study that investigated how the psychosocial difficulties experienced by Italian PWA have worsened due to COVID-19 (Pisano et al, 2020). A group of 73 chronic PWA previously discharged from rehabilitation services before the COVID-19 emergency were interviewed twice, one month before and one month after the COVID lockdown.…”

Peer-to-peer Support: Digital Networking in Aphasia to Improve Quality of Life (PeerPAL) - Study Protocol for App Development and Evaluation

“…Through autonomous networking, the shortage of specialists in the health professions, especially in rural regions (Walter & Altgeld, 2000 Due to the expected positive effects on quality of life and well-being, care of PWA could be optimised. The Covid 19 pandemic has had a major negative impact on the social well-being of all people, especially PWA (Pisano, Giachero, Rugiero, Calati & Marangolo, 2020). The pandemic reinforces the urgency to develop new solutions both for therapy and for PWA, even without therapeutic intervention, to train communication skills (Pisano et al 2020).…”

“…The Covid 19 pandemic has had a major negative impact on the social well-being of all people, especially PWA (Pisano, Giachero, Rugiero, Calati & Marangolo, 2020). The pandemic reinforces the urgency to develop new solutions both for therapy and for PWA, even without therapeutic intervention, to train communication skills (Pisano et al 2020). Digital solutions for communication exchange are therefore also relevant in the future, both to compensate for the negative consequences of the pandemic and to positively enrich the everyday lives of those affected.…”