Emotional status and fear in patients scheduled for elective surgery during COVID-19 pandemic: a nationwide cross-sectional survey (COVID-SURGERY)

Abstract

Background Fragmented data exist on the emotional and psychological distress generated by hospital admission during the pandemic in specific populations of patients, and no data exists on patients scheduled for surgery. The aim of this multicentre nationwide prospective cross-sectional survey was to evaluate the impact of pandemic on emotional status and fear of SARS-CoV-2 contagion in a cohort of elective surgical patients in Italy, scheduled for surgery during the COVID-19 pandemic. Results Twenty-nine Italian centres were involved in the study, for a total of 2376 patients surveyed (mean age of 58 years ± 16.61; 49.6% males). The survey consisted of 28 total closed questions, including four study outcome questions. More than half of patients had at least one chronic disease (54%), among which cardiovascular diseases were the commonest (58%). The most frequent type of surgery was abdominal (20%), under general anaesthesia (64%). Almost half of the patients (46%) declared to be frightened of going to the hospital for routine checkups; 55% to be afraid of getting SARS-CoV-2 infection during hospitalization and 62% were feared of being hospitalised without seeing family members. Having an oncological disease and other patient-related, centre-related or perioperative factors were independently associated with an increased risk of fear of SARS-CoV-2 infection during hospitalization and of being hospitalised without seeing family members. A previous infection due to SARS-COV-2 was associated with a reduced risk of worse emotional outcomes and fear of SARS-CoV-2 infection during hospitalization. Patients who showed the most emotionally vulnerable profile (e.g. use of sleep-inducing drugs, higher fear of surgery or anaesthesia) were at higher risk of worse emotional status towards the hospitalization during COVID-19 pandemic. Being operated in hospitals with lower surgical volume and with COVID-19 wards was associated with worse emotional status and fear of contagion. Conclusions Additional fear and worse emotional status may be frequent in patients scheduled for elective surgery during COVID-19 pandemic. More than half of the participants to the survey were worried about not being able to receive family visits. Psychological support may be considered for patients at higher risk of psychological distress to improve perioperative wellbeing during the pandemic.

The Fear of Surgery and Coronavirus in Patients Who Will Undergo a Surgical Intervention

“…Another study by Kurtgöz and Avcı 23 reported that fear of COVID-19 in patients admitted to the emergency department was at a moderate level. Montalto et al 24 revealed that 55% of patients who underwent elective surgery during the pandemic were afraid of being infected with SARS-CoV-2. Doğan et al 25 found that liver transplant patients had a high level of fear of Coronavirus.…”

Timeliness and Modality of Treatment for New Cancer Diagnoses During the COVID-19 Pandemic in Canada

“…While this likely reflects limitations in surgical resources with stringent prioritization strategies, it may also point to an increase in the appropriate receipt of neoadjuvant therapy that the pandemic has paradoxically brought about. Patients who were offered this treatment approach sometimes rejected it to opt for direct surgery, but due to the limited surgical capacity and reluctance to undergo operations during the pandemic, these patients may have embraced this care pathway to a larger extent. Future research needs to examine these speculations by following up patients beyond the receipt of initial therapy to identify their subsequent treatment and long-term outcomes …”

The unseen pandemic: treatment delays and loss to follow-up due to fear of COVID

“…Prior SARS-COV-2 infection was associated with a lower concern regarding SARS-CoV-2 re-infection during hospitalization [19]. Although reinfection with SARS-CoV-2 may occur, it seems uncommon, usually occurs with a different mutation of the virus [20][21][22], and is more common among persons that are immune suppressed [23].…”