High levels of anxiety during the COVID-19 pandemic as a risk factor of clinical worsening in patients with severe asthma

Abstract

Mental health can have a significant role in managing chronic diseases, particularly during the global pandemic. High levels of trait and state anxiety are a potential risk factor for loss of asthma symptom control and decline in disease-related quality of life.

Psychological impacts of coronavirus disease 2019 on people with asthma, allergic rhinitis, and food allergy

“…12 Furthermore, elevated anxiety levels are a potential risk factor for loss of asthma symptom control and a decline in disease-related quality of life (QoL). 6 In the context of COVID-19, 64% of people with a chronic respiratory condition, including asthma (83% of the surveyed population), reported high levels of anxiety on their respiratory condition and COVID-19. 13 COVID-19 may cause increased stress and anxiety in people with asthma, especially after the Centers for Disease Control and Prevention warning early on (before August 31, 2020) in the pandemic stating that people with chronic illness may be at a higher risk for severe illness from the disease.…”

“…21 Survey studies have found an increase in anxiety, depression, asthma symptoms, decreased symptom control, and QoL (Table 1). 6,21,22 An online questionnaire (n = 264) in people who were 12 to 78 years old found that 70% of the study participants had poorly controlled asthma (Asthma Control Test [ACT] 19Þ, 46% of the participants found that their symptoms increased during a lockdown, and 90% attributed this increase to disinfectant use which may contribute to feelings of anxiety. 21 Using the hospital anxiety and depression scale (HADS), researchers found that 35% and 26% of study participants reported anxiety and depression.…”

“…5 Mental health has a considerable impact on chronic disease management, particularly during COVID-19, the impacts of such are beginning to emerge for people with chronic allergic diseases, including asthma, AR, and food allergy (FA) (Fig 2). 6 At the beginning of the pandemic, some health authorities suggested that asthma and allergic disease may be risk factors for COVID-19. Though this sentiment has been discounted by many health authorities, it has potentially made a detrimental impact on the perception of patients of their COVID-19 risk and mental health status.…”

General Stress Among Young Adults with Asthma During the COVID-19 Pandemic

“…Early adulthood is for most individuals an active period of life, when intensive social interaction with friends, starting a new family, the beginning of a working career, and many founding events for the rest of life may take place. The coronavirus disease 2019 (COVID- 19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has profoundly affected the lives of a large part of the global population since it was declared a pandemic by the World Health Organization in March 2020. 1 The measures taken to reduce the spread such as quarantines, travel bans, and restrictions on public gatherings have caused a major impact socially and economically on people in addition to the threat of the disease in itself.…”

“…It is important to investigate COVID-19erelated anxiety in individuals with asthma, because anxiety has previously been shown to be related to asthma both in childhood and later 17,18 and clinical worsening among middle-aged individuals with severe asthma. 19 Uncontrolled asthma has in turn been found to associate with worse quality of life. 20 Allergic rhinitis and atopic diseases have also been reported to associate with increased anxiety 17,21 ; however, so far no association between allergic rhinitis and increased levels of anxiety has been established in relation to COVID-19.…”