For a qualitative-quantitative mixed-methods study, researchers sought to evaluate COVID-related stress at enrollment, subsequent stress, and clinical and behavioral traits associated with successful coping during longitudinal follow-up in a cohort gathered during the peak of mortality-associated coronavirus disease 2019 (COVID-19) in New York City.
In an interview conducted in April 2020, patients with a rheumatic disease diagnosed by a rheumatologist and receiving immunosuppressive drugs were questioned about the effects of COVID-19 on their psychological well-being. Responses to stress were divided into groups. In a follow-up interview conducted in January–March 2021, patients were questioned about their interval and current illness state and how well they felt they were coping. Throughout both interviews, patients also filled out the PROMIS-29, a 29-item questionnaire assessing physical and mental health.
The average age of the 96 patients who had follow-ups was 50 years, and 83% were female. When it came to the anxiety subscale, patients’ PROMIS-29 ratings improved when they indicated stress during enrolment. Patients reported new and ongoing pressures during the follow-up, along with various self-described coping mechanisms. Overall ratings for coping ranged from very well (30%) to well (48%) to neutral-fair-poor (22%). According to ordinal logistic regression, factors that were related to poorer overall coping included worse enrollment-to-follow-up PROMIS-29 anxiety (odds ratio [OR], 4.4; CI, 1.1-17.3; P=0.03), not reporting excellent or very good disease status at follow-up (OR, 2.7; CI, 1.1-6.5; P=0.03), pandemic-related persistent stress (OR, 5.7; CI, 1.6-20.1; P=0.007), & pandemic-related adverse long-lasting effects on employment (OR, 6.1; CI, 1.9–20.0; P=0.003) & health (OR, 3.0; CI, 1.0–9.0; P=0.05).
The study demonstrated how psychological stress and coping with COVID are changing, with the majority of patients indicating they could manage their symptoms successfully. However, to treat the long-lasting negative effects of the pandemic, multidisciplinary health care professionals are required for people who are not coping well.
