Impacts of the COVID-19 pandemic on mental and psychosocial health among patients undergoing active cancer treatment: An international survey

Abstract Background: There is limited information on the impact of the COVID-19 pandemic on the mental health of patients with cancer. Our objective was to evaluate the mental and psychosocial health impacts of the COVID-19 pandemic among individuals undergoing active cancer treatment and compare outcomes among those diagnosed <50 and ≥50 years of age.Methods: We administered an international, Internet-based cross-sectional survey. We used validated scales to assess anxiety (GAD-7), depression (PHQ-9), social isolation (LSNS6) and loneliness (UCLA3) and used multivariable regression models to identify determinants.Results: Altogether 238 (126 <50 years and 112 ≥50 years) participants undergoing active treatment for cancer completed the survey. Overall, many participants experienced anxiety (26.6%), depression (30.0%), loneliness (43.3%), and social isolation (19.8%). Younger participants were more likely to experience anxiety (GAD-7 <50 years 7.4 ± 5.1 vs. ≥50 years 5.9 ± 5.9 [p-value 0.042]) and older participants were more likely to experience social isolation (LSNS6 <50 years 17.8 ± 5.8 vs. ≥50 years 15.9± 6.0 for those [p-value 0.019]). Determinants of anxiety identified in multiple linear regression included age at cancer diagnosis (ß= -0.05; p-value 0.047), worrying about paying household expenses (ß = 1.42; p-value=0.034), social isolation (ß = 2.15; p-value 0.017) and depression (ß = 6.67; p-value<.0001). Determinants of depression included loneliness (ß = 3.77; p-value <.0001) and anxiety (ß = 6.54; p-value <.0001).Conclusions: The results of our study indicate the negative impact that the COVID-19 pandemic has had on patients with cancer undergoing active treatment across the age spectrum.