Infectious Disease

Excessive nervousness throughout a COVID-19 pandemic generally is a danger issue for scientific worsening of bronchial asthma

February 18, 2021

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Lacwik does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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High anxiety levels during the COVID-19 pandemic are a potential risk factor for clinical worsening of severe asthma and deterioration in quality of life, researchers reported.

“Mental health can play an important role in managing chronic diseases, especially during the global pandemic,” wrote Dr. Piotr Lacwik, professor at the School of Medicine at the Collegium Medicum at Jan Kochanowski University in Kielce, Poland, and colleagues in the Journal of Allergy and Clinical Immunology: In Practice.

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The researchers surveyed 87 patients with severe asthma (mean age 56.1 years; 39.1% men) who received biological treatment with omalizumab (Xolair, Genentech), mepolizumab (Nucala, GlaxoSmithKline), and benralizumab (Fasenra, AstraZeneca) in the national Treatment for Severe Asthma was given program during visits in March and June 2020. On each visit, patients completed the State-Trait Anxiety Inventory (STAI) questionnaire and a COVID-19 survey to raise concerns about the effects of COVID-19 on the fear of assessing the asthma and quality of life of patients. Complete medical data were available for all patients, including changes in the Asthma Control Questionnaire (ACQ) and Quality of Life in Mini-Asthma Questionnaire (mAQLQ) that could be compared to their last visit before COVID-19.

46% of the patients had an increase in their ACQscore, 17% reported no change and 37% had a decrease in their score. The researchers observed a greater impact on asthma-related quality of life: 62% of patients had a reduced mAQLQ score, 18% reported no change, and 20% had an elevated score. The mean change in ACQ value was 0.214 and the mean change in mAQLQ was 0.248 according to the results.

22 patients had a significant decrease in asthma symptom control and 18 patients had a significant decrease in quality of life.

The mean STAI values ​​were 44.82 for state anxiety and 42.14 for characteristic anxiety. Most patients reported that the COVID-19 pandemic significantly affected their responses. 34 percent of the patients reported having high levels of anxiety and 8 percent reported having anxiety. In patients with high levels of anxiety, the proportion of patients with significant increases in the ACQ value (53.3% versus 10.5%) and the decrease in quality of life (30% versus 15.8%) was higher than in patients with low (n = 7)) to moderate (n = 50) fear of states.

The researchers also reported a significant association between change in ACQ and state anxiety (P <0.001) and feature anxiety (P <0.01). The results showed that there was no significant association between types of anxiety and quality of life ratings.

A high level of anxiety in patients can be a risk factor for a significant decrease in ACQ (OR = 9.71; P <0.001) and quality of life (OR = 2.29; P = 0.008) compared to patients with low or medium scores his state fear, the researchers reported.

No patient experienced any exacerbations in the 3 months following the assessment.

According to the researchers, these results suggest that the main event of a global pandemic can significantly affect patients ‘anxiety levels, which is reflected in patients’ quality of life and disease control.

“Regular screening of severe asthmatics using the STAI questionnaire could be a valuable addition to asthmatic patient care,” the researchers write. “More studies are needed to assess whether an intervention to reduce anxiety might prove effective in improving asthma control.”

The researchers cited various limitations of the current study, including the lack of fear measures for the pandemic and the possibility that other factors related to COVID-19, such as increased stress or depression and increased exposure to household allergens during the stoppage, may have also appeared changes in asthma control and quality of life.

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