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. 2021 Aug;76(8):2535-2543.
doi: 10.1111/all.14796. Epub 2021 May 15.

Impact of anxiety, stress and depression related to COVID-19 pandemic on the course of hereditary angioedema with C1-inhibitor deficiency

Deniz Eyice Karabacak  1 , Semra Demir  1 , Osman Ozan Yeğit  1 , Ali Can  1 , Kadriye Terzioğlu  2 , Derya Ünal  1 , Müge Olgaç  3 , Raif Coşkun  4 , Bahauddin Çolakoğlu  1 , Suna Büyüköztürk  1 , Aslı Gelincik  1
Affiliations

Impact of anxiety, stress and depression related to COVID-19 pandemic on the course of hereditary angioedema with C1-inhibitor deficiency

Deniz Eyice Karabacak et al. Allergy. 2021 Aug.

Abstract

Background: Hereditary angioedema (HAE) attacks can be provoked with psychological factors. The aim of this study was to assess the effects of anxiety, depression and stress related to COVID-19 pandemic on disease activity of HAE patients during the quarantine period (QP) and the return to normal period (RTNP).

Methods: This study was conducted between March 2020 and September 2020 in four allergy centres. Demographic, clinical features and mental health status were evaluated in QP (from March to the beginning of June) and RTNP (from June to the beginning of September) applied by the government. The 10-point visual analogue scale (VAS10) was used to define the severity of HAE attacks. Depression, Anxiety and Stress Scales-21 (DASS-21) and Fear of COVID-19 (FC-19) scale were performed to assess mental health status.

Results: 139 HAE patients were included in the study. In QP, median attack numbers and median VAS10 scores were 5 (min-max: 0-45) and 6 (min-max: 0-10), respectively. HAE attack numbers, DASS-21 stress, anxiety, depression and total DASS-21 scores, and FC-19 scores were higher in QP than RTNP (p = 0.001, p < 0.001, p = 0.001, p < 0.001, p < 0.001, p < 0.001, respectively). However, there was no difference in attack severity scores between the two periods (p > 0.05).

Conclusions: This study revealed that the restriction measures during COVID-19 outbreak cause an increase in the number of HAE attacks in relation to anxiety, depression, stress and fear of COVID-19 pandemic. Therefore, it is important to provide psychological support to HAE patients during the pandemic.

Keywords: COVID-19; coronavirus; hereditary angioedema; pandemic; psychological effects.

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Conflict of interest statement

Authors state that there is no conflict of interest about this study.

Figures

FIGURE 1
FIGURE 1
(A). Median number of attacks in BP, QP and RTNPs. Higher frequency of attacks was observed in QP. (B). The median VAS severity scores of HAE attacks in QP and RTNPs. There was no difference regarding the severity of HAE attacks. Abbreviations: BP, before pandemic period; QP, quarantine period; RTNP, return to normal period; IQR, interquartile range; min, minimum; max, maximum; VAS, visual analogue scale
FIGURE 2
FIGURE 2
(A). Median scores of DASS‐21 dimensions in QP and RTNPs. Three dimensions of DASS‐21 and DASS‐21 total scores were higher in QP than those in RTNP. (B). Mean scores of Fear of COVID‐19 (FC‐19) scale in QP and RTNPs. FC‐19 scores were higher in QP than those in RTNP. Abbreviations: QP, quarantine period; RTNP, return to normal period; IQR, interquartile range; SD, standard deviation
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