Psychological and Emotional Impact of COVID-19 Pandemic on People Living With Chronic Disease: HIV and Cancer.

Abstract Background: COVID-19 pandemic changes the lifestyle and inducted negative emotions. People living with chronic disease (PLWCD) are the frailest social category, both for the risk of severe COVID-19 illness and for the pandemic impact on the continuum of care. Aim of this study was to analyze coping strategies and resilience in people living with HIV (PLWH) compared to people living with oncological diseases (PLWOD) during COVID-19 pandemic. Methods: In this observational study based on the administration of an anonymous questionnaire, we explored the emotional experience, the clinical and demographic factors linked to a COVID-19-related stress syndrome, the patient’s perception about the adequacy of clinical and psychological undertaking from the hospital and the level of resilience through a validated resilience scale. We performed a Kruskal-Wallis and a chi-squared test to compare the characteristics between PLWH and PLWOD and a linear regression to assess the factors associated to higher resilience. Results: We analyzed 324 questionnaires (PLWH n=167, PLWOD n=157). There were no significant differences in prevalence of psychological distress, anxiety, and fear among the whole cohort; however, PLWOD were calmer (p=0.039), less troubled (p=0.014), and more serene (p=0.026) than PLWH. Moreover, PLWH smoked more (p<0.001), ate more (p=0.003) and thus gained more weight (p=0.013) than PLWOD. 62% of patients didn’t have more feelings of solitude than usual (p=0.130) and 71,3% continued to take pleasure from their activities (p=0.511). No differences in resilience were found between the groups, however in the whole cohort lower levels of resilience were found in patients that were unemployed (-3.52; 95% CI = [-6.68 -0.35]; p=0.029), with history of psychological disorders (-2.18; 95% CI = [-3.17 -1.18]; p<0.001) and in those who experienced more feelings of anger (-1.76; 95% CI = [-2.67 -0.85]; p<0.001), anxiety and concern (-1.56; 95% CI = [-2.30 -0.82]; p<0.001). Conclusions: PLWCD had high level of resilience, preserved in general their psychological well-being, and activated adaptive coping during the pandemic. However, PLWH showed higher distress than PLWOD according to comparable resilience score. Patients with psychological problems, feelings of anger and concern deserve more attention as they show lower levels of resilience.