Posttraumatic Stress Symptoms in Patients With Cancer During the COVID-19 Pandemic: A One-Year Longitudinal Study
Background: Patients with cancer may be particularly vulnerable to psychological consequences of the COVID-19 pandemic. We studied the prevalence and evolution of posttraumatic stress symptoms (PTSS) in patients with cancer during the pandemic waves, and we investigated factors associated with high symptoms. Methods: COVIPACT is a 1-year longitudinal prospective study of French patients with solid/hematologic malignancies receiving treatment during the first nationwide lockdown. PTSS were measured every 3 months from April 2020 using the Impact of Event Scale–Revised. Patients also completed questionnaires on their quality of life, cognitive complaints, insomnia, and COVID-19 lockdown experience. Results: Longitudinal analyses involved 386 patients with at least one PTSS assessment after baseline (median age, 63 years; 76% female). Among them, 21.5% had moderate/severe PTSS during the first lockdown. The rate of patients reporting PTSS decreased at lockdown release (13.6%), increased again at second lockdown (23.2%), and slightly declined from the second release period (22.7%) to the third lockdown (17.5%). Patients were grouped into 3 trajectories of evolution. Most patients had stable low symptoms throughout the period, 6% had high baseline symptoms slowly decreasing over time, and 17.6% had moderate symptoms worsening during the second lockdown. Female sex, feeling socially isolated, worrying about COVID-19 infection, and using psychotropic drugs were associated with PTSS. PTSS were associated with impaired quality of life, sleep, and cognition. Conclusions: Approximately one-fourth of patients with cancer experienced high and persistent PTSS over the first year of the COVID-19 pandemic and may benefit from psychological support.
ClinicalTrials.gov identifier: NCT04366154
Submitted March 11, 2022; final revision received July 15, 2022; accepted for publication October 11, 2022. Published online Februry 22, 2023.
Author contributions: Conceptualization: Clarisse, Joly. Formal analysis: Lefèvre-Arbogast, Lequesne. Funding acquisition: Clarisse. Investigation: Bastien, Gernier, Binarelli, Lange, Fernette, Tron, Richard, Quilan. Methodology: Lefèvre-Arbogast, Lequesne, Clarisse. Project administration: Grellard, Richard, Leconte. Resources: Rigal, Morel, Leheurteur, Faveyrial, Joly. Supervision: Griffon, Pépin, Clarisse, Joly. Writing–original draft: Bastien, Lefèvre-Arbogast, Lequesne, Clarisse, Joly. Writing–review and editing: All authors.
Data availability: The data that support the findings of this study are available upon reasonable request from the corresponding author.
Disclosures: The authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.
Funding: This work was supported by a research grant from Fondation ARC (COVID202001320) and financial support from the GEFLUC Normandie (Les Entreprises Contre le Cancer/Campaigns Against Cancer, Rouen-Normandie).
Disclaimer: The funders had no role in the design of the study; the collection, analysis, and interpretation of the data; the writing of the manuscript; and the decision to submit the manuscript for publication.
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