STRESS AND SYMPTOM BURDEN IN ONCOLOGY PATIENTS DURING THE COVID-19 PANDEMIC

Miaskowski, Christine; Paul, Steven M.; Snowberg, Karin; Abbott, Maura; Borno, Hala; Chang, Susan; Chen, Lee May; Cohen, Bevin; Hammer, Marilyn J.; Kenfield, Stacey A.; Kober, Kord M.; Levine, Jon D.; Pozzar, Rachel; Rhoads, Kim F.; Van Blarigan, Erin L.; Van Loon, Katherine

CONTEXT: No information is available on oncology patients’ level of stress and symptom burden during the COVID-19 pandemic. We evaluated for differences in demographic and clinical characteristics, levels of social isolation and loneliness, and the occurrence and severity of common symptoms between oncology patients with low versus high levels of COVID-19 and cancer-related stress. In addition, we determined which of these characteristics were associated with membership in the high stressed group. METHODS: – Patients were >18 years of age; had a diagnosis of cancer; and were able to complete an online survey. RESULTS: Of the 187 patients in this study, 31.6% were categorized in the stressed group (Impact of Event Scale –Revised (IES-R score of >24)). Stressed group’s IES-R score exceeds previous benchmarks in oncology patients and equates with probable PTSD. In this stressed group, patients reported occurrence rates for depression (71.2%), anxiety (78.0%), sleep disturbance (78.0%), evening fatigue (55.9%), cognitive impairment (91.5%), and pain (75.9%). Symptom severity scores equate with clinically meaningful levels for each symptom. CONCLUSIONS: – We identified alarmingly high rates of stress and an extraordinarily high symptom burden among cancer patients, exceeding those previously benchmarked in this population and on par with non-cancer patients with PTSD. Given that the COVID19 pandemic will likely impact cancer care for an indefinite period of time, clinicians must exhibit increased vigilance in their assessments of patients’ level of stress and symptom burden. Moreover, an increase in referrals to appropriate supportive care resources must be prioritized for high risk patients.