A team of Polish researchers has discovered through study groups that patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) had an increased risk of developing anxiety during the coronavirus disease 2019 (COVID-19) pandemic, according to a study published in the Journal of Clinical Medicine. 

During the pandemic, patients with chronic cardiac or pulmonary diseases were advised to practice extra precautions due to their vulnerability should they contract the disease. Although the incidence of COVID-19 infections was roughly the same between patients with PAH and CTEPH and the general population, researchers sought to identify if the life-changing restrictions and burden placed on vulnerable patients during the pandemic resulted in any negative psychological manifestations. 

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The researchers performed their prospective study in 3 Polish PAH centers. A total of 223 patients with a confirmed diagnosis of either PAH or CTEPH were recruited between April 15, 2021, and May 30, 2021, which coincided with the “third wave” of the pandemic in Poland. Recruited patients were asked to fill in 2 questionnaires: the Fear of COVID-19 Scale (FCV-19S) and the Hospital Anxiety and Depression Scale (HADS). 

The results showed that the fear of COVID-19 was high, with anxiety diagnosed in 32% of patients, depression in 21% of patients, and anxiety or depression in 38% of patients. Statistical analysis showed that the fear of COVID-19 increased the odds ratio of anxiety, but not of depression. Having a history of COVID-19 infection increased the risk of both anxiety and depression. The fear of COVID-19 was found to be highest among women and the elderly. 

This study is a snapshot of the psychological burden caused by the COVID-19 pandemic throughout its various peaks and troughs. Although psychotherapy is recommended as a first step in addressing anxiety and depression, COVID-19 movement restriction directives can make psychological services difficult to access. Nevertheless, the authors of this study concluded, “Patients with PAH and CTEPH, especially women over 65 years and those who had been infected with COVID-19, may need additional psychological support due to fear of COVID-19, anxiety, or depression.”


Wieteska-Miłek M, Szmit S, Florczyk M, et al. Fear of COVID-19, anxiety and depression in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension during the pandemicJ Clin Med. 2021;10(18):4195. doi:10.3390/jcm10184195