Adverse Impact of COVID-19 on Hopelessness Levels in Patients With Ischemic Heart Disease

Purpose: The coronavirus disease-2019 (COVID-19) pandemic negatively impacted mental health outcomes. This study aimed to 1) quantify the relationship between perceived impact of COVID-19 and hopelessness in patients with ischemic heart disease (IHD) and 2) identify potential mediators of the relationship. Methods: Participants (n = 110) were recruited from 1 hospital in the Midwestern United States. Data on the perceived impact of COVID-19, state and trait hopelessness, depression, perceived social support (PSS), health-related quality of life (HRQoL), and well-being were collected 2 weeks post-hospitalization from 2020 to 2023. Linear models were used to evaluate associations between variables in adjusted and unadjusted models. Results: Most participants were male (69%), non-Hispanic White (95%), married (64%), and with some college education (66%). Hopelessness showed a modest association with perceived COVID-19 impact (state = 0.23; trait = 0.30), as did anxiety (0.40), HRQoL (0.20), PSS (−0.24), fatigue (0.25), and pain interference (0.25), in adjusted and unadjusted models. Food access, family income/employment, social support access, and stress were associated with hopelessness and perceived COVID-19 impact. The strongest evidence for mediation between hopelessness and perceived COVID-19 impact was anxiety (66% mediation state; 50% mediation trait). Conclusions: In this first study to report hopelessness levels in patients with IHD during the COVID-19 pandemic, the relationship between hopelessness and perceived COVID-19 impact was supported and mediated by anxiety. During a pandemic, food access, social support, family income/employment, and stress in patients with IHD may increase feelings of hopelessness. Further research is required to examine the hopelessness and anxiety relationship.