Mental Health and Quality of Life in Those Entering Cardiovascular Rehabilitation During the COVID-19 Pandemic

Introduction: The COVID-19 pandemic had adverse effects on mental health in persons with cardiac disease due to policies implemented. The purpose was to assess sex differences and correlates of self-reported symptoms of depression, anxiety, and quality of life (QoL) upon entry to cardiovascular rehabilitation (CR) during the COVID-19 pandemic. We hypothesized that males entering CR would have lower symptoms of depression, anxiety, and higher QoL. Methods: Using electronic medical records with complete data, 305 patients (89 (29%) female) aged 65 ± 11 yr (range 37–89), who attended an initial CR exercise session (6/2021–11/2022) at Winchester Medical Center, Winchester, VA, were included in this retrospective analysis. The Patient Health Questionnaire, General Anxiety Disorder-7, and Dartmouth Cooperative Functional Assessment Charts (COOP) questionnaires were administered at baseline. Unpaired t test and Fisher exact test were used to compare data between the sexes. Stepwise linear regression models were fitted to identify correlates of symptoms of depression, anxiety, and QoL. Results: Overall, the patients entering CR had mean Patient Health Questionnaire, Generalized Anxiety Disorder-7, and COOP scores of 5.4, 3.9, and 22.3, respectively. There were no sex-related differences in the symptoms of depression or anxiety ( P = 0.87 and P = 0.47, respectively). Females had worse perceived QoL via COOP ( P = 0.03). QoL was a common correlate of depression (ß = 0.25, 95% CI: 0.17–0.32) and anxiety (ß = 0.13, 95% CI: 0.05–0.20). Conclusions: Contrary to our hypothesis, there were no sex differences during the COVID-19 pandemic in depression or anxiety. Practicing clinicians should be aware of a potential change from the traditional view that females have higher levels of depression entering CR.