Key result
Starting cardiac rehab during COVID-19 is linked to ~8% greater odds of new-onset depressive symptoms.
Why the study?
It was unknown whether starting cardiac rehabilitation during COVID-19 influenced new-onset depressive symptoms and which factors were associated with these symptoms in UK patients.
Does commencing cardiac rehabilitation during the COVID-19 period increase new-onset depressive symptoms in patients with cardiovascular disease?
Observational (n=71,055)
Yes
Does commencing cardiac rehabilitation during the COVID-19 period increase new-onset depressive symptoms in patients with cardiovascular disease?
Effect estimate: OR 1.08 (95% CI 1.01, 1.16)
Absolute Event Rate: 19.7% vs 19.6%
Starting cardiac rehabilitation during the COVID-19 pandemic, along with factors like physical inactivity, smoking, and specific comorbidities, was associated with a higher likelihood of new-onset depressive symptoms.
May warrant enhanced depression screening at CR start amid disruptions; leaves open causal mechanisms and mitigation strategies.
OBJECTIVE: We aim to: 1) investigate whether starting cardiac rehabilitation (CR) during the COVID-19 period was influential on new-onset depressive symptoms, 2) examine the relationship between sociodemographic and medical factors with the new-onset of depressive symptoms before and during the COVID-19 period in UK patients commencing CR. METHODS: The national audit of cardiac rehabilitation (NACR) data were used and the two years of data before COVID-19 and during COVID-19 were analysed (Feb,2018 - Nov,2021). Hospital Anxiety and Depression Scale measurement was used to assess depressive symptoms. Bivariate analysis and logistic regression were conducted to examine the influence of the COVID-19 period on new-onset depressive symptoms and the patient characteristics associated with it. RESULTS: 71055 patients screened for new-onset depressive symptoms were included in the analysis. Based on multivariate analysis, patients commencing CR during COVID-19 were 8% more likely to have new onset depressive symptoms compared to patients commencing before COVID-19. Smoking (OR: 1.26, 95%CI: 1.11, 1.43), physical inactivity (OR: 1.86, 95%CI: 1.74, 1.98), high anxiety (OR: 1.45, 95%CI: 1.44, 1.46), being male (OR: 1.21, 95%CI: 1.12, 1.30), single (OR: 1.25, 95%CI: 1.16, 1.35), having comorbidities of arthritis, diabetes, chronic bronchitis, emphysema, claudication (OR range: 1.19 to 1.60), receiving CABG treatment (OR: 1.47, 95%CI: 1.25, 1.73), and having heart failure (OR: 1.33, 95%CI: 1.19, 1.48) were the factors associated with having new-onset depressive symptoms at the start of CR. CONCLUSION: Our findings have shown that starting CR during the COVID-19 period was associated with increased odds of having new-onset depressive symptoms.
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Sever et al. (2023) conducted an observational in Cardiovascular disease (patients starting cardiac rehabilitation) (n=71,055). Starting cardiac rehabilitation during the COVID-19 period vs. Starting cardiac rehabilitation during the pre-COVID-19 period was evaluated on New-onset depressive symptoms (HADS score ≥8) (OR 1.08, 95% CI 1.01, 1.16). Starting cardiac rehabilitation during the COVID-19 period was associated with an 8% increase in the odds of having new-onset depressive symptoms compared to the pre-COVID-19 period (OR 1.08).
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