Early Effects of the COVID-19 Pandemic on Patients in a Virtual Multicenter Spontaneous Coronary Artery Dissection (SCAD) Registry

The COVID-19 pandemic effects among patients with history of spontaneous coronary artery dissection (SCAD), a cause of acute coronary syndrome associated with emotional and physical stress, are unknown. For this cross-sectional cohort study, participants of the Mayo Clinic “Virtual” Multicenter SCAD Registry were surveyed about the COVID-19 pandemic. Among 1352 participants, 727(53.8%) completed surveys between 6/2/2021-9/29/2021. The majority(96.7%) of respondents were female with mean age of 54.9+9.4 years. At time of survey, which was early in the pandemic, 91(12.6%) respondents reported prior COVID-19 symptoms, with <1% experiencing hospitalization(N=4) or cardiac complications(N=6). Fourteen percent had > moderate anxiety symptoms by GAD-7 and 11.8% had > moderate depressive symptoms by PHQ-9. Higher stress on the Likert scale correlated with pandemic-related reduction in work hours/pay/unemployment(p=0.013), remote work/change of job(p<0.001), and loss of insurance/medical coverage(p=0.025). Higher anxiety on the Likert scale correlated with pandemic-related remote work/change of job(p=0.007) and loss of insurance/medical coverage(p=0.008). Since the start of the pandemic, 54% of respondents reported at least monthly chest pain. Chest pain and COVID symptoms were each associated with higher GAD-7 and PHQ-9 scores. Early in the pandemic, COVID-19 symptoms, hospitalization and cardiac complications were uncommon among SCAD patients. Burden of anxiety and depressive symptoms was minimal-mild, similar to prior reports. Likert scale measures of stress and anxiety were higher among persons with work/pay reduction/unemployment, remote/change of job and loss of insurance/medical coverage. Over half of respondents reported chest pain, which correlated with depressive and anxiety symptoms, highlighting an overarching clinical need.