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P122 The impact of COVID-19 shielding on the wellbeing, mental health and treatment adherence of adults with cystic fibrosis (CF)
  1. K Westcott,
  2. F Wilkins,
  3. M Chancellor,
  4. A Anderson,
  5. S Doe,
  6. C Echevarria,
  7. SJ Bourke
  1. Adult Cystic Fibrosis Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK


Background People with CF were considered to be extremely vulnerable to COVID-19 and were advised on 23rd March 2020 to ‘shield’ (stay at home; no outside contacts).

Methods In July an e-mail survey was sent to 137 CF adults to determine how strictly they had shielded, how they had coped and the effect on wellbeing and mental health (GAD-7 & PHQ-9). Treatment adherence (measured with ‘chipped nebulisers’- CFHealthHub) and levels of anxiety and depression pre- and during shielding were compared in a subgroup that consented to being identified. Changes were compared with the Wilcoxon rank test.

Results 63 (46%) responded; 19 replied anonymously and 44 (25 men) gave their identity. Mean age (range) was 32.7 (17.5–64) years, FEV12.1 (0.57–4.86) L, BMI 22.8 (16.4–28.6) kg/m2 and 33 were on CFTR modulator treatment. Fifty-nine (94%) reported adherence to shielding ‘all the time’/‘often’. Most (76%) found this difficult, reporting a negative impact on exercise, social support, independence, sleep and daily routines. Most were not concerned about shielding being relaxed but 44% worried that others might not adhere to social distancing with risks of COVID-19 infection (43%). Adherence rates during COVID were available in 42 patients, with a median of 91% (interquartile range 84% to 100%). In 28 patients, pre-COVID adherence results were available, with a median difference of 0 (IQR -4 to 8). In 41 patients with complete data, there was a significant difference in the median pre-COVID versus during-COVID anxiety score (pre= 2, IQR 0.5–6 compared to during =5, IQR 1–11; p=0.002). ‘Clinically significant’ (mild-severe) anxiety rose from 27% pre-COVID to 54% during COVID. In 43 patients with complete data there was no difference in median pre-COVID versus during-COVID depression scores (pre= 3, IQR 1–10 compared to during= 3, IQR 2–12; p=0.09).

Conclusions These CF patients showed high compliance with shielding, and high rates of adherence with medication, and none developed COVID-19. They coped well, with low depression scores, but negative impacts were reported on exercise, social support, and daily routines. Anxiety levels significantly increased during shielding, and 7 patients requested a psychology consultation from this survey.

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