Mental health symptoms in scleroderma during COVID-19: a Scleroderma Patient-centred Intervention Network (SPIN) cohort longitudinal study

ObjectivePeople with systemic sclerosis (SSc) are vulnerable in COVID-19 and face challenges related to shifting COVID-19 risk and protective restrictions. We evaluated mental health symptom trajectories in people with SSc through March 2022.MethodsThe longitudinal Scleroderma Patient-centred Intervention Network (SPIN) COVID-19 cohort was launched in April 2020 and included participants from the ongoing SPIN Cohort and external enrolees. Analyses included estimated means with 95% CIs for anxiety and depression symptoms pre-COVID-19 for ongoing SPIN Cohort participants and anxiety, depression, loneliness, and fear of COVID-19 for all participants across 28 COVID-19 assessments up to March 2022. We conducted sensitivity analyse including estimating trajectories using only responses from participants who completed >90% of items for = 21 of 28 possible assessments (completers) and stratified analyses for all outcomes by sex, age, country, and SSc subtype.ResultsAnxiety symptoms increased in early 2020 but returned to pre-COVID-19 levels by mid-2020 and remained stable through March 2022. Depression symptoms did not initially change but were slightly lower by mid-2020 compared to pre-COVID-19 and were stable through March 2022. COVID-19 fear started high and decreased. Loneliness did not change across the pandemic. Resultswere similar for completers and for all subgroups.ConclusionPeople with SSc continue to face COVID-19 challenges related to ongoing risk, the opening of societies, and removal of protective restrictions. People with SSc, in aggregate, appear to be weathering the pandemic well, but health care providers should be mindful that some individuals may benefit from mental health support.

Automated summary

The study evaluated mental health symptom trajectories in people with systemic sclerosis (SSc) during the COVID-19 pandemic, showing that anxiety symptoms initially increased in early 2020 but quickly returned to pre-COVID-19 levels, while depression symptoms remained stable throughout the pandemic. Fear of COVID-19 was high at first but decreased over time, and loneliness did not significantly change during the pandemic.