Depression and Anxiety Among Patients with Cancer During COVID-19 Pandemic: A Systematic Review and Meta-analysis

Erfan Ayubi, Saeid Bashirian, Salman Khazaei, Erfan Ayubi, Saeid Bashirian, Salman Khazaei

Abstract

Background: Investigations about the impact and consequences of the COVID-19 infection on the mental health of patients with chronic diseases and those with immunosuppressive conditions are growing. The current study aimed to systematically review and meta-analysis of studies that evaluated the level of depression and anxiety in cancer patients during the COVID-19 pandemic.

Methods: The PubMed, Scopus and Web of Sciences databases were searched to retrieve potential studies from January 2020 to 3 January 2021. Summary data on frequency and mean of depression and anxiety were extracted. Random-effect meta-analysis was conducted to estimate overall prevalence, mean and standardized mean difference.

Results: Thirty-four studies were included in the systematic review, of them 21 studies included in meta-analysis. Overall depression and anxiety were 0.37 (0.27, 0.47); I2 = 99.05%, P value < 0.001 and 0.38 (0.31, 0.46); I2 = 99.08%, P value < 0.001, respectively. Compared to controls, cancer patients had higher anxiety level [standard mean difference (SMD 0.25 (95% CI 0.08, 0.42)].

Conclusion: Overall, the findings of this study suggest that the prevalence of depression and anxiety among patients with cancer during the COVID-19 pandemic can reach considerable levels, although observed substantial heterogeneity should be considered when interpreting the results.

Keywords: Anxiety; COVID-19; Cancer patients; Coronavirus; Depression; Systematic review and meta-analysis.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the systematic review and meta-analyses selection process
Fig. 2
Fig. 2
Forest plot of random meta-analysis for prevalence of depression among patients with cancer
Fig. 3
Fig. 3
Forest plot of random meta-analysis for prevalence of anxiety among patients with cancer
Fig. 4
Fig. 4
Forest plot of random meta-analysis for mean difference of anxiety among patients with cancer; GAD-7; Generalized Anxiety Disorder Questionnaire, HADS-A; Hospital Anxiety and Depression Scale-depression, SAS; Self-Rating Anxiety Scale; SDM; standardized mean difference

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