Anxiety in adults with asthma during the coronavirus disease 2019 pandemic: a Canadian perspective

Sophia Linton; Kayley Xu; Lubnaa Hossenbaccus; Hannah Botting; Sarah Garvey; Adam Sunavsky; Lisa M Steacy; Dean A Tripp; Anne K Ellis

doi:10.1186/s13223-023-00833-z

Anxiety in adults with asthma during the coronavirus disease 2019 pandemic: a Canadian perspective

Allergy Asthma Clin Immunol. 2023 Aug 23;19(1):73. doi: 10.1186/s13223-023-00833-z.

Authors

Sophia Linton^{1

2

3}, Kayley Xu¹, Lubnaa Hossenbaccus^{1

2

3}, Hannah Botting^{2

3}, Sarah Garvey^{2

3}, Adam Sunavsky⁴, Lisa M Steacy^{2

3}, Dean A Tripp^{1

5}, Anne K Ellis^{6

7

8

9}

Affiliations

¹ Department of Medicine, Queen's University, Kingston, ON, Canada.
² Kingston General Health Research Institute-Allergy Research Unit, Kingston, ON, Canada.
³ Kingston Health Science Centre-KGH Site, Kingston, ON, Canada.
⁴ Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
⁵ Department of Psychology, Queen's University, Kingston, ON, Canada.
⁶ Department of Medicine, Queen's University, Kingston, ON, Canada. Anne.Ellis@kingstonhsc.ca.
⁷ Kingston General Health Research Institute-Allergy Research Unit, Kingston, ON, Canada. Anne.Ellis@kingstonhsc.ca.
⁸ Kingston Health Science Centre-KGH Site, Kingston, ON, Canada. Anne.Ellis@kingstonhsc.ca.
⁹ Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada. Anne.Ellis@kingstonhsc.ca.

Abstract

Background: Asthma is a chronic airway inflammatory disease that affects millions of Canadians and often contributes to higher levels of anxiety among patients. Since the coronavirus disease 2019 (COVID-19) pandemic was a time of increased anxiety and fear among the Canadian population, it was thought that those with asthma may experience heightened anxiety levels due to uncertain access to care, the potential to misinterpret asthma symptoms for symptoms of COVID-19 (or vice versa), and the concern about being treated differently by those around them when experiencing asthma symptoms. Therefore, this study sought to perform a cross-sectional analysis of the asthma-anxiety relationship in adults with and without asthma in the unique context of the COVID-19 pandemic from a Canadian perspective.

Methods: This study employed the COVID-19 Associated Anxiety in Allergic Rhinitis and Asthma patients Experiencing Symptoms (CAAARES) survey, consisting of COVID-19-specific questions, the Generalized Anxiety Disorder Assessment-7 (GAD-7) and the Asthma Control Questionnaire-6 (ACQ-6). Data collection occurred through the Qualtrics XM platform and data analyses were conducted with the IBM SPSS Statistics 28 software.

Results: A total of 741 valid responses were collected (asthma group, n = 244; control group, n = 497). 31.6% and 26.2% of respondents in the asthma and control groups, respectively, met the diagnostic criteria for GAD. There was no significant difference (p = .067) in mean GAD-7 scores between the two groups. A Hierarchal Multiple Regression (HMR) model was developed, and neither asthma status nor ACQ-6 score had a significant predictive effect on the GAD-7 score. There was a statistically significant (p < .001) weak positive correlation (r = .22) between GAD-7 and ACQ-6 scores. In a simple mediation (SMM) model, perceived COVID-19 stress of others was not identified as a significant mediator of the relationship between ACQ-6 and GAD-7 (indirect effect β = 0.014).

Conclusion: Our study of a Canadian cohort demonstrates elevated levels of anxiety overall, amongst both asthma and control groups. While AR status was significantly greater in the asthma group, it was not a significant predictive variable of GAD-7 score. Our data suggests that COVID-19-specific factors appear to have a greater contribution to anxiety than asthma status or control.

Keywords: Allergies; Anxiety; Asthma; COVID-19.

Abstract

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