SARS-CoV2 et cancer : quel impact psychologique ? Expérience du service d’oncologie médicale du centre hospitalier universitaire Hassan-II de Fès, Maroc
SARS-CoV-2 and Cancer: What Is the Psychological Impact? Experience of Department of Medical Oncology, Hassan-II University Hospital of Fez, Morocco
Abstract
Background: The Covid-19 disease is a cause for several mental alterations mainly in cancer patients who are already categorized as a vulnerable population.
Aim: The objective of this study is to characterize psychological disorders caused by Covid-19 infection among cancer patients on systemic treatment.
Methods: It is a cross-sectional study performed at the Department of Medical Oncology of Hassan-II University Hospital of Fez, Morocco, during a period of four months (peak of the pandemic). Symptoms of anxiety/depression and post-traumatic stress disorder in patients were screened using HADS (Hospital Anxiety and Depression Scale) and PCL-5 (post-traumatic stress disorder checklist version DSM-5) scales. Mini-MAC (mini-mental adjustment to cancer) scale was used to evaluate a mental adjustment to cancer during the context of Covid-19 infection.
Results: Of the 53 patients in this study, 45.2% had posttraumatic stress disorder, 20.7% presented symptoms of depression, and 69.8% had symptoms of anxiety. Age less than 65 years, females, and the intention of treatment (curative vs. palliative intent) were predictive factors of anxiety disorders. All of our patients returned to complete their treatment after their SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection was cured.
Conclusion: The prevalence of anxiety and post-traumatic stress was higher among cancer patients comparatively to general population. These results suggest the need of psycho-oncological supportive-care programs during the actual pandemic.
Résumé
Introduction: La Covid-19 constitue une cause de plusieurs affections mentales, notamment chez les patients atteints de cancer qui sont déjà considérés comme une population vulnérable. Ainsi, l’objectif de la présente étude était d’évaluer les troubles psychologiques des patients suivis pour une maladie tumorale maligne, sous traitement médical systémique, ayant eu une infection au SARS-CoV2 ; ainsi que les conséquences que ces troubles psychologiques peuvent avoir sur l’adhésion aux soins oncologiques.
Méthode: Il s’agit d’une étude transversale sur une période de quatre mois (pic de la pandémie) menée au département d’oncologie médicale du centre hospitalier universitaire Hassan-II de Fès, Maroc. Les symptômes anxieux/dépressifs et le stress post-traumatique ont été évalués avec les échelles HADS, PCL-5. L’échelle mini-MAC était utilisée afin d’évaluer l’ajustement psychologique des patients atteints de cancer dans le contexte d’infection à la Covid-19.
Résultats: Au total, 53 patients ont été rencontrés : 45,2 % des patients présentaient des symptômes significatifs de stress post-traumatique et 20,7 % une symptomatologie dépressive. Une symptomatologie anxieuse importante était objectivée chez 69,8 % des patients. L’âge inférieur à 65 ans, le sexe féminin et la stratégie thérapeutique envisagée (curative versus palliative) étaient des facteurs pré- dictifs de survenue de troubles anxieux. Tous les patients sont revenus pour reprendre leurs soins oncologiques après l’épisode infectieux.
Conclusion: Les troubles anxieux et le stress posttraumatique sont très fréquents chez les patients atteints de cancer et positifs à la Covid-19 par rapport à la population générale. Nos résultats suggèrent la nécessité de mettre en place des soins de support psycho-oncologiques personnalisés durant le contexte pandémique.
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