COVID-19 Vaccine Improves Mental Health in Patients With IPF

A significant decrease in the Hospital Anxiety and Depression Scale (HADS) score was observed in patients with idiopathic pulmonary fibrosis (IPF) 1 month after receiving their first COVID-19 vaccination, according to a study published in Advances in Respiratory Medicine.¹

The researchers explained that, during the pandemic, exposed patients with IPF experienced an increased risk of COVID-19–related severe acute respiratory syndrome (SARS) and faced about 50% higher rates of hospitalization and mortality. Consequently, patients with IPF were strongly advised to adopt preventive measures and were granted priority vaccination access in several countries, including Greece, where the current study was conducted.

In general, depression and anxiety are prevalent comorbidities among patients with IPF. Depression and anxiety tend to become more severe among this population when they experience irreversible or unpredictable conditions, like what they experienced during the COVID-19 pandemic; the feeling of social isolation and the fear of forthcoming death frequently cause psychological distress.

Past research found that the availability of vaccines had a positive impact on the mental health of vulnerable groups who faced the highest risk of hospitalization or death. Therefore, the researchers conducted a multicenter, prospective study to assess their hypothesis that the COVID-19 vaccine also had a beneficial impact on depression and anxiety in patients with IPF.

COVID-19 vaccination significantly reduced anxiety and depression in patients with idiopathic pulmonary fibrosis (IPF). | Image Credit: M.Rode-Foto - stock.adobe.com

The study was conducted between February 2021 and August 2021 among patients with IPF referred to 13 specialized ILD centers in Greece who were regularly followed up with; in Greece, vaccination was available after March 2021 for patients with IPF. The researchers collected demographic, functional, and clinical data for all participants. These data included vaccination history, comorbidities, time since first diagnosis, and data on any immunosuppressive and/or antifibrotic treatment.

To accurately evaluate depression and anxiety in patients with IPF, the researchers used the HADS score. This self-assessment questionnaire consists of 14 questions, with 7 dedicated to assessing anxiety and 7 to depression. It helps to detect and evaluate the severity of both emotional disorders in a hospital outpatient setting, with a score of less than 8 indicating the presence of anxiety and depression. Therefore, the HADS score was assessed in all patients before they received their COVID-19 vaccination and again 1 month after their first dose.

The study population consisted of 180 patients with IPF and a median (IQR) age of 73.5 (68-78) years. Among the patients, the median (IQR) disease duration was about 36 (20-53) months, and the median (IQR) forced vital capacity (FVC) was 79% (64%-91%). Also, most patients had a history of smoking, and 81.1% (n = 145 patients) received antifibrotic treatment.

Before vaccination, the median (IQR) HADS scores for anxiety and depression were 6 (2-9) and 5 (2-8), indicating the presence of both emotional disorders. One month after the first COVID-19 vaccination, the researchers found a significant reduction in both scores (P < .01). More specifically, there was a statistically significant decrease of 1 unit in both the anxiety and depression scores, with the reductions falling within the moderate anxiety range and the higher end of the depression scale.

These postvaccination decreases demonstrated its additional beneficial effect on the mental health and quality of life of patients with IPF. Similar findings were observed in a study of a nationally representative cohort of US adults, where COVID-19 vaccination was associated with reductions in distress scores and death-related anxiety.²

Lastly, the researchers acknowledged their limitations, one being the chosen time frame.¹ They explained that 1 month may not provide enough time to detect long-lasting changes post vaccination, limiting their ability to make conclusions about the long-term mental health impacts. Given these constraints, the researchers suggested areas for future investigation.

“Further studies with additional measures to evaluate quality of life and overall well-being might offer further insight and a more thorough explanation of the therapeutic relevance of these findings,” the authors concluded.

References

1. Tomos I, Papaioannou AI, Daniil ZI, et al. Beneficial impact of vaccination against SARS-CoV-2 on the mental health of IPF patients. Adv Respir Med. 2024;92(6):466-471. doi:10.3390/arm92060042
2. Koltai J, Raifman J, Bor J, McKee M, Stuckler D. COVID-19 vaccination and mental health: a difference-in-difference analysis of the Understanding America study. Am J Prev Med. 2022;62(5):679-687. doi:10.1016/j.amepre.2021.11.006