The Impact of the COVID-19 Pandemic on Anxiety and Depression in Breast Cancer Patients in Tunisia

Objective : The COVID-19 generated an unprecedented set of emotional challenges for cancer patients. We aimed to investigate the impact of COVID-19 on anxiety and depression in breast cancer patients.Method: Between September and December 2020, women aged 18 years old or older with breast cancer (stage I to IV) who have started treatment before the onset of the pandemic were included. They must have an evaluation of anxiety and depression with the HAD scale before the onset of COVID-19. After inclusion, each patient was asked to complete the HAD scale to evaluate her mental health during the pandemic.Results: 100 patients were included. The mean age was 51 years. The prevalence of anxiety and depression before the COVID-19 pandemic were 63% and 43 % respectively. Under pandemic, the prevalence of anxiety was 77% : 25 women had mild anxiety, 29 moderate anxiety and 23 severe anxiety. For depression, the prevalence was 62% : 25 were experiencing mild anxiety, 20 moderate anxiety and 17 severe anxiety. The COVID 19 was significantly correlated with the increase of anxiety and depression rate ( p=0,027 and p=0,005) respectively. Other clinical factors were significantly associated with the increase of the anxiety and depression. In multivariate Analysis including the incidence of anxiety and depression during the pandemic and these factors, COVID-19 was an independent factor affecting the incidence of anxiety and depression (pConclusions: this study underlined the negative psychological impact of COVID-19 in breast cancer patient, showing the importance of the psychological support.