Mental health in people at risk from COVID‑19 due to a pre-existing medical condition: longitudinal study of risk factors, outcomes, and the role of vaccination
The COVID‑19 pandemic has disrupted the lives of people in Canada and across the world due to its rapid spread, number of deaths, toll on health care systems, and devastating economic impact. In addition to fears of being infected or that friends and family members will be infected, there are fears that health care systems will not be able to provide necessary care, that isolation and movement restrictions will be long-lasting with a heavy toll on mental health; and that individual and societal resources will be insufficient. Serious mental health implications will likely extend beyond the acute outbreak period, particularly for vulnerable individuals with pre-existing medical conditions and elevated risk of medical complications or mortality from COVID-19. Many of these individuals are acutely afraid of infection and are under strict isolation protocols that will continue well beyond the period required for other people. Addressing mental health in vulnerable populations and providing effective responses, during COVID‑19 and subsequently, requires understand patterns of symptoms and factors associated with them. Vaccination may play an important role. The Scleroderma Patient-centered Intervention Network (SPIN) is a collaboration of patients, researchers from 8 countries, and > 25 patient organizations from around the world. SPIN maintains an ongoing cohort (N > 2,000) of participants from 50 centres through which SPIN studies patient-prioritized problems and develops and tests interventions to address those problems. SPIN launched a separate COVID‑19 cohort and enrolled over 800 people before closing enrolment on April 27, 2020. We continue to follow over 550 participants who complete monthly assessments. This is the only cohort in the world that has compared mental health in COVID‑19 to pre-COVID-19 levels and followed participants across the pandemic with frequent assessments. It is critical that we continue to collect crucial data.