e88 © The Author(s) 2021. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com Inesa Buneviciene, PhD Romas Bunevicius, MS Sarunas Bagdonas Adomas Bunevicius, MD, PhD Journal of Public Health | Vol. 44, No. 1, pp. e88–e95 | https://doi.org/10.1093/pubmed/fdab248 | Advance Access Publication June 26, 2021 The impact of pre-existing conditions and perceived health status on mental health during the COVID-19 pandemic Inesa Buneviciene 1,2 , Romas Bunevicius 3 , Sarunas Bagdonas 3 , Adomas Bunevicius 2,4 1 Vytautas Magnus University, Department of Public Communications, Kaunas 44248, Lithuania 2 Cura Te Ipsum, Garliava 53274, Lithuania 3 ProIT, Vilnius 09312, Lithuania 4 Lithuanian University of Health Sciences, Kaunas 44307, Lithuania Address correspondence to Adomas Bunevicius, E-mail: a.bunevicius@yahoo.com ABSTRACT Background Patients with pre-existing conditions and poor health status are vulnerable for adverse health sequalae during the COVID-19 pandemic. We investigated the association of pre-existing medical conditions and self-perceived health status with the risk of mental health complications during the COVID-19 pandemic. Methods In October—December, 2020, 1036 respondents completed online survey that included assessment of pre-existing conditions, self-perceived health status, depressive (Patient Health Questionnaire-8 score ≥ 10), anxiety (Generalized Anxiety Disorders-7 score ≥ 10) and post-traumatic stress (Impact of Events Scale Revised) symptoms, alcohol use (AUDIT), and COVID-19 fear (COVID-19 Fears Questionnaires for Chronic Medical Conditions). Results Study participants were predominantly women (83%), younger than 61 years of age (94%). Thirty-six percent of respondents had a pre-existing condition and 5% considered their health status as bad or very bad. Pre-existing conditions and poor perceived health status were associated with increased risk for moderate to severe depressive and anxiety symptoms, fear of COVID-19 and post-traumatic stress symptoms, independently from respondents’ age, gender, living area, smoking status, exercise, alcohol consumption and diet. Conclusions Pre-existing medical conditions and poor perceived health status are associated with increased risk of poor mental health status during the COVID-19 pandemic. Keywords COVID-19, pre-existing conditions, depression, anxiety, stress Introduction COVID-19 pandemic has caused a global health crisis that will continue in the nearest future. People with certain pre- existing medical conditions, such as cardiovascular and pul- monary diseases, obesity and cancer, are at increased risk to experience severe illness, complicated clinical course and poor outcomes from the SARS-CoV-2 infection. 3 , 6 , 10 , 30 , 50 Sub-optimal management of pre-existing conditions due to limited access to healthcare resources and social distancing orders during the pandemic is also associated with excess health risks in vulnerable patients. 4 , 46 , 47 Excess mortality from non-COVID-19 related causes has been documented during the COVID-19 pandemic. 21 , 36 COVID-19 pandemic has also caused a global crisis of mental health problems. 12 , 20 , 31 , 41 Patients with common pre-existing somatic conditions, such as cardiovascular disease and diabetes, are at increased risk for mental health complications that in turn are associated with elevated risk for disability, poor treatment adherence and unfavor- able outcomes from the pre-existing condition. 5 , 7 , 18 , 27 , 37 COVID-19 pandemic can increase the risk for new onset mental health complications or exacerbation of pre-existing mental disorder(s) in vulnerable individuals with pre-existing conditions that can subsequentially complicate the course and prognosis of the pre-existing condition. 13 , 15 , 20 , 28 , 39 It is therefore important to better understand the risks for mental health complications in vulnerable patients with pre- existing condition during the COVID-19 pandemic in order to optimize allocation of resources and possibly attempt to mitigate adverse consequence of the COVID-19. Downloaded from https://academic.oup.com/jpubhealth/article/44/1/e88/6309912 by guest on 13 July 2022