The COVID-19 pandemic has disrupted the continuity of care of U.S. adults living with chronic diseases, including immunocompromised adults. Disruption in care may be a barrier to identifying COVID-19 associated sequelae, such as mental health symptoms, among the immunocompromised. Our objectives were to evaluate COVID-19-related preventive behaviors, with a focus on canceling doctor's appointments as a proxy for continuity of care, and to compare COVID-19-related mental health symptoms among the immunocompromised with the general population. We used nationally-representative data of 10,760 U.S. adults from the publicly-available COVID-19 Household Impact Survey. We defined immunocompromised as adults with a self-reported diagnosis of “a compromised immune system” (n = 854, 7.6%). We adherence to self-reported COVID-19 preventive behaviors among immunocompromised adults to others using χ²-tests. We focused on continuity of care and estimated determinants of canceling doctor's appointments among the immunocompromised using multivariable Poisson regression to estimate adjusted prevalence ratios (aPRs) with 95% confidence intervals (95% CIs). We evaluated associations of mental health symptoms with being immunocompromised using multinomial logistic regression and estimated conditional odds ratios (cOR) with 95% CIs. Immunocompromised adults were more likely to adhere to recommended COVID-19 preventive behaviors, including washing or sanitizing hands (96.3% vs. 89.8%, χ² <0.001), maintaining social distance (91.9% vs. 83.7%, χ² <0.001), and canceling a doctor's appointment (47.1% vs. 29.7%, χ² <0.001). Hispanic immunocompromised adults (aPR: 1.47, 95% CI: 1.12–1.92) and immunocompromised women (aPR: 1.25, 95% CI: 1.00–1.56) were more likely to cancel doctor's appointments compared to non-Hispanic White immunocompromised adults and men, respectively. Immunocompromised adults reported higher odds of feeling nervous/anxious/on edge (cOR: 1.89, 95% CI: 1.44–2.51), depressed (cOR: 2.81, 95% CI: 2.17–3.64), lonely (cOR: 2.28, 95% CI: 1.74–2.98), and hopeless (cOR: 2.86, 95% CI: 2.21–3.69) 3–7 days in the last week. Immunocompromised adults were more likely to cancel their doctor's appointments and report COVID19-related mental health symptoms. The continuity of care of immunocompromised adults should be prioritized through alternative interventions, such as telehealth.

中文翻译：

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COVID-19 大流行期间免疫功能低下的成年人的预防行为和心理健康相关症状：COVID 影响调查分析


COVID-19 大流行扰乱了美国患有慢性病的成年人（包括免疫功能低下的成年人）的护理连续性。护理中断可能会成为识别免疫功能低下者中与 COVID-19 相关的后遗症（例如心理健康症状）的障碍。我们的目标是评估与 COVID-19 相关的预防行为，重点是取消医生预约作为护理连续性的代表，并比较免疫功能低下者与普通人群中与 COVID-19 相关的心理健康症状。我们使用了公开的 COVID-19 家庭影响调查中 10,760 名美国成年人的全国代表性数据。我们将免疫功能低下定义为自我报告诊断为“免疫系统受损”的成年人（ n = 854，7.6%）。我们使用χ ²测试遵守免疫功能低下成年人向其他人自我报告的 COVID-19 预防行为。我们重点关注护理的连续性，并使用多变量泊松回归估计免疫功能低下者取消医生预约的决定因素，以 95% 置信区间 (95% CI) 估计调整后患病率 (aPR)。我们使用多项 Logistic 回归和估计条件比值比 (cOR)（95% CI）评估了心理健康症状与免疫功能低下的关联。免疫功能低下的成年人更有可能遵守推荐的 COVID-19 预防行为，包括洗手或消毒双手（96.3% vs. 89.8%， χ ² <0 id=25>χ ² <0 id=27>χ ² <0.001）。西班牙裔免疫功能低下成年人（aPR：1.47，95% CI：1.12-1.92）和免疫功能低下女性（aPR：1.25，95% CI：1.00-1）。56）分别比非西班牙裔白人免疫功能低下的成年人和男性更有可能取消医生预约。免疫功能低下的成年人报告感到紧张/焦虑/紧张（cOR：1.89，95% CI：1.44–2.51）、抑郁（cOR：2.81，95% CI：2.17–3.64）、孤独（cOR：2.28，95%）的几率更高CI：1.74–2.98），上周 3–7 天无希望（cOR：2.86，95% CI：2.21–3.69）。免疫功能低下的成年人更有可能取消医生预约并报告与新冠病毒相关的心理健康症状。应通过远程医疗等替代干预措施优先考虑免疫功能低下成年人的连续性护理。