The impact of pre-existing conditions and perceived health status on mental health during the COVID-19 pandemic

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.