COVID-19 Pandemic Conditions Affecting QoL and Mental Health of Oncology Patients in Poland
Authors: Działach Eliza , Malchrowicz-Mośko Ewa , Rozmiarek Mateusz , Meller Jolanta , Juraszek Paweł , Nowara Elżbieta , Czech Elżbieta , Nowaczyk Piotr , Grajek Mateusz 
Published: February 2025

Background: The COVID-19 pandemic has caused widespread disruptions in oncology care, significantly affecting both the quality of life (QoL) and mental health of cancer patients. This study aimed to evaluate the long-term impacts of the pandemic on oncology patients, focusing on the periods before, during, and after the pandemic. Objective: The objective of this study was to assess the changes in QoL, illness acceptance, and mental health indicators, including the risk of depression, generalized anxiety, elevated stress levels, and post-traumatic stress disorder (PTSD) among oncology patients, comparing these factors across the pre-pandemic, pandemic, and post-pandemic periods. Material and Methods: This study included 2000 oncology patients, divided into three cohorts based on the time of assessment: pre-pandemic (2019, n = 600), during the pandemic (2020–2021, n = 800), and post-pandemic (2023, n = 600). This study included a balanced sample of 52% female and 48% male participants, with a mean age of 58 years (SD = 11.9), representing a wide range of cancer types including breast (25.7%), lung (20.9%), and colorectal cancer (14.8%). Additional demographics showed a mean BMI of 25.8, with varied educational levels, marital statuses, income levels, and lifestyle factors such as smoking and alcohol consumption. QoL was assessed using the EORTC QLQ-C30, while the Hospital Anxiety and Depression Scale (HADS) was used to measure depression and anxiety. The PTSD Checklist for DSM-5 (PCL-5) was used to evaluate PTSD symptoms, and stress levels were measured with the Perceived Stress Scale (PSS). Statistical analyses were conducted using ANOVA and chi-square tests to assess differences between the groups. Results: During the pandemic, the prevalence of depression symptoms rose significantly, from 15% pre-pandemic to 32% (p < 0.001), while the risk of generalized anxiety increased from 18% to 40% (p < 0.001). Stress levels also saw a sharp rise, with 45% of patients reporting elevated stress during the pandemic compared to 22% before (p < 0.001). The rate of PTSD symptoms increased from 10% pre-pandemic to 28% during the pandemic (p < 0.001). QoL scores dropped markedly, with the mean EORTC QLQ-C30 global health status score decreasing by 25% during the pandemic (p < 0.01). Illness acceptance declined, with 60% of patients reporting poor acceptance during the pandemic, compared to 35% before. In the post-pandemic period, a slight improvement was observed across all measures. Depression levels dropped to 28% (p < 0.05 compared to the pandemic period), and anxiety levels decreased to 35% (p < 0.05). Stress and PTSD symptoms also showed modest reductions, with 38% reporting elevated stress and 22% exhibiting PTSD symptoms (p < 0.05). However, these post-pandemic values remained significantly higher than pre-pandemic levels (p < 0.001). QoL improved marginally, with a 10% increase in the global health status score compared to the pandemic period, though it remained lower than pre-pandemic scores (p < 0.05). Conclusions: The COVID-19 pandemic had a profound impact on the mental health and QoL of oncology patients, with significant increases in depression, anxiety, stress, and PTSD symptoms, along with a decrease in QoL and illness acceptance. While post-pandemic recovery trends are apparent, the psychological burden remains elevated compared to pre-pandemic conditions. These findings highlight the need for continued mental health support and interventions for oncology patients, even after the immediate pandemic effects have subsided.