Social participation and mental health of immunocompromised individuals during the COVID-19 pandemic – Results of a longitudinal observational study over three time points

Gloria Heesen

Keywords: immunocompromised persons; social participation; mental health, quality of life; observational study; SARS-CoV-2 vaccination; pre/post design

Background:

The coronavirus disease 2019 (COVID-19) pandemic impacted how people perform their daily lives in manifold and sometimes massive ways. Particularly, individuals who are at high risk for a severe disease progression, like immunocompromised people, may have experienced drastic changes in social participation during the pandemic.
A COVID-19 basic vaccination may have changed their safety behavior in terms of infection risk and thereby influence social participation and mental wellbeing.

Research questions:

How does the self-perceived social participation change in immunocompromised individuals at baseline before and at follow-up one and six months after basic vaccination?

Method:

Beginning in March 2021, 274 immunocompromised persons 18 years or older were enrolled in the COVID-19 Contact Immune study in Lower Saxony, Germany. Measurements were performed at three time points regarding social participation (Index for the Assessment of Health Impairments [IMET]), mental health (Patient Health Questionnaire-4 [PHQ-4]), subjective health status (five-point Likert-scale) and quality of life (five-point Likert-scale).

Results:

In total, about 60% of the participants showed increasing social participation over time. The greatest increase in social participation was observed within the first month after basic vaccination (p< 0.001). During the following five months, social participation remained stable. The domains “Social activities”, “Recreation and leisure” and “Close personal relationships” were responsible for the overall change in social participation. No association was found between social participation, mental health, sociodemographic or medical factors (except hypertension).

Conclusions:

The protection expected of a COVID-19 vaccination is likely to have increased social participation. These results highlight the heterogeneity of changes in social participation during a similar time period. It is helpful for general practitioners to address health-related consequences of more social participation among immunocompromised persons. Further factors that might influence social participation need to be investigated in order to be able to advise and treat patients in standard care better and more individually.

Points for discussion:

Dealing with persons with a high risk for a severe COVID-19 course as GP

Social participation as an outcome in Primary Care Research

COVID-19 vaccination and its impact on the behaviour of persons with a high risk for a severe COVID-19 course