SF-36 Mental Component Score Trajectories Do Not Show a Strong Impact of the COVID-19 Pandemic in Current and Former Smokers

Abstract

Background: CDC recommended increased social distancing in order to reduce virus transmission during the COVID-19 pandemic. This included physical isolation for older adults at elevated risk for COVID-19 due to age and chronic medical conditions such as lung disease. While social distancing is effective at reducing the spread of COVID-19, the secondary negative impact of isolation and reduction in social resources is likely to impact vulnerable older adults with medical risk factors such as a history of heavy smoking and chronic lung disease. In this study we will examine the impact of pandemic on longitudinal change in SF-36 Mental Component Score. Methods: COPDGene is a longitudinal study of current and former smokers with at least a 10 pack-year smoking history. The study has included 3 visits (Baseline, Phase 2 at 5-years, and Phase 3 at 10-years), during which quality of life was assessed using the SF-36. Phase 3 in-person visits were interrupted by COVID-19 in March 2020. SF-36 was included in virtual visits conducted from March-October of 2020 using telephony and online surveys. We examined vectors of change in MCS across the 3 timepoints employing group-based trajectory models (SAS Proc Traj) to identify group membership and the probability of the observed MCS given group memberships. Each model used baseline and 5-year data in the same way. The first model used phase 3 data collected in-person (PRE) and the second used phase 3 data collected during the pandemic (DURING). Trajectory membership was compared using demographic profiles of participants pre- vs post-pandemic. Results: Figure 1 shows the trajectories identified for each group. The PRE group (n=2,242) included 4 trajectories: 1) 68% began high (MCS=56.1) and continued to be high across 10 years, 2) 15% began low (MCS=38.8) and improved, 3) 11.0% began high (MCS=51.4) and decreased and 4) 6.4% began low (MCS=30.0%) and remained low. The DURING group included three trajectories with the majority of observations beginning high (MCS=54.5) and remaining high, and two other groups that duplicated the pattern of PRE groups 2 and 3. The most consistent predictors of group membership in both PRE and DURING were age, MMRC and 6 minute walk at both baseline and year 10 follow-up (p<0.0001 in all cases). Conclusions: Trajectories of change in mental-health related quality of life do not reflect a large negative impact of the COVID- 19 pandemic in this large sample of older current and former smokers with and without COPD.