PSYCHOLOGICAL STRESS AND ATOPIC DERMATITIS SEVERITY FOLLOWING THE COVID-19 PANDEMIC AND AN EARTHQUAKE

Background: The course of chronic diseases can be influenced by psychological stress, suggesting a potential influence of current/recent disasters on atopic dermatitis (AD) patients. The aim of the study was to examine effects of the COVID-19 pandemic and Zagreb earthquake on the psychological stress level and disease condition of AD patients. Subjects and methods: This cross-sectional study included 150 AD patients (three groups with 50 patients): 1) those not exposed to either the COVID-19 pandemic or the earthquake; 2) those who only experienced the COVID-19 pandemic; and 3) those who experienced both the pandemic and the earthquake. Patients' data from the Perceived Stress Scale (PSS), on AD severity (SCORAD), and their answers from our newly designed questionnaire on disease-related behaviors and AD condition during the pandemic and quarantine were examined and statistically analyzed. Results: The subjects who experienced both disasters had a greater PSS than those experiencing only the COVID-19 pandemic, especially women, and they also had higher disease severity (SCORAD) than those in the other two groups. Also, 59% of patients reported psychological stress during the pandemic, mostly caused by: the possibility of infection (31%), a changed work life and possible loss of income (23%), general pandemic-related conditions (17%), worry about physical survival (11%) and other (6%). Concerning the earthquake, the PSS significantly positively correlated with the psychological experience of the earthquake and with the intensity of sleep disturbances. Conclusion: To the best of our knowledge, this is the first study to specifically confirm that the COVID-19 pandemic influenced AD patients' stress levels and that stress from two disasters affected skin disease. Further research and therapeutic measures are needed.

Automated summary

This study found that AD patients who experienced both the COVID-19 pandemic and the Zagreb earthquake had higher levels of psychological stress and disease severity. During the pandemic, patients reported stress mainly due to the fear of infection, changes in work life, and worries about physical survival. The psychological experience of the earthquake and the intensity of sleep disturbances were positively correlated with patients' stress levels.