Document Type : Original Article


1 Department of Radiation Oncology, Iran University of Medical Sciences, Tehran, Iran

2 Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

3 Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran

4 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran


Background: Coronavirus disease 2019 (COVID-19) emerged in December 2019 in China and exhibited as a highly contagious viral infection which led to a high level of mortality and morbidity. It is followed by a great deal of complications, such as serious psychological disorders. There are a few studies evaluating the psychological status of COVID-19 on the patients with cancer in Iran.
Method: This was a cross-sectional study carried out on 94 patients with cancer who referred to Haft-e-Tir hospital for radiotherapy and chemotherapy from 20 April to 15 may, 2020. The data collection tool was the impact of events scale-revised (IES-R).
Results: The prevalence of anxiety disorders and obsessive compulsive disorder based on past psychiatric history in the patients was 11.7% and 2.1%, respectively. The results revealed that age was significantly related to avoidance dimension score (B = -0. 209, 95% CI: -0.084 to - 0.335). Regarding hyper arousal dimension score, the results were as follows: rural residency (B = 5.091, 95% CI: 0.610 to 9.573), past psychiatric history (PPH) (B = 8.312, 95% CI: 4.314 to 12.310), and radiotherapy (B = -2.976, 95% CI: -5.878 to -0.074) had a statistically significant relationship with the hyper arousal dimension score.
Conclusion: The patients with cancer had a severe form of COVID-19. Individuals with cancer who had a previous psychiatric history are more vulnerable to post-traumatic stress disorder symptoms after trauma.


How to cite this article:

Novin K, Hassanlouei B, Motamed M, Faraji S, Najafi M, Fadavi P, et al. Psychological status during COVID-19 pandemic on the patients with cancer. Middle East J Cancer. 2022;13(4):648-56.doi: 10.30476/mejc.2021. 89195.1511.

1. de Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol. 2016;14(8):523-34. doi: 10.1038/nrmicro.2016.81.
2. Paules CI, Marston HD, Fauci AS. Coronavirus infections-more than just the common cold. JAMA. 2020;323(8):707-8. doi: 10.1001/jama.2020.0757.
3. Besharat S, Malekpour Alamdari N, Dadashzadeh N, Talaie R, Mousavi SS, Barzegar A, et al. Clinical and demographic characteristics of patients with COVID-19 who died in Modarres Hospital. Open Access Maced J Med Sci. 2020;8(T1):144-9.
4. Rahimi MM, Jahantabi E, Lotfi B, Forouzesh M, Valizadeh R, Farshid S. Renal and liver injury following the treatment of COVID-19 by remdesivir. J Nephropathol. 2021;10(2):e10.
5. Samimi Ardestani SH, Mohammadi Ardehali M, Rabbani Anari M, Rahmaty B, Erfanian R, Akbari M, et al. The coronavirus disease 2019: the prevalence, prognosis, and recovery from olfactory dysfunction (OD). Acta Otolaryngol. 2021;141(2):171-80. doi: 10.1080/00016489.2020.1836397.
6. Forouzesh M, Rahimi A, Valizadeh R, Dadashzadeh N, Mirzazadeh A. Clinical display, diagnostics and genetic implication of Novel Coronavirus (COVID-19) Epidemic. Eur Rev Med Pharmacol Sci. 2020;24(8):4607-15. doi: 10.26355/eurrev_202004_ 21047.
7. Barzegar A, Ghadipasha M, Rezaei N, Forouzesh M, Valizadeh R. New hope for treatment of respiratory involvement following COVID-19 by bromhexine. J Nephropharmacol. 2021;10(2):e11. doi: 10.34172/npj. 2021.11.
8. Daneshfar M, Dadashzadeh N, Ahmadpour M, Ragati Haghi H, Rahmani V, Forouzesh M, et al. Lessons of mortality following COVID-19 epidemic in the United States especially in the geriatrics. J Nephropharmacol. 2021;10(1):e06. doi: 10.34172/npj.2021.06.
9. WHO Coronavirus disease (COVID-19) Situation Report - 114.Coronavirus. [Internet] World Health Organization website. [Accessed at: Dec 2, 2020]. Available at: /diseases/novel-coronavirus-2019/situation-reports
10. Bao Y, Sun Y, Meng S, Shi J, Lu L. 2019-nCoV epidemic: address mental health care to empower society. Lancet. 2020; 395(10224):e37-8. doi: 10.1016/S0140-6736(20)30309-3.
11. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5):1729. doi: 10.3390/ijerph17051729.
12. Hall RC, Hall RC, Chapman MJ. The 1995 Kikwit Ebola outbreak: lessons hospitals and physicians can apply to future viral epidemics. Gen Hosp Psychiatry. 2008;30(5):446-52. doi: 10.1016/j.genhosppsych. 2008.05.003.
13. Zhang L, Zhu F, Xie L, Wang C, Wang J, Chen R, et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020;31(7):894-901. doi: 10.1016/j.annonc.2020. 03.296.
14. Kutikov A, Weinberg DS, Edelman MJ, Horwitz EM, Uzzo RG, Fisher RI. A war on two fronts: Cancer care in the time of COVID-19. Ann Intern Med. 2020;172(11):756-8. doi: 10.7326/M20-1133.
15. Hao F, Tan W, Jiang L, Zhang L, Zhao X, Zou Y, et al. Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry. Brain Behave Immun. 2020;87:100-6. doi: 10.1016/j.bbi.2020.04.069.
16. Rodríguez-Rey R, Garrido-Hernansaiz H, Collado S. Psychological impact of COVID-19 in Spain: Early data report. Psychol Trauma. 2020;12(5):550-2. doi: 10.1037/tra0000943.
17. Panaghi L, Mogadam JA. Persian version validation in impact of event Scale-Revised. [In Persian] Tehran Univ Med J. 2006;64(3):52-60.
18. Creamer M, Bell R, Failla S. Psychometric properties of the impact of event scaleórevised. Behav Res Ther. 2003;41(12):1489-96. doi: 10.1016/j.brat.2003.07.010.
19. Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4):300-2.
20. Hao F, Tan W, Jiang L, Zhang L, Zhao X, Zou Y, et al. Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry. Brain Behav Immun. 2020;87:100-6. doi: 10.1016/j.bbi.2020.04.069.
21. Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020:112954. doi: 10.1016/j.psychres.2020.112954.
22. Yao H, Chen JH, Xu YF. Patients with mental health disorders in the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4):e21. doi: 10.1016/S2215-0366(20)30090-0.
23. Stein KD, Syrjala KL, Andrykowski MA. Physical and psychological long-term and late effects of cancer. Cancer. 2008;112(11 Suppl):2577-92. doi: 10.1002/ cncr.23448.
24. Garutti M, Cortiula F, Puglisi F. Seven shades of black thoughts: COVID-19 and its psychological consequences on cancer patients. Front Oncol. 2020;10:1357. doi: 10.3389/fonc.2020.01357.
25. Jones D, Neal RD, Duffy SR, Scott SE, Whitaker KL, Brain K. Impact of the COVID-19 pandemic on the symptomatic diagnosis of cancer: the view from primary care. Lancet Oncol. 2020;21(6):748-50. doi: 10.1016/S1470-2045(20)30242-4.
26. Tan BYQ, Chew NWS, Lee GKH, Jing M, Goh Y, Yeo LLL, et al. Psychological impact of the COVID-19 pandemic on health care workers in Singapore. Ann Intern Med. 2020;173(4):317-20. doi: 10.7326/M20-1083.
27. Wu JT, Leung K, Leung GM. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet. 2020;395(10225):689-97.
28. Kamboj M, Sepkowitz KA. Nosocomial infections in patients with cancer. Lancet Oncol. 2009;10(6):589-97.
29. Paterson C, Gobel B, Gosselin T, Haylock PJ, Papadopoulou C, Slusser K, et al. Oncology nursing during a pandemic: Critical reflections in the context of COVID-19. Semin Oncol Nurs. 2020;36(3):151028. doi: 10.1016/j.soncn.2020.151028.