1427P the Role of Anxiety and Self-Isolation in Seropositivity for COVID-19 in Actively Treated Cancer Patients in Sweden

In Sweden, recommendations to reduce the risk of COVID-19 has relied on each citizen’s own sense of responsibility rather than mandatory lockdowns. We studied how COVID-19-related anxiety and self-isolation correlated to seropositivity and PCR-positivity in Swedish patients with cancer. In a longitudinal cohort study at Uppsala University Hospital in Sweden; 622 cancer patients on active treatment, and 358 cancer care staff were included April 1st 2020 to August 1st 2020. Serological testing for COVID-19 was done at inclusion and every 8-12-week until March 30th 2021, until vaccination started. Patients initially completed a survey regarding self-reported degree of COVID-19-related anxiety and self-isolation. 622 patients were included; solid malignancy (SM) n=475, hematological malignancy (HM) n=147. 10.5% of SM patients and 6.5% of HM patients became seropositive. Staff seropositivity was higher, 16.2% (p=0.003). PCR-positivity for SM patients (n=52, 11.0%) was similar to seropositivity (n=50, 10.5%), while HM patients had higher PCR-positivity (n=14, 9.7%) than seropositivity (n=10, 6.8%). PCR-positive HM patients required more advanced in-patient treatment (67%) compared to PCR-positive SM patients (29%). High anxiety was expressed by 193 patients (31%), and no to mild anxiety by 403 (65%). Patients with SM expressed higher anxiety than those with HM (n=159, 35% vs n=34, 25%, p=0.04), but self-isolated to a similar degree (53.8% vs 57.6%). Women (OR: 3.37, 2.29-5.02, p=0.001) and patients born outside of Sweden (OR: 2.47, 1.11-5.62, p=0.027) expressed more anxiety. Patients with high anxiety were numerically less likely to test seropositive (7.2% vs 10.6%, p=0.23), while the reverse was seen for those who self-isolated (10.9% vs 8.1%, p=0.27). Seroprevalence for COVID-19 among cancer patients was not impacted by a higher degree of anxiety or self-isolation in Sweden in 2020, with guidelines resembling those adopted globally today. Patients with hematological malignancies expressed less anxiety but were more likely to require advanced care if diagnosed with COVID-19, and less likely to develop an antibody response.