Available online 27 May 2023

This is the first study the prevalence, correlates and network structure of depressive symptoms in Chinese myocardial fraction (MI) patients during the COVID-19 pandemic.

MI patients with depression were less likely to consult a doctor regularly after discharge, and more likely to experience more severe anxiety symptoms and fatigue.

The prevalence of depression among MI survivors during the COVID-19 pandemic was 38.1 %, which was significantly associated with poor quality of life (QOL).

“Fatigue” was the most central symptom in the network and had the highest negative association with QOL.

Depression is common among myocardial infarction (MI) survivors and is strongly associated with poor quality of life (QOL). The aim of this study was to examine the prevalence, correlates and the network structure of depression, and its association with QOL in MI survivors during the COVID-19 pandemic.

This cross-sectional study evaluated depression and QOL in MI survivors with the Chinese version of the nine-item Patient Health Questionnaire (PHQ-9) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) respectively. Univariable analyses, multivariable analyses, and network analyses were performed.

The prevalence of depression (PHQ-9 total score ≥ 5) among 565 MI survivors during the COVID-19 pandemic was 38.1 % (95 % CI: 34.1–42.1 %), which was significantly associated with poor QOL. Patients with depression were less likely to consult a doctor regularly after discharge, and more likely to experience more severe anxiety symptoms and fatigue. Item PHQ4 “Fatigue” was the most central symptom in the network, followed by PHQ6 “Guilt” and PHQ2 “Sad mood”. The flow network showed that PHQ4 “Fatigue” had the highest negative association with QOL.

Depression was prevalent among MI survivors during the COVID-19 pandemic and was significantly associated with poor QOL. Those who failed to consult a doctor regularly after discharge or reported severe anxiety symptoms and fatigue should be screened for depression. Effective interventions for MI survivors targeting central symptoms, especially fatigue, are needed to reduce the negative impact of depression and improve QOL.

Myocardial infarction

Depression

Quality of life

Prevalence

Network analysis

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