Background: The COVID-19 pandemic has dramatically changed lifestyles and quality of life (QoL) of the global population. Little is known regarding the psychological impact of the COVID-19 outbreak on patients with gastroenteropancreatic (GEP) or bronchopulmonary (BP) neuroendocrine tumors (NETs). Methods: We prospectively evaluated seven specific constructs (depression, anxiety, stress, QoL, NET-related QoL, patient-physician relationship, psychological distress) by using validated screening instruments including the Depression anxiety stress scale-21 (DASS-21), the EORTC QLQ-C30, the EORTC QLQ GI.NET21, the patient doctor relationship questionnaire 9 (PDRQ9) and the Impact of event scale-revised (IES-R). Mental symptoms and concerns of patients with any stage, well-differentiated GEP or BP-NET were surveyed twice, during the plateau phase of the first (W1) and second epidemic waves (W2) in Italy. Results: We enrolled 197 patients (98 males) with a median age of 62 years (G1/G2: 96%;pancreas: 29%;small bowel: 25%;active treatment: 38%). At W1, the prevalence of depression, anxiety and stress was 32%, 36% and 26% respectively. The frequency of depression and anxiety increased to 38% and 41% at W2, with no modifications in the frequency of stress. By ordinal logistic regression analysis, female patients showed more severe forms of stress at W1 (OR=0.45±0.14;p=0.01), while the educational status was associated with the levels of anxiety at both W1 (OR=1.33±0.22;p=0.07) and W2 (OR=1.45±0.26;p=0.03). An improvement of the physical (p=0.03) and emotional functioning domains (p=0.001) was observed over time. Both nausea/vomiting (p=0.0002), appetite (p=0.02), treatment-related symptoms (p=0.005), disease-related worries (p=0.0006) and sexual function (p=0.02) improved between W1 and W2, suggesting that NET patients were able to cope with the perturbations caused by the pandemic. No difference was seen between W1 and W2 in the mean score (>4/5) of the PDRQ9. By IES-R, post-traumatic stress disorder was observed in 53% of patients at W2. Conclusions: The implementation of psychological interventions within NET clinics might favor functional coping strategies, attenuating the psychological distress caused by the COVID-19 pandemic. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
1109P The psychological impact of COVID-19 pandemic on patients with NETs: Between resilience and vulnerability