Background: During the COVID-19 pandemic, patients with non-communicable diseases (NCDs), even without symptoms or a diagnosis of COVID-19, may be affected more than the general population due to the lockdown and healthcare service redistribution. This study aims to investigate the impact of COVID-19 lockdown on lifestyle behaviors and depressive symptom among patients with NCDs.Methods: We incorporated a COVID-19 survey to the WELL China cohort, a prospective cohort study with the baseline survey conducted 8-16 months before the COVID-19 outbreak in Hangzhou, China. The COVID-19 survey was carried out to collect information on lifestyle and depressive symptom during lockdown.Findings: A total of 3,327 participants were included in the COVID-19 survey, including 2,098 (63.1%) reported having NCDs at baseline and 1,457 (44%) without NCDs. The prevalence of current drinkers decreased from 42.9% before COVID-19 lockdown to 23.7% during lockdown, current smokers from 15.9% to 13.5%, and poor sleepers from 23.9% to 15.3%, while low physical activity increased from 13.4% to 25.2%, among participants with NCDs. Participants with NCDs were more likely than those without to have depressive symptom (OR, 1.30;95% CI, 1.05-1.61), especially among those who need to refill their medication during the COVID-19 lockdown (OR, 1.52;95% CI, 1.15-2.02).Interpretation: Our findings provide insight into the development of targeted interventions to better prepare patients with NCDs and healthcare system to meet the challenge of future pandemic and lockdown, which is highly likely to happen in the near future.Funding: Initial foundational funding for the Stanford Wellness Living laboratory (WELL) was provided by Amway via an unrestricted gift through the Nutrilite Health Institute Wellness Fund to Stanford University. Through Zhejiang University, the Cyrus Tang Foundation and Zhejiang University Education Foundation also provided important financial support for the study. The follow-up survey was supported by Hsun K. Chou Fund of Zhejiang University Education Foundation.Declaration of Interest: The authors declare no conflict of interest.Ethical Approval: The WELL-China project was approved by the ethics review board at both Zhejiang University (No. ZGL201507-3) in China and Stanford University (IRB- 35020) in USA. All participants provided written informed consent. The follow-up telephone interview was further approved by the ethics review board at Zhejiang University (No. ZGL202004-01).
Changes in Lifestyles and Depressive Symptom Among Patients with Chronic Diseases During COVID-19 Lockdown