Toulouse researchers have measured the impact, over a year, of the first confinement thanks to an unprecedented survey. They show that the restrictive measures taken to fight against Covid-19 between March 17 and May 11, 2020 have impacted the cardiovascular and psychological health of the French people.
There were the immediate effects of the first confinement to fight against the Covid-19 epidemic, between March and May 2020: postponements of intervention, examinations and consultations which sometimes led to delays in treatment. And then there were the remote effects: changes in lifestyle, stress, which impacted mental health and cardiovascular health. To measure it in the general population, a Toulouse team questioned a panel of 534 inhabitants of Haute-Garonne at three different times: one month, six months and twelve months after confinement.
534 inhabitants of Haute-Garonne interviewed
Cardiovascular epidemiology teams and the Methodological Research Support Unit of the University Hospital Center (CHU) of Toulouse and Inserm interviewed a panel of inhabitants of Haute-Garonne for this survey on the effects of the first confinement (March 17, 2020 – May 11, 2020).
These 534 people, aged between 50 and 89, come from the Mona Lisa cohort that they joined in 2006 and 2007 for a study on cardiovascular risk factors.
They agreed to answer about their behavior in daily life, their state of health and their morale during telephone surveys carried out one month, six months and twelve months after the first confinement put in place on March 17, 2020. Their pathologies and their medication use have been included.
A first study, published in the journal Preventive Medicine Reports in December 2020, showed that after 44 days, 63% of subjects had an increase in cardiovascular risk due to a decrease in physical activity, a of weight and degradation of their diet. She had also shown, over the 44 days following the start of confinement, symptoms of anxiety and depression in 32% of the subjects.
Reduced physical activity
New work incorporates the results of the survey conducted in May 2021, one year after the end of the first confinement. They have just been published in the scientific journal “International Journal of Environmental Research and Public Health”. They show significant and lasting consequences, both physiologically and psychologically.
Thus the consumption of drugs (control of diabetes, blood pressure, cholesterol levels) increased by 12%. And it was not always accompanied by lifestyle measures: 65% of survey participants reduced their physical activity, 27% reported weight gain (on average, an increase of 3.5kg) and 61% said they had a lower quality diet (more fatty and sugary foods and more alcohol). The study also indicates an increase in tobacco consumption in 9% of subjects. “These changes can impact cardiovascular health. The constraints suffered on a daily basis, the extra time spent in front of the screens, have marked the way of life and have had a definitive impact on the weight”, underlines Pr Jean Ferrières, cardiologist at the Toulouse University Hospital and director of the research team. ARTERRE at Inserm, the last signatory of the study.
More depression in rural areas
“But the most important consequences of confinement concern mental health”, continues the researcher: 35% of respondents report anxiety that is always present and 35% symptoms of depression. “Our consultations confirm this. Every day, we see patients who no longer want to go out, ”adds Professor Jean Ferrières. He also notes that in people with symptoms of depression, the disruption of the internal clock (day/night rhythm) is 2.4 times higher; that women, very stressed between workload and family life, were three times more exposed to the risk of depression; and that living in a rural area is 1.7 times more at risk of depression due to social isolation. “People who worked during this period in contact with the public, in particular cashiers, nurses, doctors, are 3.4 times more likely to have developed anxiety,” adds Professor Jean Ferrières.
He concludes: “Containment has indeed made it possible to limit the health consequences of the Covid-19 epidemic, but it is to be hoped that there will be no other confinement of this type as the psychological distress is palpable. We fear an impact on cardiovascular health: if we no longer consult, if we no longer take our treatments and if we add an emotional shock, the risk is to switch to a heart attack”.(1) Federation of Cardiology, USMR Epidemiology Department of Toulouse University Hospital and Inserm UMR 1295