ObjectiveCare patterns and Traditional Chinese Medicine (TCM) constitution affects the emotion and health of patients with systemic sclerosis (SSc) while the prevalence of COVID-19 may aggravate such patients’ emotion and health. We investigated the depression and anxiety levels of patients with SSc during the pandemic to identify the correlation between care patterns, TCM constitution, and patients’ emotion.Materials and methodsThis was a cross-sectional study. Patients with SSc and healthy individuals were surveyed using the patient health questionnaire-9, generalized anxiety disorder-7, and constitution in Chinese medicine questionnaire and a modified care pattern questionnaire. Factors correlated with depression and anxiety were screened using univariate and multivariate logistic regression analyses.ResultsA total of 273 patients with SSc and 111 healthy individuals were included in the analysis. The proportion of patients with SSc who were depressed was 74.36%, who had anxiety was 51.65%, and who experienced disease progression during the pandemic was 36.99%. The proportion of income reduction in the online group (56.19%) was higher than that in the hospital group (33.33%) (P = 0.001). Qi-deficiency [adjusted odds ratio (OR) = 2.250] and Qi-stagnation (adjusted OR = 3.824) constitutions were significantly associated with depression. Remote work during the outbreak (adjusted OR = 1.920), decrease in income (adjusted OR = 3.556), and disease progression (P = 0.030) were associated with the occurrence of depression.ConclusionChinese patients with SSc have a high prevalence of depression and anxiety. The COVID-19 pandemic has changed the care patterns of Chinese patients with SSc, and work, income, disease progression, and change of medications were correlates of depression or anxiety in patients with SSc. Qi-stagnation and Qi-deficiency constitutions were associated with depression, and Qi-stagnation constitution was associated with anxiety in patients with SSc.Trial registrationhttp://www.chictr.org.cn/showproj.aspx?proj=62301, identifier ChiCTR2000038796.

Background: Care patterns and TCM constitution affects systemic scleroderma (SSc) patients’ emotion and health while the prevalence of covid-19 may aggravate this situation. Thus, we investigated depression and anxiety level in SSc patients during the COVID-19 pandemic to identify the correlation between care patterns, TCM constitution and patients' emotion. Methods: This was a cross-sectional study. SSc patients and healthy individuals were surveyed through the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, the Constitution in Chinese Medicine Questionnaire and a modified care pattern questionnaire. Factors correlated with depression and anxiety were screened by univariate and multivariate logistic regression. Results: A total of 273 SSc patients and 111 healthy individuals were included. The median age was 45 years in both patient and healthy groups. 74.36% of SSc patients were in depression and 51.65% were in anxiety. 69.60% worked remotely and 50.92% experienced a decrease in income, which were both higher than in the healthy group (38.74%, 29.73%). The proportion of income reduction in the online group (56.19%) was higher than that in the hospital group (33.33%) (P = 0.001). 36.99% of SSc patients had disease progression during the pandemic. Yang-deficiency constitution (82.05%) was the TCM constitution characteristic of SSc patients, while Qi-deficiency(73.63%) and Blood-stasis constitution (57.14%) were also more common. TCM constitution of patients from different sources distributed roughly similar. Qi-deficiency (adjusted OR=2.250) and Qi-stagnation (adjusted OR= 3.824) constitution were significantly associated with depression. The major constitution of dampness-heat was associated with a decrease in depression (adjusted OR=0.160). Remote work during the outbreak (adjusted OR= 1.920), decreasing in income (adjusted OR=3.556), and disease progression (P=0.030) were associated with the occurrence of depression. Conclusion: Chinese SSc patients have a high prevalence of depression and anxiety. The COVID-19 pandemic has changed the care patterns of Chinese SSc patients in terms of work, income, and ways of getting medical support. Within the care patterns, work, income, disease and change of medications were correlates of depression or anxiety in SSc patients. Qi-stagnation and Qi-deficiency constitution were associated with depression, and Qi-stagnation constitution was associated with anxiety in SSc patients. Further research is needed. Trial registration: ChiCTR, ChiCTR2000038796, Registered 02 October 2020, http://www.chictr.org.cn/showproj.aspx?proj=62301