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Article

Perspectives on Knowledge, Precautionary Behaviors, and Psychological Status of Patients with Cardiovascular Diseases During the First Wave of the COVID-19 Pandemic in Lebanon: A Multicentric Cross-Sectional Study

by
Marc Machaalani
1,†,
Battoul Fakhry
1,†,
Kassem Farhat
1,†,
Juliano Haddad
1,
Youssef Rahmeh
1,
Peter Ghiya
1,2,
Diana Carolina Awad
1,3,
Aline Zaiter
1,4,
Jean G. Louka
1,5,
Layal Olaywan
1,6,
Ahmad Halawi
1,
Hassan Cherry
1,
Mohamad Ghazal
1,
Mustapha Sahili
1,
Bachir Atallah
1,
Wadih Naja
7,
Elie Chammas
8,
Roland Asmar
9,10,
Nadine Yared
11 and
Mirna N. Chahine
1,9,10,12,*
1
Department of Research, Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon
2
Department of Urology, Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon
3
Department of General Surgery, Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon
4
Department of Internal Medicine, Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon
5
Department of Orthopedic Surgery and Traumatology, Simone-Veil Hospital, 95600 Eaubonne, France
6
Department of Pulmonary and Critical Care, Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon
7
Department of Psychiatry, Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon
8
Department of Cardiology, Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon
9
Foundation-Medical Research Institutes (F-MRI®), Achrafieh, Beirut 1100, Lebanon
10
Foundation-Medical Research Institutes (F-MRI®), 1211 Geneva, Switzerland
11
Department of Infectious Diseases, Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon
12
Department of Basic Sciences, Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon
 
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*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
COVID 2025, 5(9), 155; https://doi.org/10.3390/covid5090155
Submission received: 22 June 2025 / Revised: 2 September 2025 / Accepted: 9 September 2025 / Published: 12 September 2025
(This article belongs to the Section COVID Public Health and Epidemiology)
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Abstract

Cardiovascular diseases (CVDs) are among the most common comorbidities in COVID-19 patients. This multicenter cross-sectional study assessed knowledge, risk perception, precautionary measures, and psychological burden related to COVID-19 among Lebanese individuals with and without CVD during the pandemic’s first wave. A total of 485 CVD patients and 1033 control group (CG) participants completed standardized questionnaires, including the Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), and Coronavirus Anxiety Scale. Compared to CG, CVD patients demonstrated significantly lower COVID-19-related knowledge (86.4% vs. 90.0%, p < 0.001) and adherence to preventive measures (81.5% vs. 85.7%, p < 0.001). After stratification, limited knowledge was more common among CVD patients (45.7% vs. 31.8%), as was limited precautionary behavior (70.3% vs. 54.2%). Risk perception was suboptimal in both groups, with no significant difference (41.3% vs. 38.6%, p = 0.072). Anxiety (GAD-7 ≥ 10) and depression (PHQ-9 ≥ 10) were more prevalent among CVD patients (13.4% and 11.3%) than CG participants (9.5% and 16.5%). Survey outcomes were influenced by educational, socioeconomic, and psychosocial factors. These findings highlight the need to target CVD patients in public health campaigns to enhance preparedness and mental health support during pandemics.
Keywords: CVD; COVID-19; perspective; knowledge; perception; precautions; anxiety depression CVD; COVID-19; perspective; knowledge; perception; precautions; anxiety depression

Share and Cite

MDPI and ACS Style

Machaalani, M.; Fakhry, B.; Farhat, K.; Haddad, J.; Rahmeh, Y.; Ghiya, P.; Awad, D.C.; Zaiter, A.; Louka, J.G.; Olaywan, L.; et al. Perspectives on Knowledge, Precautionary Behaviors, and Psychological Status of Patients with Cardiovascular Diseases During the First Wave of the COVID-19 Pandemic in Lebanon: A Multicentric Cross-Sectional Study. COVID 2025, 5, 155. https://doi.org/10.3390/covid5090155

AMA Style

Machaalani M, Fakhry B, Farhat K, Haddad J, Rahmeh Y, Ghiya P, Awad DC, Zaiter A, Louka JG, Olaywan L, et al. Perspectives on Knowledge, Precautionary Behaviors, and Psychological Status of Patients with Cardiovascular Diseases During the First Wave of the COVID-19 Pandemic in Lebanon: A Multicentric Cross-Sectional Study. COVID. 2025; 5(9):155. https://doi.org/10.3390/covid5090155

Chicago/Turabian Style

Machaalani, Marc, Battoul Fakhry, Kassem Farhat, Juliano Haddad, Youssef Rahmeh, Peter Ghiya, Diana Carolina Awad, Aline Zaiter, Jean G. Louka, Layal Olaywan, and et al. 2025. "Perspectives on Knowledge, Precautionary Behaviors, and Psychological Status of Patients with Cardiovascular Diseases During the First Wave of the COVID-19 Pandemic in Lebanon: A Multicentric Cross-Sectional Study" COVID 5, no. 9: 155. https://doi.org/10.3390/covid5090155

APA Style

Machaalani, M., Fakhry, B., Farhat, K., Haddad, J., Rahmeh, Y., Ghiya, P., Awad, D. C., Zaiter, A., Louka, J. G., Olaywan, L., Halawi, A., Cherry, H., Ghazal, M., Sahili, M., Atallah, B., Naja, W., Chammas, E., Asmar, R., Yared, N., & Chahine, M. N. (2025). Perspectives on Knowledge, Precautionary Behaviors, and Psychological Status of Patients with Cardiovascular Diseases During the First Wave of the COVID-19 Pandemic in Lebanon: A Multicentric Cross-Sectional Study. COVID, 5(9), 155. https://doi.org/10.3390/covid5090155

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