Table 3.

Themes and Illustrative Quotations from Free-Text Responses on the Impact of the COVID-19 Pandemic

Theme	Quotation
Anxiety/Depression	“It has increased my anxiety, and I've had trouble sleeping, even though I am already over-tired from having a newborn.” “Covid has caused anxiety, depression and overall sadness.” “Stress and anxiety mostly. Don't know what information to trust.”
Isolation	“Periodic feelings of isolation. Sad at times that I cannot socialize with friends and family.” “Isolation has caused depression and exacerbated symptoms” “Some isolation … Less support because of distancing.”
Health risk due to immunosuppression	“Because I have Lupus and have been on the medication I take for over 40 years, I am concerned about being immunocompromised. Covid-19 and health concerns have impacted the decisions I make regarding my exposure to others during this time.” “The stress over being immunosuppressed amid a pandemic has been challenging at times.”
Decreased physical activity	“Doing aquatics classes at a community center greatly improved my health in the year prior to the pandemic - both physically and emotionally. I had few symptoms, reduced pain, and went down in dosage on my antidepressants. I am unable to go to the community center for these classes or get my therapeutic massage therapy, so my pain has increased, my overall health and physical ability has declined, and I am crawling out of a terrible depression after increasing my antidepressants and doubling down on therapy.” “I have practiced extreme social distancing. Prior to the pandemic I used to go for walks for exercise. In the first two months of the pandemic I stayed inside which has negatively impacted my health and well-being. I try to increase my time outdoors.” “Inability to exercise outdoors, weight gain.” “Not being able to go to the gym has been very hard on me. I have gained too much weight which makes my pulmonary issues worsen as well as pain.”
Decreased access to medications/health care	“There was a shortage of one of my medications—hydroxychloroquine.” “I was unable to receive monthly infusion treatments, delayed appointments for specialists as office was closed.” “an in-person visit with my doctor had to be rescheduled.” “Harder to go to physical therapy”
Financial strain	"I had to stop working, that affected my financial situation."
Positive impact	“It did not affect my health in a negative way. In fact, I was feeling better than what I had been feeling before Covid19.” “Not having to commute has allowed me to rest more.” “I was having a lupus flare right before pandemic began. My health has improved since I started teleworking back in Feb 2020.” “Living in a quieter place has reduced my stress and increased my health.”
No impact	“Not much has changed in my health due to Covid19”