Abstract:Background: Coronavirus disease (COVID-19) hospitalization has been related to Post-Traumatic Stress Disorder (PTSD). Available information is limited by insufficient follow-up and lack of longitudinal studies. Baseline factors (e.g., sex; obesity) have been related to PTSD, but post-hospitalization factors have not been studied. Objective: This study aimed to analyse prevalence, baseline, post-discharge factors and possible clinical courses of PTSD after hospitalization for COVID-19. Method: 109 patients (94.… Show more
“…In accordance with the previous studies on PTSD in patients with COVID-19 and critical diseases [ 19 , 23 , 25 ], there exist four different courses of PTSD after COVID-19. The majority of patients (75%) were “resilient,” with no clinically relevant PTSD symptoms at all time points, and 10% of the patients were “recovery,” with a decrease in PTSD symptoms.…”
Section: Discussionsupporting
confidence: 88%
“…In the sample, 49 patients (68.1%) were men. The median length of hospital stay was 13.0 days (IQR [ 8 , 25 ]), and 21 participants were classified into the severity scale 3, 34 to the severity scale 4, five to severity scale 5, and 12 to severity scale 6 or 7. Figure 1 Patient flow IES-R, Impact of event-scale revised.…”
“…In accordance with the previous studies on PTSD in patients with COVID-19 and critical diseases [ 19 , 23 , 25 ], there exist four different courses of PTSD after COVID-19. The majority of patients (75%) were “resilient,” with no clinically relevant PTSD symptoms at all time points, and 10% of the patients were “recovery,” with a decrease in PTSD symptoms.…”
Section: Discussionsupporting
confidence: 88%
“…In the sample, 49 patients (68.1%) were men. The median length of hospital stay was 13.0 days (IQR [ 8 , 25 ]), and 21 participants were classified into the severity scale 3, 34 to the severity scale 4, five to severity scale 5, and 12 to severity scale 6 or 7. Figure 1 Patient flow IES-R, Impact of event-scale revised.…”
“…Previous studies have shown that patients affected by COVID-19 should be considered as at risk patients for developing PTSD, and some authors have requested a specific survey for these patients to detect the occurrence of posttraumatic symptoms as early as possible [ 47 ]. We did not find these results for the presumptive diagnosis of PTSD assessed by PCL-5.…”
Background
Posttraumatic stress disorder (PTSD) after a stay in the intensive care unit (ICU) can affect one in five ICU survivors. At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, admission to the ICU for COVID-19 was stressful due to the severity of this disease. This study assessed whether admission to the ICU for COVID-19 was associated with a higher prevalence of PTSD compared with other causes of ICU admission after adjustment for pre-ICU psychological factors.
Methods
This prospective observational comparative cohort study included 31 ICUs. Eligible patients were adult ICU survivors hospitalized during the first wave of COVID-19 pandemic in France, regardless of the reason for admission. The prevalence of presumptive diagnosis of PTSD at 6 months was assessed using the PTSD Checklist for DSM-5 (PCL-5). Sociodemographics, clinical data, history of childhood trauma (Childhood Trauma Questionnaire [CTQ]), and exposure to potentially traumatic events (Life Events Checklist for DSM-5 [LEC-5]) were assessed.
Results
Of the 778 ICU survivors included during the first wave of COVID-19 pandemic in France, 417 and 361 were assigned to the COVID-19 and non-COVID-19 cohorts, respectively. Fourteen (4.9%) and 11 (4.9%), respectively, presented with presumptive diagnosis of PTSD at 6 months (p = 0.976). After adjusting for age, sex, severity score at admission, use of invasive mechanical ventilation, ICU duration, CTQ and LEC-5, COVID-19 status was not associated with presumptive diagnosis of PTSD using the PCL-5. Only female sex was associated with presumptive diagnosis of PTSD. However, COVID-19 patients reported significantly more intrusion and avoidance symptoms than non-COVID patients (39% vs. 29%, p = 0.015 and 27% vs. 19%, p = 0.030), respectively. The median PCL-5 score was higher in the COVID-19 than non-COVID-19 cohort (9 [3, 20] vs. 4 [2, 16], p = 0.034).
Conclusion
Admission to the ICU for COVID-19 was not associated with a higher prevalence of PTSD compared with admission for another cause during the first wave of the COVID-19 pandemic in France. However, intrusion and avoidance symptoms were more frequent in COVID-19 patients than in non-COVID-19 patients.
Trial Registration: Clinicaltrials.gov Identifier NCT03991611, registered on June 19, 2019.
“…Mazza et al found a significant increasing trend of depression and anxiety in Covid-19 survivors 6 and 12 months after recovery (Mazza et al, 2022 ). Serra et al reported a 23.9% PTSD prevalence in Covid-19 survivors one year after hospitalization (Serra et al, 2022 ). Therefore, all these findings confirm the high probability of mental disorders in the survivors of Covid-19 over time.…”
Background: Decreased psychological and cognitive functioning is one of the complications of Covid-19 disease. We aimed to evaluate mental health, cognitive functioning, and salivary cortisol levels in Covid-19 patients with different disease severities in three 45-day intervals after recovery. Methods: 258 Covid-19 patients were assigned into three groups based on their disease severity: 112 patients in mild group, 67 patients in moderate group and 79 patients in severe group. The participants underwent psychological evaluations (including Depression, Anxiety and Stress Scale questionnaire, Beck Depression Inventory, SpeilBerger State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Inventory), cognitive assessments (The Paced Auditory Serial Addition Test) and salivary cortisol level evaluation in three 45-day periods. Non-parametric statistical methods were applied for psychological and cognitive indicators, while two-way mixed model ANOVA was used to evaluate the cortisol concentration in three replications. Results: The group of mild patients became more anxious and the group of moderate patients became more anxious and depressed. But all three groups of patients developed severe sleep disorders over time. For cognitive functioning, although the results showed a decrease in the correct response rate, a significant increase in the correct response rate was observed in all three groups in all three measurements. However, the response speed not only did not increase, but also decreased in severe group. Cortisol level had a markedly increasing trend in all three groups. Conclusion: Improvement of cognitive functioning was in line with the increase in cortisol. Besides, the decrease in mental health had no effect on the cognitive functioning.
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