Psychological Impact of COVID-19 on ICU Caregivers

Abstract

Subject and purpose Just as every pandemic, COVID-19 could lead to emotional and psychological disturbances among caregivers, especially in the Intensive Care Unit (ICU), where significant stress related to the influx of patients, exposure to the virus and the lack of documentation on this new SARS occurred. The present study aimed at assessing the psychological impact of COVID-19 on the caregivers at the peak of the “crisis period”. Materials and methods A survey using the Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale – Revised (IES-R) was proposed to the persons working in 5 ICUs of a French teaching hospital (April 8 to April 21, 2020). Logistic regression was performed to find independent risk factors for anxiety and post-traumatic stress disorder (PTDS). A value of p < 0.05 was considered significant. Results The incidence of anxiety and depression were 48% and 16%, respectively. PTSD (post-traumatic stress disorder) symptoms were present in 27% of respondents. The independent risk factors for developing anxiety syndrome were being assigned in COVID-19 + ICU (OR = 2.081 [95% confident interval (CI), 1.035-4.184)], and not be trained in intensive care medicine, OR = 2.570 [95% CI, 1.344-4.901]. The independent risk factors for PTSD are having a history of burn-out (OR = 4.591 [95% CI, 1.464-14.397] and not being trained in ICU, (OR = 2.155 [95% CI, 1.047-4.440]). Conclusion COVID-19 could lead to strong impact on ICU workers. These findings should lead to prevention procedures (ICU training sessions) in persons at risk.

Psychological impact of the SARS-CoV-2 outbreak on the staff of a French hospital

“…The difference between our findings and those of other previously published studies is all the more significant because we used a threshold of = 40 IES-R points, as recommended in France, instead of the threshold of = 24 or 26 points employed in the previous studies. However, our results are consistent with the 16% to 27% incidence of PTSD obtained with various evaluation scales (IES-R, Post-traumatic Stress Disorder Checklist for DSM-5) among French ICU professionals and pharmacists [4] , [5] , [10] .…”

“…When compared to the 2 French studies using the same HAD scale cut-off value as ours (11 points), which disclosed 14.6% and 19% anxiety, and 12% and 9% depression among radiologists and ICU healthcare workers respectively [5] , [6] , the psychological impact in our population is slightly higher than expected. Other French studies used a lower HAD scale cut-off value (8 points) [3] , [7] , but did not mention their cut-off [4] or apply other evaluation scales [9] , which precluded comparisons with our results.…”

“…Previous comparable studies suffer from the same bias. The study by Caillet et al constitutes an exception: the authors showed a higher incidence of anxiety, depression and PTSD in ICU healthcare professionals during the first peak of the SARS-CoV-2 epidemic compared to data from the literature on ICU professionals’ mental health [4] . Unfortunately, there exist no global reference data about mental health status of hospital staff in France before the SARS-CoV-2 epidemic.…”

“…Several studies conducted in China during the SARS-CoV-2 outbreak and previous studies conducted during the Severe Acute Respiratory Syndrome (SARS) et Middle East Respiratory Syndrome (MERS) epidemics revealed high levels of anxiety, depression and post-traumatic stress disorders (PTSD) among healthcare professionals [1] , [2] . In France, studies have evaluated the psychological impact of the SARS-CoV-2 epidemic on specific populations, such as intensive care unit (ICU) healthcare professionals [3] , [4] , [5] , radiologists [4] , residents in oncology, radiotherapy, urology and surgery [7] , [8] , [9] , community pharmacists [10] and professionals working in acute care geriatric facilities [11] . However, global data on the psychological impact of the SARS-CoV-2 epidemic on hospital staff are lacking.…”

Post-Traumatic Stress Symptoms in Healthcare Workers Dealing with the COVID-19 Pandemic: A Systematic Review

“…Moreover, brief passive psychoeducational interventions targeting high-risk groups were shown to be effective during the peak of the pandemic, although to date, the extent of their benefit remains unknown. Consistent with these studies, Caillet et al [ 28 ] showed lack of medical training as an independent factor for PTSS in HCWs employed in COVID-19-intensive care units (OR = 2.155 (95% CI, 1.047–4.440), p = 0.04); given this finding, the authors suggested the need for training and re-training HCWs continuously exposed to the risk of both acquiring the disease and spreading SARS-CoV-2 to their family, friends, and colleagues. Regarding the protective role of training, interesting research was conducted by Tan et al [ 17 ] evaluating, among others, traumatic stress among medical workers (doctors and nurses) and non-medical workers (caregivers, pharmacists, technicians.…”