Article ; Online: Impact of COVID-19 on posttraumatic stress disorder in ICU survivors: a prospective observational comparative cohort study.
Critical care (London, England)
2024 Volume 28, Issue 1, Page(s) 77
Abstract: 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 ... ...
| Abstract | 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. |
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| MeSH term(s) | Adult ; Humans ; Female ; Stress Disorders, Post-Traumatic/psychology ; COVID-19/epidemiology ; COVID-19/complications ; Cohort Studies ; Pandemics ; Intensive Care Units ; Survivors ; Psychological Tests ; Self Report |
| Language | English |
| Publishing date | 2024-03-14 |
| Publishing country | England |
| Document type | Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 2041406-7 |
| ISSN | 1466-609X ; 1364-8535 |
| ISSN (online) | 1466-609X |
| ISSN | 1364-8535 |
| DOI | 10.1186/s13054-024-04826-1 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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