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Crit Care . Impact of COVID-19 on posttraumatic stress disorder in ICU survivors: a prospective observational comparative cohort study

tetano

Editor, Senior Moderator
Crit Care


. 2024 Mar 14;28(1):77.
doi: 10.1186/s13054-024-04826-1. Impact of COVID-19 on posttraumatic stress disorder in ICU survivors: a prospective observational comparative cohort study

Pierre Kalfon[SUP] 1 2 3 [/SUP], Wissam El-Hage[SUP] 4 5 [/SUP], Marie-Agnès Geantot[SUP] 6 [/SUP], Constance Favier[SUP] 7 [/SUP], Laetitia Bodet-Contentin[SUP] 8 9 [/SUP], Khaldoun Kuteifan[SUP] 10 [/SUP], Pierre-Yves Olivier[SUP] 11 [/SUP], Didier Thévenin[SUP] 12 [/SUP], Julien Pottecher[SUP] 13 [/SUP], Jullien Crozon-Clauzel[SUP] 14 [/SUP], Bénédicte Mauchien[SUP] 15 [/SUP], Arnaud Galbois[SUP] 16 [/SUP], Roland de Varax[SUP] 17 [/SUP], Sabine Valera[SUP] 18 [/SUP], Philippe Estagnasie[SUP] 19 [/SUP], Audrey Berric[SUP] 20 [/SUP], Martine Nyunga[SUP] 21 [/SUP], Nathalie Revel[SUP] 22 [/SUP], Georges Simon[SUP] 23 [/SUP], Benjamin Kowalski[SUP] 24 [/SUP], Achille Sossou[SUP] 25 [/SUP], Thomas Signouret[SUP] 26 [/SUP], Marc Leone[SUP] 27 [/SUP], Charles Delalé[SUP] 28 [/SUP], Aurélien Seemann[SUP] 29 [/SUP], Sigismond Lasocki[SUP] 30 [/SUP], Jean-Pierre Quenot[SUP] 31 [/SUP], Antoine Monsel[SUP] 32 [/SUP], Olivier Michel[SUP] 33 [/SUP], Mathieu Page[SUP] 34 [/SUP], René-Gilles Patrigeon[SUP] 35 [/SUP], Walid Nicola[SUP] 36 [/SUP], Arnaud W Thille[SUP] 37 [/SUP], Guillaume Hekimian[SUP] 38 [/SUP], Pascal Auquier[SUP] 7 [/SUP], Karine Baumstarck[SUP] 7 [/SUP]; PTSD-REA Study group



Collaborators, Affiliations
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.

Keywords: COVID-19; Critical care; Intensive care unit; Posttraumatic stress disorder.

 
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