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

2024; BioMed Central; Volume: 28; Issue: 1 Linguagem: Inglês

10.1186/s13054-024-04826-1

1466-609X

Pierre Kalfon, Wissam El‐Hage, Marie-Agnès Geantot, Constance Favier, Laëtitia Bodet-Contentin, Khaldoun Kuteifan, Pierre‐Yves Olivier, Didier Thévenin, Julien Pottecher, Jullien Crozon-Clauzel, Bénédicte Mauchien, Arnaud Galbois, Roland De Varax, Sabine Valéra, Philippe Estagnasié, Audrey Berric, Martine Nyunga, Nathalie Revel, Georges Simon, Benjamin Kowalski, Achille Sossou, Thomas Signouret, Marc Léone, Charles Delalé, Aurélien Seemann, Sigismond Lasocki, Jean‐Pierre Quenot, Antoine Monsel, Olivier Michel, Mathieu Page, René-Gilles Patrigeon, Walid Nicola, Arnaud W. Thille, Guillaume Hékimian, Pascal Auquier, Karine Baumstarck, Hortense Catry, Anne-Laure Dubus, Léa Laugery, Marion Lintaff, Mélanie Lourseyre, Lou Merigard, Lisa Michel, Nawal Ouhmad, Solenn Petit, Laurence Tricoche, Florent Beaumale, Anne-Sylvie Scholastique, Emmanuelle Mougenot, Céline Delerue, Marc Feller, Julien Grouille, Charles-Edouard Rochon, Juliette Audibert, Gaëtan Badre, Cécile Jourdain, Leslie Lehaie, Hasni Si Abdelkader, Émilie Henry, Marie Labruyère, Claire Boulle-Geronimi, Stéphanie Beaussard, Olivier Nigeon, Anthéa Loiez, Valérie Cerro, Laetitia Marchand‐Martin, Charlotte Arbelot, Karine Buzelier, Deborah A. Levy, Pascale Leloup, Karim Messaoudi, Camille Alzina, Lee S. Nguyen, Steve Nowak, Carole Ichai, Aminata Suzanne Diop, Hélène Brisson, Jean‐Michel Constantin, Samia Lakhal, M Oudihat, Rémi Coudroy, Carole Guyon, Jean‐Pierre Frat, R. Robert, Nadine Lubango, Lisa Villequey, Stéphane Hecketsweiler, Nicolas Partouche, Laurent Ducros, Vincent Gardan, Julie Rivoire, Stéphanie Deparis-Dusautois, Lamia Lamri, Alexandra Lavalart,

Family and Patient Care in Intensive Care Units

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.