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

Author:

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

Abstract

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.

Publisher

Springer Science and Business Media LLC

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