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Multicenter Study
. 2022 Mar;48(3):322-331.
doi: 10.1007/s00134-021-06615-8. Epub 2022 Feb 1.

Mental health symptoms in family members of COVID-19 ICU survivors 3 and 12 months after ICU admission: a multicentre prospective cohort study

Hidde Heesakkers  1 , Johannes G van der Hoeven  2 , Stijn Corsten  3 , Inge Janssen  4 , Esther Ewalds  5 , Dominique Burgers-Bonthuis  6 , Thijs C D Rettig  7 , Crétien Jacobs  8 , Susanne van Santen  9 , Arjen J C Slooter  10   11 , Margaretha C E van der Woude  12   13 , Marieke Zegers #  2 , Mark van den Boogaard #  14
Affiliations
Multicenter Study

Mental health symptoms in family members of COVID-19 ICU survivors 3 and 12 months after ICU admission: a multicentre prospective cohort study

Hidde Heesakkers et al. Intensive Care Med. 2022 Mar.

Abstract

Purpose: Long-term mental outcomes in family members of coronavirus disease 2019 (COVID-19) intensive care unit (ICU) survivors are unknown. Therefore, we assessed the prevalence of mental health symptoms, including associated risk factors, and quality of life (QoL) in family members of COVID-19 ICU survivors 3 and 12 months post-ICU.

Methods: A prospective multicentre cohort study in ICUs of ten Dutch hospitals, including adult family members of COVID-19 ICU survivors admitted between March 1, and July 1, 2020. Symptom prevalence rates of anxiety, depression (Hospital Anxiety and Depression Scale) and Post-Traumatic Stress Disorder (Impact of Event Scale-6), and QoL (Short Form-12) before ICU admission (baseline), and after 3 and 12 months were measured. Additionally, associations between family and patient characteristics and mental health symptoms were calculated.

Results: A total of 166 out of 197 (84.3%) included family members completed the 12-month follow-up of whom 46.1% and 38.3% had mental health symptoms 3 and 12 months post-ICU, respectively; both higher compared to baseline (22.4%) (p < 0.001). The mental component summary score of the SF-12 was lower at 12-month follow-up compared with baseline [mean difference mental component score: - 5.5 (95% confidence interval (CI) - 7.4 to - 3.6)]. Furthermore, 27.9% experienced work-related problems. Symptoms of anxiety (odds ratio (OR) 9.23; 95% CI 2.296-37.24; p = 0.002) and depression (OR 5.96; 95% CI 1.29-27.42; p = 0.02) prior to ICU admission were identified as risk factors for mental health symptoms after 12 months.

Conclusion: A considerable proportion of family members of COVID-19 survivors reported mental health symptoms 3 and 12 months after ICU admission, disrupting QoL and creating work-related problems.

Keywords: COVID-19; Critical care; Family members; Mental health; Quality of life.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Enrolment of family members of COVID-19 ICU survivors
Fig. 2
Fig. 2
Prevalence of mental health symptoms in family members. NA not applicable. *p value < 0.05. **p value < 0.001. aAnxiety and depression symptoms were defined by a score of ≥ 8 on the Hospital Anxiety and Depression Scale (HADS). bSymptoms of Post-traumatic stress disorder (PTSD) were defined by a mean of all questions ≥ 1.75 on the IES-6. Baseline data is not applicable. cComposite score for mental: one or more mental health symptoms (Anxiety, depression, PTSD) present
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