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. 2022 Jul 15:13:931349.
doi: 10.3389/fpsyt.2022.931349. eCollection 2022.

The course and determinants of post-traumatic stress over 12 months after hospitalization for COVID-19

Knut Stavem  1   2   3 , Trond Heir  2   4 , Toril Dammen  2   5 , Eivind Brønstad  6   7 , Tøri Vigeland Lerum  2   8 , Michael T Durheim  2   9 , Kristine M A Lund  10 , Bernt B Aarli  11   12 , Gunnar Einvik  1   2
Affiliations

The course and determinants of post-traumatic stress over 12 months after hospitalization for COVID-19

Knut Stavem et al. Front Psychiatry. .

Abstract

Objective: To assess the trajectory of symptoms and symptom-defined post-traumatic stress disorder (PTSD) from 1.5 to 12 months after hospitalization for COVID-19 and determine risk factors for persistent symptoms and PTSD.

Methods: This was a prospective cohort study of consecutive patients discharged after hospitalization for COVID-19 before 1 June 2020 in six hospitals in Southern Norway. Symptom-defined PTSD was assessed by the post-traumatic stress disorder (PTSD) checklist for DSM-5 (PCL-5) at 1.5, 3 and/or 12 months after hospitalization, using DSM-5 criteria. Changes in PCL-5 symptom score and the prevalence of PTSD were analyzed with multivariable mixed models.

Results: In total, 388 patients were discharged alive, and 251 (65%) participated. Respondents had a mean (SD) age of 58.4 (14.2) years, and 142 (57%) were males. The prevalence of symptom-defined PTSD was 14, 8, and 9% at 1.5, 3, and 12 months, respectively. WHO disease severity for COVID-19 was not associated with PCL-5 scores. Female sex, lower age and non-Norwegian origin were associated with higher PCL-5 scores. The odds ratio (OR) (95%CI) for PTSD was 0.32 (0.12 to 0.83, p = 0.019) at 3 months and 0.38 (0.15 to 0.95, p = 0.039) at 12 months compared to 1.5 months. There was no association between PTSD and WHO severity rating.

Conclusions: The level of PTSD symptoms decreased from 1.5 to 3 months after hospitalization, but did not decrease further to 12 months, and there was no association between PTSD symptoms and COVID-19 disease severity.

Keywords: COVID-19; PCL-5 questionnaire; cohort; follow-up; medium-term; post-traumatic stress disorder (PTSD).

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Figures

Figure 1
Figure 1
Proportions of hospitalized COVID-19 patients with symptom-defined PTSD (DSM-5 scoring) over time, according to WHO disease severity: 3, no oxygen requirement (n = 87); 4, oxygen by mask or nasal prongs (n = 121); 5–7, high-flow oxygen, non-invasive ventilation or intubation/mechanical ventilation (n = 43).
Figure 2
Figure 2
Margin plots from the linear mixed models, illutrating the effects of covariates on estimated PCL-5 scores over time. (A) WHO ordinal disease severity, (B) sex, (C) Norwegian origin, and (D) age. Other covariates than those shown were kept at mean values.
See this image and copyright information in PMC

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