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

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

Pierre Kalfon et al. Crit Care. .

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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Conflict of interest statement

Dr. Kalfon received consulting fees from General Electric Healthcare. On behalf of all remaining authors, the corresponding author states that the remaining authors have no conflict of interest.

Figures

Fig. 1
Fig. 1
CONSORT-style flow diagram of patients in the PTSD-REA COVID study. PCL-5 PTSD Checklist for DSM-5
See this image and copyright information in PMC

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