One-third of ED-admitted COVID-19 patients may experience PTSD
Nearly one-third of patients with severe COVID-19 had PTSD after acute infection, according to results of a research letter published in JAMA Psychiatry.
“Previous coronavirus epidemics were associated with PTSD diagnoses in post-illness stages, with meta-analytic findings indicating a prevalence of 32.2% (95% CI, 23.7-42),” Delfina Janiri, MD, of the department of psychiatry at the Gemelli University Hospital in Italy, and colleagues wrote. “However, information after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is piecemeal. We aimed at filling this gap by studying a group of patients with [COVID-19] who sought treatment at the [ED], most of whom required hospitalization, eventually recovered, and were subsequently referred to a post-acute care service for multidisciplinary assessment.”
The investigators analyzed data of 381 consecutive patients presenting to the ED with SARS-CoV-2 and who had recovered from COVID-19 infection. All patients were white, 43.6% were women and the mean age was 55.26 years. Participants received a comprehensive and interdisciplinary medical and psychiatric assessment that included data on demographic, clinical, psychopathological and COVID-19 characteristics. Trained psychiatrists used the Clinician-Administered PTSD Scale for DSM-5 to diagnose PTSD, and they used the Structured Clinical Interview for DSM-5 to make additional diagnoses.
Results showed 81.1% of participants were hospitalized during acute COVID-19 illness, with a mean length of hospital stay of 18.41 days. The researchers noted PTSD among 115 (30.2%) participants. Additional diagnoses in the total sample were depressive episode (17.3%), hypomanic episode (0.7%), generalized anxiety disorder (7%) and psychotic disorders (0.2%). Those with PTSD were more likely to be women (55.7%), report higher rates of history of psychiatric disorders (34.8%) and delirium or agitation during acute illness (16.5%) and to present with more persistent medical symptoms in the post-illness stage (62.6%). Factors linked to PTSD included sex, delirium or agitation and persistent medical symptoms, according to logistic regression.
“This study had limitations, including the relatively small sample size and cross-sectional design, as PTSD symptom rates may vary over time,” Janiri and colleagues wrote. “Furthermore, this was a single-center study that lacked a control group of patients attending the [ED] for other reasons. Further longitudinal studies are needed to tailor therapeutic interventions and prevention strategies.”