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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2024年3月14日

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

摘要

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.