학술논문
Impact of COVID-19 on posttraumatic stress disorder in ICU survivors: a prospective observational comparative cohort study
intensive care units
intensive care units
Document Type
Report
Author
Kalfon, Pierre; El-Hage, Wissam; Geantot, Marie-Agnès; Favier, Constance; Bodet-Contentin, Laetitia; Kuteifan, Khaldoun; Olivier, Pierre-Yves; Thévenin, Didier; Pottecher, Julien; Crozon-Clauzel, Jullien; Mauchien, Bénédicte; Galbois, Arnaud; de Varax, Roland; Valera, Sabine; Estagnasie, Philippe; Berric, Audrey; Nyunga, Martine; Revel, Nathalie; Simon, Georges; Kowalski, Benjamin; Sossou, Achille; Signouret, Thomas; Leone, Marc; Delalé, Charles; Seemann, Aurélien; Lasocki, Sigismond; Quenot, Jean-Pierre; Monsel, Antoine; Michel, Olivier; Page, Mathieu; Patrigeon, René-Gilles; Nicola, Walid; Thille, Arnaud W.; Hekimian, Guillaume; Auquier, Pascal; Baumstarck, Karine; Catry, Hortense; Dubus, Anne-Laure; Laugery, Léa; Lintaff, Marion; Lourseyre, Mélanie; Merigard, Lou; Michel, Lisa; Ouhmad, Nawal; Petit, Solenn; Tricoche, Laurence; Beaumale, Florent; Scholastique, Anne-Sylvie; Mougenot, Emmanuelle; Delerue, Céline; Feller, Marc; Grouille, Julien; Rochon, Charles-Edouard; Audibert, Juliette; Badre, Gaëtan; Jourdain, Cécile; Lehaie, Leslie; Abdelkader, Hasni Si; Henry, Emilie; Labruyere, Marie; Boulle-Geronimi, Claire; Beaussard, Stéphanie; Nigeon, Olivier; Loiez, Anthea; Cerro, Valérie; Marchand, Laetitia; Arbelot, Charlotte; Buzelier, Karine; Levy, Deborah; Leloup, Pascale; Messaoudi, Karim; Alzina, Camille; Nguyen, Lee; Nowak, Steve; Ichai, Carole; Diop, Aminata; Brisson, Hélène; Constantin, Jean-Michel; Lakhal, Samia; Oudihat, Madjid; Coudroy, Rémi; Guyon, Carole; Frat, Jean-Pierre; Robert, René; Lubango, Nadine; Villequey, Lisa; Hecketsweiler, Stéphane; Partouche, Nicolas; Ducros, Laurent; Gardan, Vincent; Rivoire, Julie; Deparis-Dusautois, Stéphanie; Lamri, Lamia; Lavalart, Alexandra
Source
Critical Care. March 14, 2024, Vol. 28 Issue 1
Subject
Language
English
ISSN
1364-8535
Abstract
Author(s): Pierre Kalfon[sup.1,2,36] , Wissam El-Hage[sup.3,4] , Marie-Agnès Geantot[sup.5] , Constance Favier[sup.2] , Laetitia Bodet-Contentin[sup.6,7] , Khaldoun Kuteifan[sup.8] , Pierre-Yves Olivier[sup.9] , Didier Thévenin[sup.10] , Julien Pottecher[sup.11] , Jullien Crozon-Clauzel[sup.12] [...]
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: Critical care, Posttraumatic stress disorder, COVID-19, Intensive care unit
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: Critical care, Posttraumatic stress disorder, COVID-19, Intensive care unit