Family members of patients hospitalized in the intensive care unit (ICU) with acute respiratory distress syndrome (ARDS) from COVID-19 have an elevated threat of post-traumatic tension disorder (PTSD)-associated symptoms, according to a study published in February in the Journal of the American Medical Association. The threat is larger than that posed by other causes of ARDS.
The potential cohort study took spot in 23 ICUs in France from January 2020 to June 2020, with final stick to-up occurring in October 2020. Family member symptoms of PTSD at 90 days immediately after ICU discharge was the major outcome, measured by the Impact of Events Scale-Revised (score variety, [best] to 88 [worst] presence of PTSD symptoms defined by score >22). Secondary outcomes incorporated family members member indicators of anxiousness and depression at 90 days evaluated by the Hospital Anxiety and Depression Scale at 90 days immediately after ICU discharge.
Of 602 family members members prospectively enrolled, 517 (86%, median interquartile variety [IQR] age, 51 [40-63] years 72% females 48% spouses 26% bereaved due to study patient’s death 303 [50%] relatives of COVID-19 patients) completed the evaluation at 90 days. Among 307 patients, 273 (89%, median IQR age, 61 [50-69] years 34% females 181 [59%] with COVID-19) completed the assessment. Compared with family members members of patients devoid of COVID-19 ARDS, these of patients with COVID-19 ARDS seasoned a substantially larger incidence of PTSD symptoms (35% [103/293] vs 19% [40/211] distinction, 16% [95% CI, 8%-24%] P <.001), anxiousness (41% [121/294] vs 34% [70/207] distinction, 8% [95% CI, 0%-16%] P =.05), and depression (31% [91/291] vs 18% [37/209] distinction, 13% [95% CI, 6%-21%] P <.001). In multivariable models adjusting for age, sex, and degree of social help, COVID-19 ARDS was related substantially with a heightened threat of PTSD-associated symptoms in family members members (odds ratio [OR], 2.05 [95% CI, 1.30-3.23]). Multiple sensitivity analyses yielded related benefits.
Additional things independently related with PTSD symptoms incorporated male sex (OR, .39 [95% CI, 0.23-0.67]), age (OR, .83 per 10-year improve [95% CI, 0.72-0.96]), and degree of social help reported on a 10-point scale [OR, 0.82 [95% CI, 0.74-0.90]). The typical age of family members members in the COVID-19 cohort was younger (median age, 50 vs 55 years). They had been much less regularly permitted to pay a visit to the ICU (35% vs 88%) and more generally obtained patient information and facts by phone get in touch with (84% vs 20%) rather than in particular person.
Limitations of the study incorporate acquiring benefits from early in the pandemic only lacking benefits from ICUs not devoted to enhancing family members care limiting participation to hospitals only in France failing to have all patients meet strict consensus criteria for ARDS and not involving ICU clinical employees, who may well have contributed to distinctive patient and family members experiences.
The researchers mentioned that, for the reason that of the require to comply with strict isolation measures throughout the pandemic and the strain place on ICU employees due to the surge, a breakdown in social help for family members members may well have contributed to their findings. “When ICUs are perceived as closed departments, visitors may feel unwelcome, and these closed ICUs can generate stress and symptoms of anxiety, depression, or PTSD in the family members,” the authors explained.
Disclosure: Multiple authors declared affiliations with the pharmaceutical market. Please refer to the original post for a complete list of disclosures.
Azoulay E, Resche-Rigon M, Megarbane B, et al. Association of COVID-19 acute respiratory distress syndrome with symptoms of posttraumatic stress disorder in family members after ICU discharge. JAMA. Published on the net February 18, 2022. doi:10.1001/jama.2022.2017
This post initially appeared on Pulmonology Advisor