117: DIFFERENCES IN POST-INTENSIVE CARE SYNDROME SEQUELAE BETWEEN ARDS AND COVID ARDS SURVIVORS

Abstract

Introduction: Post-intensive care syndrome (PICS) is a disorder with psychological sequalae often seen in acute respiratory distress syndrome (ARDS) survivors after intensive care unit (ICU) stays. Studies have reported post-traumatic stress disorder (PTSD) in up to 39% of ARDS survivors, and 66% have anxiety. COVID-19 respiratory failure often mirrors ARDS. We hypothesized that PICS symptoms would be worse in COVID ARDS secondary to longer ventilator hours and social isolation. Methods: The cross-sectional study enrolled survivors of ARDS and COVID ARDS admitted after 01/01/20 for a pilot study to screen for PICS. We recruited participants through Facebook ARDS survivor groups. Participants completed the Impact of Events Scale-R (PTSD), Patient Health Questionnaire-9 (PHQ-9; depression), and General Anxiety Disorder-7 (GAD-7). Independent-Samples Mann-Whitney U and Chi-Square tests were used to examine group differences. Results: We analyzed data from 16 participants (ARDS 44%; COVID ARDS 56%); median age 34.5; 63% female; 88% white, 13% Hispanic. COVID ARDS had higher median ICU days (46 vs. 10) and ventilator days (35 vs. 8) than ARDS (p=.32). Family visitation occurred in 78% of COVID vs 86% ARDS (p=.69). Clinical PTSD noted in 56% COVID ARDS compared to 29% ARDS; p=.03). Moderate depression or higher noted in 46% of survivors with no difference between groups (p=.65). Moderate anxiety or higher noted in 44% of survivors; no difference between groups (p=.20). Of those working, 38% of COVID ARDS and 14% of ARDS were unable to return to work after discharge (p=.31). Conclusions: Both groups exhibited PTSD, anxiety, and depression, impacting their ability to return to work. COVID survivors were nearly twice as likely to screen positive for clinically significant PTSD; differences in PTSD may be explained by longer ICU stays and ventilator time. Interventions to reduce PTSD and early treatment for PTSD may be needed. Group differences for ICU days and ventilator days were clinically significant; statistical significance likely impacted by sample size. COVID ARDS survivors were less likely to have visitors, which may have contributed to PICS sequelae. It is unclear if personal protective equipment and strict isolation may have impacted visitation and contributed to higher PTSD in the COVID ARDS group.