Abstract
Suffering from COVID-19 and witnessing the suffering and deaths of patients with COVID-19 may place frontline healthcare workers (HCWs) at particularly high risk for posttraumatic stress disorder (PTSD); however, few data are available on the clinical characteristics of PTSD among frontline HCWs who survived COVID-19 (“surviving HCWs” hereafter). The present study examined the prevalence, correlates, and clinical symptoms of possible PTSD in surviving HCWs 6 months after the COVID-19 outbreak in China. A total of 291 surviving HCWs and 42 age- and gender-matched COVID-19-free frontline HCWs (control group) were recruited and administered the Chinese Essen Trauma Inventory, which was used to assess the presence of possible PTSD according to DSM-IV-TR criteria. Survivors’ clinical data and characteristics of exposure to COVID-19 were collected via self-report questionnaires. Surviving HCWs had significantly higher rates of possible PTSD than controls (19.9% vs. 4.8%, P = 0.017). Correlates of PTSD in survivors were ICU admission (OR = 8.73, P = 0.003), >10 respiratory symptoms during the most symptomatic period of COVID-19 (OR = 3.08, P = 0.006), the residual symptom of dizziness (OR = 2.43, P = 0.013), the residual symptom of difficult breathing (OR = 2.23, P = 0.027), life in danger due to COVID-19 (OR = 16.59, P = 0.006), and exposure to other traumatic events (OR = 2.94, P = 0.035). Less commonly seen PTSD symptoms in survivors were having nightmares about the event (34.5%), suddenly feeling like they were living through the event suddenly (25.9%), being unable to remember an important part of the event (32.8%), and overalertness (31.0%). Nearly one-fifth of the surviving HCWs had possible PTSD 6 months after the COVID-19 outbreak. Mental health services for this vulnerable population should include periodic screening for PTSD, expanded social support, and, when necessary, psychotherapy and psychopharmacological treatment.
Highlights
The ongoing coronavirus disease 2019 (COVID-19) pandemic has been the most severe global public health crisis since the 1918 flu pandemic
Results of the Chi-square test show that survivors with possible posttraumatic stress disorder (PTSD) were significantly more likely to have more than 10 respiratory symptoms during the acute phase, to have been admitted to intensive care unit (ICU), to be physically harmed by COVID-19, to have their lives in danger due to COVID-19, to witness others physically harmed by COVID-19, to witness others’ lives in danger due to COVID-19, and to be exposed to other traumatic events in addition to COVID-19
To the best of our knowledge, this is the first study in China to examine the clinical epidemiology of possible PTSD in frontline healthcare workers (HCWs) who survived COVID-19 6 months after the COVID-19 outbreak
Summary
The ongoing coronavirus disease 2019 (COVID-19) pandemic has been the most severe global public health crisis since the 1918 flu pandemic. Findings from recent studies have shown that posttraumatic stress disorder (PTSD), a common psychological consequence of major disasters and pandemics, has become a substantial mental health challenge for the general population, COVID-19 patients, and healthcare workers (HCWs) [1,2,]. During the period of exponential increase in the number of COVID-. In the early period of the COVID-19 outbreak in many countries, due to inadequate supplies of protective gear, frontline HCWs had to serve under high risk of direct exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [7]. Frontline HCWs have witnessed the suffering and deaths of patients with COVID-19, which increase their susceptibility to PTSD. Studies have reported a significantly higher prevalence of PTSD symptoms and significantly more severe PTSD symptoms in frontline than nonfrontline HCWs [10,11,12]
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