Abstract
Background: Post-traumatic stress disorder (PTSD) is the most common psychiatric sequelae among novel coronavirus disease (COVID-19) patients. The aim of this study was to determine the prevalence of PTSD symptoms, PTSD-related factors, and its relationship with quality of life at long-term follow-up in hospitalized COVID-19 survivors.Methods: A cross-sectional study was undertaken to evaluate the health consequences of hospitalized COVID-19 survivors. All participants were interviewed face-to-face through a series of questionnaires: a researcher-developed symptom questionnaire, the Post-traumatic Stress Disorder Checklist–Civilian Version, the Generalized Anxiety Disorder 7-item, and the 36-item Short Form.Results: A total of 574 participants were enrolled with an average age of 57 years. The median follow-up time post-discharge was 193.9 days (SD = 15.32). Among the participants, 77.9% of survivors presented with at least one symptom, where fatigue or muscle weakness (47.9%) was reported the most frequently, followed by chest distress (29.4%) and sleep difficulty (29.4%). The prevalence of PTSD was 11.15% [95% confidence interval (CI): 8.56, 13.73] with a cut-off score of 44. Factors such as respiratory symptoms [odds ratio (OR): 3.53; 95% CI: 1.68–7.42], anxiety (OR: 14.64; 95% CI: 7.09–30.21), and sleep difficulty (OR: 2.17; 95% CI: 1.14–4.16) were positively related to PTSD. Those COVID-19 survivors with potential PTSD had significantly lower quality of life than those without (P < 0.05).Conclusion: Our study illustrated that a significant number of COVID-19 survivors were suffering from physical or mental distress to varying degrees at 6 months post-discharge. People with PTSD were more likely to experience persistent respiratory symptoms and sleep difficulty, as well as anxiety and a decreased quality of life. Such survivors require greater attention to their mental health, particularly the PTSD symptoms at the early phase, which may play an important role in the recovery of both the physical and psychological health of COVID-19 survivors.
Highlights
The novel coronavirus disease (COVID-19) has spread rapidly throughout the world with millions of people infected by the severe acute respiratory syndrome coronavirus 2 (SARS-COV2), while the clinical spectrum of SARS-COV-2 infection ranges from asymptomatic infection to life-threatening and fatal disease
129 COVID-19 survivors treated in other hospitals during the acute phase in Wuhan were recruited through our social media channels and completed the assessment
According to the results of the univariate analyses (Tables 1, 2), we found that female survivors (P = 0.013); those who were with ongoing symptoms at discharge (P = 0.001); those who struggled with long-lasting symptoms at follow-up (P < 0.001), including general (P < 0.001), respiratory (P < 0.001), and digestive (P < 0.001) symptoms; those who experienced difficulty in sleeping (P < 0.001); and those who had a lower score in GAD-7 (P < 0.001), physical component summary (PCS) (P < 0.001), or mental component summary (MCS) (P < 0.001) were more likely to be accompanied by posttraumatic stress disorder (PTSD) symptoms
Summary
The novel coronavirus disease (COVID-19) has spread rapidly throughout the world with millions of people infected by the severe acute respiratory syndrome coronavirus 2 (SARS-COV2), while the clinical spectrum of SARS-COV-2 infection ranges from asymptomatic infection to life-threatening and fatal disease. A systematic review and meta-analysis on severe acute respiratory syndrome coronavirus (SARS) and Middle East respiratory syndrome (MERS) survivors found an increased prevalence of psychological sequelae during both the illness and postillness stages [4], including depression, anxiety, and posttraumatic stress disorder (PTSD). The prevalence of PTSD symptoms is in the range of 3% among the general population, which increases to over 40% among the survivors of coronavirus [6, 7]. Follow-up studies on Ebola virus disease and SARS have shown that PTSD symptoms were the most common psychological sequelae [8, 9]. Post-traumatic stress disorder (PTSD) is the most common psychiatric sequelae among novel coronavirus disease (COVID-19) patients. The aim of this study was to determine the prevalence of PTSD symptoms, PTSD-related factors, and its relationship with quality of life at long-term follow-up in hospitalized COVID-19 survivors
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