Prevalence and Risk Factors for Post-Traumatic Stress in Hospitalized and Non-Hospitalized COVID-19 Patients.

Gunnar Einvik,Trond Heir,Waleed Ghanima,Knut Stavem,Toril Dammen

doi:10.3390/ijerph18042079

Abstract

This population-based study assessed the prevalence and determinants of symptom-defined post-traumatic stress disorder (PTSD) in a cohort of hospitalized and non-hospitalized patients about 1.5–6 months after their COVID-19 onset. The data were acquired from two mixed postal/web surveys in June–September 2020 from patients all aged ≥18 years with a positive polymerase chain reaction for severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) until 1 June 2020, comprising both hospitalized and non-hospitalized subjects. The catchment areas of the two included hospitals covers about 17% of the population of Norway. In total, 211 hospitalized and 938 non-hospitalized subjects received invitation. The prevalence of symptom-defined PTSD was assessed using the PTSD checklist for DSM-5 (PCL-5). Determinants of symptom-defined PTSD and PTSD symptoms were analyzed using multivariable logistic and linear regression analysis. In total, 583 (51%) subjects responded at median 116 (range 41–200) days after COVID-19 onset. The prevalence of symptom-defined PTSD was 9.5% in hospitalized and 7.0% in non-hospitalized subjects (p = 0.80). Female sex, born outside of Norway, and dyspnea during COVID-19 were risk factors for persistent PTSD symptoms. In non-hospitalized subjects, previous depression and COVID-19 symptom load were also associated with persistent PTSD symptoms. In conclusion, COVID-19 symptom load, but not hospitalization, was associated with symptom-defined PTSD and PTSD symptom severity.

Highlights

Introduction iationsThe coronavirus disease 2019 (COVID-19) has to date affected more than 100 million people worldwide [1]
Post-traumatic stress disorder (PTSD) is a chronic and debilitating mental condition that may develop in response to catastrophic life events, including critical medical conditions
We investigated post-traumatic stress symptoms in a geographically defined population of hospitalized and non-hospitalized COVID-19-infected subjects on average 3 months after symptom onset

Summary

Introduction

The coronavirus disease 2019 (COVID-19) has to date affected more than 100 million people worldwide [1]. The proportion of cases in Norway having severe disease requiring hospitalization is about 5%, in the early phase of the pandemic, 13% of all cases were hospitalized [2]. Severe COVID-19 is characterized by dyspnea, chest pain, or confusion and 12% of hospitalized patients have critical illness requiring care in the intensive unit. There is considerable concern about being infected [3], and social isolation and quarantine for several weeks or months may have important social and psychological impacts. Post-traumatic stress disorder (PTSD) is a chronic and debilitating mental condition that may develop in response to catastrophic life events, including critical medical conditions. According to a meta-analysis, 17–44% of critical illness survivors report clinically

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