Family members of patients admitted to the intensive care unit (ICU) for COVID-19 were more likely to have symptoms of post-traumatic stress disorder (PTSD) than in patients with acute respiratory distress syndrome (ARDS) from another illness, according to researchers.
In a study published in the JAMA Network, a team of French authors conducted a prospective cohort study on 23 intensive care units in France from January to June 2020 – and a final follow-up in October 2020.
ARDS survivors and family members – one family member per patient – was enrolled, with 517 family members in total.
Family members’ symptoms of PTSD 90 days after ICU discharge were measured by the Impact of Events Scale-Revised score, and symptoms of anxiety and depression 90 days were assessed by the Hospital Anxiety and Depression Scale.
The researchers used multivariable logistic regression models to determine the relationship between COVID-19 status and outcomes.
They found PTSD in 35% of family members related to patients with COVID-19 ARDS compared to 19% for other cases of respiratory problems.
Symptoms of anxiety and depression were also higher among family members of patients with COVID-19 ARDS.
According to the authors, the limitations of the study include that the patients were admitted early in the pandemic, that the results may not apply to intensive care units that do not place much focus on family care, that the participating hospitals are in France, that not all patients may have met the strict consensus criteria for ARDS. and that ICU clinical staff did not participate in the study.
“There are many potential explanations for these findings, including the need to comply with strict isolation measures to prevent virus transmission and the strain on intensive care unit staff due to the increase in patient numbers caused by the pandemic. When intensive care units are perceived as closed wards, visitors may feel unwelcome. these closed intensive care units can generate stress and symptoms of anxiety, depression or PTSD in family members. ” they explained, noting that their findings are consistent with previous research.
Finally, they pointed out that perceived social support during intensive care was an important factor associated with family outcomes, citing a study of nearly 900 patients admitted with COVID-19 in China who found that poorer perceived social support was associated with anxiety, depression and PTSD.
Social support is the subjective perception of the extent to which family, friends and other network members are available and helpful.