Title

One Year Later: Family Members of Patients with COVID-19 Experience Persistent Symptoms of Posttraumatic Stress Disorder

Authors

Melanie Ambler, School of Medicine, Stanford University, Stanford, California.
Sarah Rhoads, Division of Pulmonary Sciences and Critical Care Medicine.
Ryan Peterson, Division of Pulmonary Sciences and Critical Care Medicine.
Ying Jin, Division of Pulmonary Sciences and Critical Care Medicine.
Priscilla Armstrong, Division of Pulmonary, Critical Care, and Sleep Medicine, Cambia Palliative Care Center of Excellence, and.
Priscilla Collier, Division of Internal Medicine, Department of Medicine.
Margaret Hope Cruse, Division of Pulmonary Sciences and Critical Care Medicine.
Nicholas Csikesz, South Shore Health, Weymouth, Massachusetts.
May Hua, Department of Anesthesiology and.
Ruth A. Engelberg, Division of Pulmonary, Critical Care, and Sleep Medicine, Cambia Palliative Care Center of Excellence, and.
Karin Halvorson, Department of Pulmonary Critical Care, School of Medicine, Tulane University, New Orleans, Louisiana.
Joanna Heywood, Division of Pulmonary, Critical Care, and Sleep Medicine, Cambia Palliative Care Center of Excellence, and.
Melissa Lee, Evergreen Health Care, Kirkland, Washington.
Keely Likosky, Evergreen Health Care, Kirkland, Washington.
Megan Mayer, Division of Internal Medicine, Department of Medicine.
Donald McGuirl, Department of Vascular Surgery, Maine Medical Center, Portland, Maine.
Marc Moss, Division of Pulmonary Sciences and Critical Care Medicine.
Elizabeth Nielsen, Division of Pulmonary, Critical Care, and Sleep Medicine, Cambia Palliative Care Center of Excellence, and.
Olivia Rea, Division of Pulmonary, Critical Care, and Sleep Medicine, Cambia Palliative Care Center of Excellence, and.
Wendy Tong, Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
James Wykowski, Department of Medicine, University of Washington, Seattle, Washington.
Stephanie Yu, School of Medicine, University of Colorado, Aurora, Colorado.
Renee D. Stapleton, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont; and.
J Randall Curtis, Division of Pulmonary, Critical Care, and Sleep Medicine, Cambia Palliative Care Center of Excellence, and.
Timothy Amass, Division of Pulmonary Sciences and Critical Care Medicine.

Document Type

Article

Publication Date

5-2023

Journal Title

Annals of the American Thoracic Society

MeSH Headings

Humans; Stress Disorders, Post-Traumatic (etiology); Prospective Studies; Critical Illness; COVID-19 (complications); Family

Abstract

Family members of critically ill patients with coronavirus disease (COVID-19) have described increased symptoms of posttraumatic stress disorder (PTSD). Little is known about how these symptoms may change over time. We studied changes in PTSD symptoms in family members of critically ill patients with COVID-19 over 12 months. This prospective, multisite observational cohort study recruited participants at 12 hospitals in five states. Calls were made to participants at 3-4 months, 6 months, and 12 months after patient admission to the intensive care unit. There were 955 eligible family members, of whom 330 (53.3% of those reached) consented to participate. Complete longitudinal data was acquired for 115 individuals (34.8% consented). PTSD symptoms were measured by the IES-6 (Impact of Events Scale-6), with a score of at least 10 identifying significant symptoms. At 3 months, the mean IES-6 score was 11.9 ± 6.1, with 63.6% having significant symptoms, decreasing to 32.9% at 1 year (mean IES-6 score, 7.6 ± 5.0). Three clusters of symptom evolution emerged over time: persistent symptoms (34.8%,  = 40), recovered symptoms (33.0%,  = 38), and nondevelopment of symptoms (32.2%,  = 37). Although participants identifying as Hispanic demonstrated initially higher adjusted IES-6 scores (2.57 points higher [95% confidence interval (CI), 1.1-4.1;  < 0.001]), they also demonstrated a more dramatic improvement in adjusted scores over time (4.7 greater decrease at 12 months [95% CI, 3.2-6.3;  < 0.001]). One year later, some family members of patients with COVID-19 continue to experience significant symptoms of PTSD. Further studies are needed to better understand how various differences contribute to increased risk for these symptoms.

First Page

713

Last Page

720

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