Posttraumatic stress disorder (PTSD) had a prevalence of 30.2% among acute COVID-19 infection survivors, researchers found in a cross-sectional study published in JAMA Psychiatry. They found that women, those with history of psychiatric disorders, and those who experienced acute COVID-19 characteristics of delirium or agitation and persistent COVID-19 symptoms were more likely to develop PTSD.
The researchers sought to find out whether the prevalence of PTSD in COVID-19 survivors was similar to that found in previous coronavirus epidemics, which according to meta-analytics findings was 32.2% (95% CI, 23.7-42.0).
The researchers studied data of 381 consecutive White patients (166 women, 215 men) who had presented to the emergency department with SARS-CoV-2 and recovered from the COVID-19 infection within 30 to 120 days. The patients then were referred for postrecovery health check to a post-acute care service April 21, 2020, to October 15, 2020, in Rome, Italy.
The patients had a mean age of 55.26 years (standard deviation [SD]: 14.86; range, 18-89). The vast majority (309 of 381) had been hospitalized during the acute COVID-19 illness, with a mean stay of 18.41 (17.27) days.
Psychiatrists diagnosed PTSD according to the criterion-standard Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). They reached a Cohen κ interrater reliability of 0.82. The patients had to have had at least 1 DSM-5 criterion B and C symptom, at least 2 criterion D and E symptoms, and both Criteria F and G.
PTSD was found in 115 participants (30.2%). Other diagnoses included depressive episode (66 [17.3%]), hypomanic episode (3), generalized anxiety disorder (27 [7.0%]), and psychotic disorders (1).
Data from all patients, with and without PTSD, were compared with the χ2 test for nominal variables and one-way analysis of variance for continuous variables.
The researchers found that patients with PTSD were more likely to be women (64 [55.7%]), reported higher rates of history of psychiatric disorders (40 [34.8%]) and delirium or agitation during acute illness (19 [16.5%]), and presented with more persistent medical symptoms in the post-illness stage (more than 3 symptoms, 72 [62.6%]).
Logistic regression specifically identified sex (Wald1 = 4.79; P =.02), delirium or agitation (Wald1 = 5.14; P =.02), and persistent medical symptoms (Wald2 = 12.46; P =.002) as factors associated with PTSD.
The limitations of the study included its small sample size and cross-sectional design because PTSD symptom rates can vary over time. The single-center study also did not include a control group of patients who presented to the emergency department for other reasons.
Disclosure: One study author declared affiliations with the industry. Please see the original reference for a full list of authors’ disclosures.
Janiri D, Carfi A, Kotzalidis GD, Bernabei R, Landi F, Sani G. Gemelli Against COVID-19 Post-Acute Care Study Group. Posttraumatic stress disorder in patients after severe COVID-19 infection. JAMA Psychiatry. Published online February 18, 2021. doi:10.1001/jamapsychiatry.2021.0109