PDF(Pubmed)
Abstract：
Background: Intensive care unit (ICU) admission and invasive mechanical ventilation (IMV) are associated with psychological distress and trauma. The COVID-19 pandemic brought with it a series of additional long-lasting stressful and traumatic experiences. However, little is known about comorbid depression and post-traumatic stress disorder (PTSD).Objective: To examine the occurrence, co-occurrence, and persistence of clinically significant symptoms of depression and PTSD, and their predictive factors, in COVID-19 critical illness survivors.Method: Single-centre prospective observational study in adult survivors of COVID-19 with ≥24 h of ICU admission. Patients were assessed one and 12 months after ICU discharge using the depression subscale of the Hospital Anxiety and Depression Scale and the Davidson Trauma Scale. Differences in isolated and comorbid symptoms of depression and PTSD between patients with and without IMV and predictors of the occurrence and persistence of symptoms of these mental disorders were analysed.Results: Eighty-nine patients (42 with IMV) completed the 1-month follow-up and 71 (34 with IMV) completed the 12-month follow-up. One month after discharge, 29.2% of patients had symptoms of depression and 36% had symptoms of PTSD; after one year, the respective figures were 32.4% and 31%. Coexistence of depressive and PTSD symptoms accounted for approximately half of all symptomatic cases. Isolated PTSD symptoms were more frequent in patients with IMV (p≤.014). The need for IMV was associated with the occurrence at one month (OR = 6.098, p = .005) and persistence at 12 months (OR = 3.271, p = .030) of symptoms of either of these two mental disorders.Conclusions: Comorbid depressive and PTSD symptoms were highly frequent in our cohort of COVID-19 critical illness survivors. The need for IMV predicted short-term occurrence and long-term persistence of symptoms of these mental disorders, especially PTSD symptoms. The specific role of dyspnea in the association between IMV and post-ICU mental disorders deserves further investigation.Trial registration: ClinicalTrials.gov identifier: NCT04422444.
Clinically significant depressive and post-traumatic stress disorder symptoms in survivors of COVID-19 critical illness, especially in patients who had undergone invasive mechanical ventilation, were highly frequent, occurred soon after discharge, and persisted over the long term.
Clinically significant depressive and post-traumatic stress disorder symptoms in survivors of COVID-19 critical illness, especially in patients who had undergone invasive mechanical ventilation, were highly frequent, occurred soon after discharge, and persisted over the long term.
摘要：
背景：重症监护病房（ICU）入院和有创机械通气（IMV）与心理困扰和创伤有关。COVID-19大流行带来了一系列额外的持久压力和创伤经历。然而,对共病抑郁症和创伤后应激障碍（PTSD）知之甚少。目的：检查发生，共现,抑郁症和创伤后应激障碍的临床症状持续存在，以及它们的预测因素，在COVID-19危重病幸存者中。方法：对入住ICU≥24小时的COVID-19成年幸存者进行单中心前瞻性观察性研究。在ICU出院后1个月和12个月，使用医院焦虑和抑郁量表和戴维森创伤量表的抑郁量表对患者进行评估。分析了有和没有IMV的患者之间抑郁和PTSD的孤立和共病症状的差异，以及这些精神障碍症状的发生和持续存在的预测因素。结果：89例患者（42例患有IMV）完成了1个月的随访，71例（34例患有IMV）完成了12个月的随访。出院后一个月，29.2%的患者有抑郁症状,36%的患者有PTSD症状;一年后,分别为32.4%和31%。抑郁症和PTSD症状并存约占所有症状病例的一半。孤立的PTSD症状在IMV患者中更为常见（p≤0.014）。对IMV的需求与这两种精神障碍中任何一种的症状在一个月时的发生（OR=6.098，p=0.005）和在12个月时的持续（OR=3.271，p=0.030）相关。结论：在我们的COVID-19危重病幸存者队列中，共患抑郁症和PTSD症状非常常见。对IMV的需求预测了这些精神障碍症状的短期发生和长期持续，特别是PTSD症状。呼吸困难在IMV与ICU后精神障碍之间的关联中的具体作用值得进一步研究。试用注册：ClinicalTrials.gov标识符：NCT04422444。
COVID-19危重病幸存者的临床显着抑郁和创伤后应激障碍症状，特别是在接受有创机械通气的患者中，非常频繁，发生在出院后不久，并长期坚持。
COVID-19危重病幸存者的临床显着抑郁和创伤后应激障碍症状，特别是在接受有创机械通气的患者中，非常频繁，发生在出院后不久，并长期坚持。
