Vlake Johan H, Van Bommel Jasper, Hellemons Merel E, Wils Evert-Jan, Bienvenu O Joseph, Schut Anna F C, Klijn Eva, Van Bavel Marten P, Gommers Diederik, Van Genderen Michel E
Department of Intensive Care, Erasmus Medical Center, Rotterdam, the Netherlands.
Department of Intensive Care, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.
Crit Care Explor. 2021 Aug 10;3(8):e0497. doi: 10.1097/CCE.0000000000000497. eCollection 2021 Aug.
To quantify short- and long-term psychologic distress, that is, symptoms of posttraumatic stress disorder, anxiety, and depression, and the health-related quality of life in coronavirus disease 2019 ICU survivors.
A prospective, observational cohort study.
Postcoronavirus disease 2019 clinics of three hospitals in Rotterdam, the Netherlands.
Adult patients admitted for coronavirus disease 2019 to the ICU, who visited the postcoronavirus disease 2019 follow-up clinic.
The primary outcomes were psychologic distress and overall and mental health-related quality of life, assessed using the Impact of Event Scale-Revised, Hospital Anxiety and Depression Scale, Short-Form 36, and European Quality of Life 5D, 6 weeks, 3 months, and 6 months post hospital discharge. Second, we compared 3-month psychologic and mental health-related quality of life outcomes with a historical critical illness survivor cohort and overall and mental health-related quality of life with the Dutch population. We included 118 patients with a median age of 61 years (95% range, 36-77 yr) of whom 79 (68%) were male. At 6 weeks, 13 patients (23%) reported psychologic distress, copresence of probable psychiatric disorders was common, and no decline in psychologic distress was observed throughout follow-up. Coronavirus disease 2019 patients tend to suffer less from posttraumatic stress disorder and reported less severe symptoms of anxiety (Hospital Anxiety and Depression Scale Anxiety Score: 3 [0-17] vs 5 [0-16]; estimated mean difference 2.3 [95% CI, 0.0-4.7]; = 0.05) and depression (Hospital Anxiety and Depression Scale Depression Score: 3 [0-15] vs 5 [0-16]; estimated mean difference 2.4 [95% CI, 0.1-2.4]; = 0.04) than the historical critical illness cohort. Overall and mental health-related quality of life increased over time. Coronavirus disease 2019 ICU survivors reported better mental health-related quality of life than our historical cohort, but overall and mental health-related quality of life was still poorer than the Dutch population.
Psychologic distress was common in coronavirus disease 2019 ICU survivors and remained similar until 6 months after hospital discharge. Health-related quality of life increased over time and was higher than in a historical cohort, but was lower than in the Dutch population. Our findings highlight that coronavirus disease 2019 ICU survivors should be monitored after ICU treatment to detect possible psychologic distress.
为了量化新型冠状病毒肺炎重症监护病房幸存者的短期和长期心理困扰，即创伤后应激障碍、焦虑和抑郁症状，以及与健康相关的生活质量。
一项前瞻性观察性队列研究。
荷兰鹿特丹三家医院的新型冠状病毒肺炎后诊所。
因新型冠状病毒肺炎入住重症监护病房的成年患者，他们前往新型冠状病毒肺炎后随访诊所就诊。
主要结局是心理困扰以及整体和心理健康相关的生活质量，使用事件影响量表修订版、医院焦虑抑郁量表、简明健康调查问卷36项和欧洲五维健康量表在出院后6周、3个月和6个月进行评估。其次，我们将3个月时的心理和心理健康相关生活质量结果与一个历史重症疾病幸存者队列进行比较，并将整体和心理健康相关生活质量与荷兰人群进行比较。我们纳入了118名患者，中位年龄为61岁（95%范围，36 - 77岁），其中79名（68%）为男性。在6周时，13名患者（23%）报告有心理困扰，可能的精神障碍共病很常见，并且在整个随访期间未观察到心理困扰的下降。新型冠状病毒肺炎患者往往较少患创伤后应激障碍，并且报告的焦虑症状（医院焦虑抑郁量表焦虑评分：3[0 - 17]对5[0 - 16]；估计平均差异2.3[95%置信区间，0.0 - 4.7]；P = 0.05）和抑郁症状（医院焦虑抑郁量表抑郁评分：3[0 - 15]对5[0 - 16]；估计平均差异2.4[95%置信区间，0.1 - 2.4]；P = 0.04）比历史重症疾病队列轻。整体和心理健康相关的生活质量随时间提高。新型冠状病毒肺炎重症监护病房幸存者报告的心理健康相关生活质量比我们的历史队列更好，但整体和心理健康相关生活质量仍比荷兰人群差。
心理困扰在新型冠状病毒肺炎重症监护病房幸存者中很常见，并且在出院后6个月内保持相似。与健康相关的生活质量随时间提高，且高于历史队列，但低于荷兰人群。我们的研究结果强调，新型冠状病毒肺炎重症监护病房幸存者在重症监护治疗后应进行监测，以检测可能的心理困扰。
