新冠肺炎住院幸存者的创伤后应激症状。

Posttraumatic Stress Symptoms Among COVID-19 Survivors After Hospitalization.

机构信息

Department of Neurology (all authors) and the Evelyn F. McKnight Brain Institute (Sacco, Rundek), University of Miami; Department of Neurology, Jackson Memorial Hospital, Miami (Sobczak, Swafford, Samano, Kottapally, Merenda, O'Phelan, Romano, Sacco, Rundek, Alkhachroum).

出版信息

J Neuropsychiatry Clin Neurosci. 2023 Summer;35(3):256-261. doi: 10.1176/appi.neuropsych.20220126. Epub 2023 Jan 30.

DOI:10.1176/appi.neuropsych.20220126

PMID:36710628

Abstract

OBJECTIVE

Limited data are available on posttraumatic stress symptoms (PTSS) among COVID-19 survivors. This study aimed to contribute to this knowledge base.

METHODS

PTSS among COVID-19 survivors who had been hospitalized were investigated. Patients were identified as COVID-19 positive at hospital admission. COVID-19 survivors were surveyed with the Posttraumatic Stress Disorder Checklist (PCL-5) between March and October 2020 at 5- and 12-month postdischarge follow-up points.

RESULTS

Of 411 patients, 331 (81%) survived to hospital discharge. Of these survivors, 83 (25%) completed the PCL-5 at the 5-month follow-up. Of those patients, 12 (14%) screened positive for PTSS. At the 12-month follow-up, four of eight patients remained PTSS positive. Mean age of follow-up participants was 62±15 years; 47% were women, 65% were White, and 63% were Hispanic. PTSS-positive patients were predominantly non-White (67% vs. 30%, p=0.02), and although the differences were not statistically significant, these patients tended to be younger (56 vs. 63 years, p=0.08) and have shorter intensive care unit stays (2.0 vs. 12.5 days, p=0.06). PTSS-positive and PTSS-negative groups did not differ significantly in prehospitalization neurological diagnoses (11% vs. 8%), psychiatric diagnoses (17% vs. 21%), and intensive care admission status (25% vs. 25%). More patients in the PTSS-positive group had returned to the emergency department (50% vs. 14%, p<0.01) and reported fatigue at follow-up (100% vs. 42%, p<0.001). In the multivariate logistic regression model, non-White race (OR=11, 95% CI=2-91) and returning to the emergency department (OR=19, 95% CI=3-252) were associated with PTSS-positive status.

CONCLUSION

PTSS were twice as common among hospitalized COVID-19 survivors than among those in the general population.

摘要

目的

关于 COVID-19 幸存者的创伤后应激症状（PTSS），目前数据有限。本研究旨在为此提供相关知识基础。

方法

调查了因 COVID-19 住院的幸存者的 PTSS。患者在住院时被确定为 COVID-19 阳性。COVID-19 幸存者在出院后 5 个月和 12 个月的随访点，通过创伤后应激障碍检查表（PCL-5）进行调查。

结果

411 名患者中，有 331 名（81%）存活至出院。在这些幸存者中，有 83 名（25%）在 5 个月的随访中完成了 PCL-5。在这些患者中，有 12 名（14%）筛查出 PTSS 阳性。在 12 个月的随访中，8 名患者中有 4 名仍为 PTSS 阳性。随访参与者的平均年龄为 62±15 岁；47%为女性，65%为白人，63%为西班牙裔。PTSS 阳性患者主要为非白人（67% vs. 30%，p=0.02），虽然差异无统计学意义，但这些患者的年龄较小（56 岁 vs. 63 岁，p=0.08），且 ICU 住院时间较短（2.0 天 vs. 12.5 天，p=0.06）。PTSS 阳性组和 PTSS 阴性组在住院前的神经系统诊断（11% vs. 8%）、精神科诊断（17% vs. 21%）和 ICU 入院状态（25% vs. 25%）方面无显著差异。PTSS 阳性组中有更多的患者返回急诊科（50% vs. 14%，p<0.01），并在随访时报告疲劳（100% vs. 42%，p<0.001）。在多变量逻辑回归模型中，非白人种族（OR=11，95%CI=2-91）和返回急诊科（OR=19，95%CI=3-252）与 PTSS 阳性状态相关。