The course and determinants of post-traumatic stress over 12 months after hospitalization for COVID-19

Knut Stavem; Trond Heir; Toril Dammen; Eivind Brønstad; Tøri Vigeland Lerum; Michael T Durheim; Kristine M A Lund; Bernt B Aarli; Gunnar Einvik

doi:10.3389/fpsyt.2022.931349

The course and determinants of post-traumatic stress over 12 months after hospitalization for COVID-19

Front Psychiatry. 2022 Jul 15:13:931349. doi: 10.3389/fpsyt.2022.931349. eCollection 2022.

Authors

Knut Stavem^{1

2

3}, Trond Heir^{2

4}, Toril Dammen^{2

5}, Eivind Brønstad^{6

7}, Tøri Vigeland Lerum^{2

8}, Michael T Durheim^{2

9}, Kristine M A Lund¹⁰, Bernt B Aarli^{11

12}, Gunnar Einvik^{1

2}

Affiliations

¹ Department of Pulmonary Medicine, Akershus University Hospital, Lørenskog, Norway.
² Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
³ Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.
⁴ Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.
⁵ Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
⁶ Thoracic Department, St. Olavs Hospital, Trondheim, Norway.
⁷ Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
⁸ Department of Pulmonary Medicine, Oslo University Hospital Ullevål, Oslo, Norway.
⁹ Department of Respiratory Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
¹⁰ Department of Infectious Diseases, Østfold Hospital Trust Kalnes, Grålum, Norway.
¹¹ Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.
¹² Department of Clinical Science, University of Bergen, Bergen, Norway.

Abstract

Objective: To assess the trajectory of symptoms and symptom-defined post-traumatic stress disorder (PTSD) from 1.5 to 12 months after hospitalization for COVID-19 and determine risk factors for persistent symptoms and PTSD.

Methods: This was a prospective cohort study of consecutive patients discharged after hospitalization for COVID-19 before 1 June 2020 in six hospitals in Southern Norway. Symptom-defined PTSD was assessed by the post-traumatic stress disorder (PTSD) checklist for DSM-5 (PCL-5) at 1.5, 3 and/or 12 months after hospitalization, using DSM-5 criteria. Changes in PCL-5 symptom score and the prevalence of PTSD were analyzed with multivariable mixed models.

Results: In total, 388 patients were discharged alive, and 251 (65%) participated. Respondents had a mean (SD) age of 58.4 (14.2) years, and 142 (57%) were males. The prevalence of symptom-defined PTSD was 14, 8, and 9% at 1.5, 3, and 12 months, respectively. WHO disease severity for COVID-19 was not associated with PCL-5 scores. Female sex, lower age and non-Norwegian origin were associated with higher PCL-5 scores. The odds ratio (OR) (95%CI) for PTSD was 0.32 (0.12 to 0.83, p = 0.019) at 3 months and 0.38 (0.15 to 0.95, p = 0.039) at 12 months compared to 1.5 months. There was no association between PTSD and WHO severity rating.

Conclusions: The level of PTSD symptoms decreased from 1.5 to 3 months after hospitalization, but did not decrease further to 12 months, and there was no association between PTSD symptoms and COVID-19 disease severity.

Keywords: COVID-19; PCL-5 questionnaire; cohort; follow-up; medium-term; post-traumatic stress disorder (PTSD).