One Year Later: Family Members of Patients with COVID-19 Experience Persistent Symptoms of Posttraumatic Stress Disorder

• Published in: Annals of the American Thoracic Society Vol. 20; no. 5; pp. 713 - 720
• Main Authors: Ambler, Melanie, Rhoads, Sarah, Peterson, Ryan, Jin, Ying, Armstrong, Priscilla, Collier, Priscilla, Cruse, Margaret Hope, Csikesz, Nicholas, Hua, May, Engelberg, Ruth A, Halvorson, Karin, Heywood, Joanna, Lee, Melissa, Likosky, Keely, Mayer, Megan, McGuirl, Donald, Moss, Marc, Nielsen, Elizabeth, Rea, Olivia, Tong, Wendy, Wykowski, James, Yu, Stephanie, Stapleton, Renee D, Curtis, J Randall, Amass, Timothy
• Format: Journal Article
• Language: English
• Published: United States American Thoracic Society 01.05.2023
• Subjects: COVID-19; COVID-19 - complications; Critical Illness; Families & family life; Family; Health risk assessment; Humans; Medical research; Original Research; Post traumatic stress disorder; Prospective Studies; Stress Disorders, Post-Traumatic - etiology; COVID-19; intensive care; stress disorders; post traumatic
• ISSN: 2329-6933; 2325-6621
• DOI: 10.1513/AnnalsATS.202209-793OC

Family members of critically ill patients with coronavirus disease (COVID-19) have described increased symptoms of posttraumatic stress disorder (PTSD). Little is known about how these symptoms may change over time. We studied changes in PTSD symptoms in family members of critically ill patients with COVID-19 over 12 months. This prospective, multisite observational cohort study recruited participants at 12 hospitals in five states. Calls were made to participants at 3-4 months, 6 months, and 12 months after patient admission to the intensive care unit. There were 955 eligible family members, of whom 330 (53.3% of those reached) consented to participate. Complete longitudinal data was acquired for 115 individuals (34.8% consented). PTSD symptoms were measured by the IES-6 (Impact of Events Scale-6), with a score of at least 10 identifying significant symptoms. At 3 months, the mean IES-6 score was 11.9 ± 6.1, with 63.6% having significant symptoms, decreasing to 32.9% at 1 year (mean IES-6 score, 7.6 ± 5.0). Three clusters of symptom evolution emerged over time: persistent symptoms (34.8%,  = 40), recovered symptoms (33.0%,  = 38), and nondevelopment of symptoms (32.2%,  = 37). Although participants identifying as Hispanic demonstrated initially higher adjusted IES-6 scores (2.57 points higher [95% confidence interval (CI), 1.1-4.1;  < 0.001]), they also demonstrated a more dramatic improvement in adjusted scores over time (4.7 greater decrease at 12 months [95% CI, 3.2-6.3;  < 0.001]). One year later, some family members of patients with COVID-19 continue to experience significant symptoms of PTSD. Further studies are needed to better understand how various differences contribute to increased risk for these symptoms.