Probable post-traumatic stress disorder following discharge from hospital with COVID-19: prospective cohort study.

Abstract

Background: The psychological consequences of hospital admission for COVID-19, such as post-traumatic stress disorder (PTSD), are under-researched.

Aims: To describe the prevalence of, and risk factors for, psychological trauma symptoms in COVID-19 patients discharged from hospital.

Method: We used data from the Post-Hospitalisation COVID-19 (PHOSP-COVID) study of adults discharged from UK hospitals after COVID-19. Psychological trauma was assessed using the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) 5 and 12 months after discharge. We used log binomial regression to identify risk factors for probable PTSD.

Results: We describe 1565 study participants discharged from hospital between February 2020 and March 2021 following an admission for COVID-19. Most were male (61.3%), White (77.4%) and from more deprived areas (62%). Of these, 15% had probable PTSD (PCL-5 ≥34) at 5 months which was associated with being 18 to 50 years old (risk ratio: 3.0 (2.1- 4.3), p < 0.001), lower income (e.g. <£19,001, risk ratio 2.1, 95% CI: 1.5 - 2.8, p < 0.001), longer admission and a history of depression or anxiety. Out of 236, 136 (57.6%) with probable PTSD at 5 months still had probable PTSD at 12 months. Persistence was associated with intensive care unit (ICU) admission (risk ratio 1.3, 95% CI 1.1-1.6, p < 0.001) and higher anxiety and PCL-5 scores at 5 months.

Conclusions: Probable PTSD was common 5 months after admission for COVID-19 and was associated with lower socioeconomic status, longer admission and previous depression or anxiety. Over half remained symptomatic at 12 months, associated with ICU admission and higher 5-month PCL-5 scores.