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

• DOI: 10.1513/annalsats.202209-793oc
• Publication Date: 2022-12-12T17:31:00Z
• Authors: Melanie Ambler; Sarah Rhoads; Ryan Peterson; Ying Jin; Priscilla Armstrong; Priscilla Collier; Margaret Hope Cruse; Nicholas Csikesz; May Hua; Ruth A. Engelberg; Karin Halvorson; Joanna Heywood; Melissa Lee; Keely Likosky; Megan Mayer; Donald McGuirl; Marc Moss; Elizabeth Nielsen; Olivia Rea; Wendy Tong; James Wykowski; Stephanie Yu; Renee D. Stapleton; J. Randall Curtis; Timothy Amass
• Keywords: Stress Disorders, Post-Traumatic; 03 medical and health sciences; 0302 clinical medicine; Critical Illness; Humans; COVID-19; Family; Prospective Studies; Original Research

Rationale: 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. Objectives: We studied changes in PTSD symptoms in family members of critically ill patients with COVID-19 over 12 months. Methods: 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. Results: 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%, n = 40), recovered symptoms (33.0%, n = 38), and nondevelopment of symptoms (32.2%, n = 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; P < 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; P < 0.001]). Conclusions: 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.