Psychological impact of an intensive care admission for COVID-19 on patients in the United Kingdom

Background: The psychological impact of surviving an admission to an intensive care unit (ICU) with COVID-19 is uncertain. The objective of the study was to assess the prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in ICU survivors treated for COVID-19 infection, and identify risk factors for psychological distress.

Methods: This observational study was conducted at 52 ICUs in the United Kingdom. Participants, treated for COVID-19 infection during an ICU admission of ⩾24h, were recruited post-ICU discharge. Self-report questionnaires were completed at 3, 6 and/or 12months. Symptoms of anxiety and depression were identified using the Hospital Anxiety and Depression Scale. PTSD was assessed using the Impact of Events Scale-6. Demographic, clinical, physical and psychosocial factors were considered as putative predictors of psychological distress.

Results: 1620 patients provided consent and 1258 (77.7%) responded to at least one questionnaire, with responses at 3months (N=426), 6months (N=656) and 12months (N=1050) following ICU admission. The following prevalence rates were found at 3, 6 and 12months, respectively: anxiety in 28.8% (95% CI 24.6–33.1), 30.4% (95% CI 27.0–33.8) and 29.3% (95% CI 26.5–32.1); depression in 25.1% (21.0–29.3), 25.9% (22.7–29.3) and 24.0% (21.5–26.6); and PTSD in 43.5% (38.8–48.2), 44.3% (40.6–48.0) and 43.2% (40.2–46.1) of patients. Risk factors for psychological distress included a previous mental health diagnosis, unemployment or being on sick leave, and a history of asthma or COPD.

Conclusion: Clinically significant symptoms of anxiety, depression and PTSD were common and persisted up to 12months post-ICU discharge.