Post-traumatic Stress Disorder Symptoms and Quality of Life of COVID-19 Survivors at 6-Month Follow-Up: A Cross-Sectional Observational Study

Liqun Huang; Xiaohua Xu; Lingjie Zhang; Danwen Zheng; Yuntao Liu; Bing Feng; Jiajun Hu; Qiaoli Lin; Xiaotu Xi; Qian Wang; Meixuan Lin; Xin Zhou; Zehui He; Heng Weng; Qiuying Deng; Banghan Ding; Jianwen Guo; Zhongde Zhang

doi:10.3389/fpsyt.2021.782478

Post-traumatic Stress Disorder Symptoms and Quality of Life of COVID-19 Survivors at 6-Month Follow-Up: A Cross-Sectional Observational Study

Front Psychiatry. 2022 Jan 10:12:782478. doi: 10.3389/fpsyt.2021.782478. eCollection 2021.

Authors

Liqun Huang¹, Xiaohua Xu¹, Lingjie Zhang², Danwen Zheng³, Yuntao Liu³, Bing Feng⁴, Jiajun Hu², Qiaoli Lin⁵, Xiaotu Xi³, Qian Wang¹, Meixuan Lin¹, Xin Zhou¹, Zehui He⁶, Heng Weng⁶, Qiuying Deng³, Banghan Ding³, Jianwen Guo⁷, Zhongde Zhang^{3

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Affiliations

¹ The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
² Department of Medical Administration, Hubei Provincial Hospital of Traditional Chinese and Western Medicine, Wuhan, China.
³ Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
⁴ Department of Pharmacology of Traditional Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
⁵ Department of Geriatrics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
⁶ Department of Clinical Epidemiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
⁷ Department of Medical Administration, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
⁸ Guangdong Provincial Key Laboratory of Research on Emergency in Traditional Chinese Medicine, Guangzhou, China.

Abstract

Background: Post-traumatic stress disorder (PTSD) is the most common psychiatric sequelae among novel coronavirus disease (COVID-19) patients. The aim of this study was to determine the prevalence of PTSD symptoms, PTSD-related factors, and its relationship with quality of life at long-term follow-up in hospitalized COVID-19 survivors. Methods: A cross-sectional study was undertaken to evaluate the health consequences of hospitalized COVID-19 survivors. All participants were interviewed face-to-face through a series of questionnaires: a researcher-developed symptom questionnaire, the Post-traumatic Stress Disorder Checklist-Civilian Version, the Generalized Anxiety Disorder 7-item, and the 36-item Short Form. Results: A total of 574 participants were enrolled with an average age of 57 years. The median follow-up time post-discharge was 193.9 days (SD = 15.32). Among the participants, 77.9% of survivors presented with at least one symptom, where fatigue or muscle weakness (47.9%) was reported the most frequently, followed by chest distress (29.4%) and sleep difficulty (29.4%). The prevalence of PTSD was 11.15% [95% confidence interval (CI): 8.56, 13.73] with a cut-off score of 44. Factors such as respiratory symptoms [odds ratio (OR): 3.53; 95% CI: 1.68-7.42], anxiety (OR: 14.64; 95% CI: 7.09-30.21), and sleep difficulty (OR: 2.17; 95% CI: 1.14-4.16) were positively related to PTSD. Those COVID-19 survivors with potential PTSD had significantly lower quality of life than those without (P < 0.05). Conclusion: Our study illustrated that a significant number of COVID-19 survivors were suffering from physical or mental distress to varying degrees at 6 months post-discharge. People with PTSD were more likely to experience persistent respiratory symptoms and sleep difficulty, as well as anxiety and a decreased quality of life. Such survivors require greater attention to their mental health, particularly the PTSD symptoms at the early phase, which may play an important role in the recovery of both the physical and psychological health of COVID-19 survivors.

Keywords: COVID-19; clinical sequelae; post-traumatic stress disorder; quality of life (QoL); survivors.