Impact on the mental health of family members of severe COVID-19 patients

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The severe disease process affects survivors as well as their families. This fallout is known as Family Post Intensive Care Syndrome (PICS-F). The long-term impact may lower the quality of life for family members of severe Covid-19 survivors.

New disabilities and persistent symptoms seen in Covid-19 survivors have already been described in the literature and analyzed here on the portal. Post-Covid Syndrome long covid It may involve an impact on survivors’ mental health, functional ability and return to work. However, the impact on the long-term mental health of family members of serious COVID-19 patients admitted to the intensive care unit remains unknown.

About the study

Posted in Intensive care medicinein February 2022, the article Mental health symptoms in family members of COVID-19 survivors in the intensive care unit 3 and 12 months after ICU admission: a prospective multicenter study. The aim of the study was to assess the prevalence of symptoms related to mental health and quality of life of family members of Covid-19 survivors who were admitted to the intensive care unit. The analysis included periods of three and twelve months after admission to the intensive care unit. In addition, it aims to explore the risk factors associated with affecting the mental health of this population.

This is a prospective cohort study involving intensive care units from ten hospitals in the Netherlands. To recruit family members, 254 acute COVID-19 survivors who were admitted to the intensive care unit were included. These patients were admitted to the intensive care unit during the first wave of cases in the Netherlands, represented by the period from March 2020 to July 2020.

Patients were included in the study after discharge from the intensive care unit. Once inclusion occurred, shortly after hospital discharge, the closest family members were contacted for inclusion in the study, with consent. Three questionnaires were delivered to family members at three different times:

Questionnaire 0 (baseline) – on perceived quality of life prior to patient admission to the intensive care unit. A reply was made shortly after embedding.
Questionnaire 1 – Presentation is made three months after the patient is admitted to the intensive care unit;
Questionnaire 2 – Presentation is made twelve months after the patient’s admission to the intensive care unit.

The surveyed findings were symptoms related to depression, anxiety, and post-traumatic stress disorder (PTSD). For symptoms related to anxiety and depression, the HADS (Hospital Anxiety and Depression Scale) was used. To measure PTSD, the revised Event Impact Scale (IES-R) was used. In addition, quality of life was measured using the SF-12 (Short Form Health Survey), PCS (Physical Components Summary) and MCS (Mental Components Summary).

know more: Covid-19 severe impact on new disabilities and return to work

consequences

A total of 197 family members agreed to participate in the study. 166 family members completed baseline questionnaires and twelve-month follow-up questionnaires. Of these 166 individuals, only 153 individuals completed the three-month questionnaire. The average age of the family members was 57.8 years. About 55% of household members reported experiencing symptoms of COVID-19.

Let us now evaluate the main findings related to Mental health of family members:

The Prevalence of symptoms of anxiety and depression I was much higher At a twelve-month follow-up compared to baseline. However, the peak in the assessment occurred for three months.

– Worried: Before admission to the intensive care unit (17%), three months (31.6%) and twelve months (29%);

depression Before admission to the intensive care unit (15.8%), three months (28.3%) and twelve months (22.8%);

related to Post-traumatic stress disorder (PTSD)At three months the prevalence was 29.6% and at twelve months it was 20.2%.
compared to the baseline, Family members had significantly more mental health-related symptoms, at three and twelve months: a positive mental composite score of 22.4% vs. 46.1% (p < 0.001) and 22.4% vs. 38.3% (p < 0.001), respectively.

at Regarding returning to work, A total of 104 family members worked before the survivors were admitted to the intensive care unit. Twelve months later admission to the intensive care unit, Twenty-nine family members reported work-related problems.

Risk factors associated with affecting mental health

After multivariate analysis, the existence anxiety and depression, Before admission to the intensive care unit was Significantly associated risk factors with a twist Mental health symptoms in family members, twelve months After admission to the intensive care unit (p = 0.002).

Authors’ conclusions

As of publication of this study, there are no other studies in the literature showing outcomes within twelve months of mental health in family members of patients who have survived severe COVID-19 illness.

Severe COVID-19 disease not only imposes long-term symptoms on surviving patients, but also affects their families. Three and twelve months after ICU admission, the prevalence of mental health-related symptoms in family members of COVID-19 survivors (who were hospitalized in the ICU) is significantly higher compared to the pre-ICU condition. In addition, family members have reduced quality of life and difficulty returning to work.

Practical messages

Post-Covid Syndrome long covid It presents a variety of clinical manifestations in acute COVID-19 survivors. A greater number and variety of symptoms have been documented in post-severe patients;
The aforementioned study indicates that family members also suffer from the impact of serious illness affecting family members;
Attention is drawn to the high prevalence of mental symptoms in family members (anxiety and depression), peaking at three months.
In many centers, there have been restrictions on visits or lack of communication with family members due to health issues related to the epidemic.
The above findings can help guide strategies for family members (eg, improved communication, humanization of care and flexible visits) for mitigating the impact on mental health and should be known to teams and institutions.

author:

Specialist in Intensive Care Medicine by the Brazilian Association of Intensive Medicine (AMIB) ⦁ Clinical Research Fellowship in Intensive Care Medicine – Hôpital Erasme (University Libre de Bruxelles) ⦁ Routine Physician in the Intensive Care Service of the Hospital of São Domingos (São Luis-MA) ⦁ President of the Association Intensive Care in Maranhão (SOTIMA / AMIB) – Biennial 2022/2023 ⦁ Social media: @FilipeAmado

References:

Heesakkers, H., van der Hoeven, J. G., Corsten, S. et al. Mental health symptoms in family members of COVID-19 survivors in the intensive care unit 3 and 12 months after ICU admission: a prospective multicenter study. Intensive care center (2022). https://doi.org/10.1007/s00134-021-06615-8