1 in 3 Covid patients put on a ventilator experience extensive symptoms of PTSD

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1 in 3 (35%) Covid patients put on a ventilator experience extensive symptoms of PTSD  

• 1 in 5 (18%) Covid patients hospitalised without requiring a ventilator also experience extensive symptoms 

• Findings highlight the importance of mental health follow-up and access to mental health treatment for Covid patients  

1 in 3 (35%) Covid-19 patients put on a ventilator experience extensive symptoms of post-traumatic stress disorder (PTSD), according to new research by Imperial College London and the University of Southampton, published in the Royal College of Psychiatrists’ BJPsych Open today.

The findings come as the numbers of Covid-19 patients in hospital have reached a record high in the UK, far exceeding the numbers in May when the study was conducted.

The researchers surveyed symptoms of PTSD in over 13,000 UK patients with experience of confirmed or suspected Covid-19. Extensive symptoms of PTSD were found in 35% of patients put on a ventilator and 18% of patients hospitalised without requiring a ventilator. They also found lower levels of extensive symptoms of PTSD for patients given medical help at home (16%) and patients who required no help at home but experienced breathing problems (11%). The symptoms of PTSD can start immediately or after a delay, but usually within 6 months of the traumatic event. A traumatic event is one where you see that you are in danger, your life is threatened, or where you see other people dying or being injured. Without timely treatment, PTSD symptoms can continue for years and prevent people from moving on with their lives.

The most common PTSD symptom experienced by Covid-19 patients was intrusive images, sometimes known as ‘flashbacks’. For example, this could be intrusive images of the ICU environment, ICU doctors wearing full PPE or other patients in the ICU.

Dr Adam Hampshire, from Imperial College London, said:

"The data collected from our online studies is helping to provide insights into the psychological impact of Covid-19. We can see that the pandemic is likely to be having an acute and lasting impact, including for a significant proportion of patients who remained at home with respiratory problems and received no medical help. This evidence could be important for informing future therapy and reducing the long-term health burden of this disease."

The researchers adapted a clinical questionnaire, selecting 10 questions on symptoms of PTSD most relevant to Covid, including intrusive images, trying to ‘erase’ memories and being easily startled. While 35% of patients put on a ventilator experienced all 10 of these symptoms, 41% of all Covid patients experienced at least one to an ‘extremely’ high degree.

Professor Sam Chamberlain, from the University of Southampton, said:

“This study adds to mounting evidence linking Covid-19 to population-level negative mental health effects and shows that these can be measured conveniently in the general population using innovative digital methodologies.” 

The authors argue this demonstrates the importance of following up with Covid-19 patients for symptoms of PTSD. More detailed research, looking at symptoms of PTSD over time, is also essential for understanding the full impact of the virus on mental health and demand for mental health services.

Dr Adrian James, President of the Royal College of Psychiatrists, said:

“It is clear that Covid-19 can have serious mental health consequences. This virus isn’t just a threat to our physical health, it also poses significant risks to mental health during and following the illness. 

“Over 400,000 patients have been hospitalised from Covid in the UK and sadly there will be more to come. Many of those fortunate enough to survive their ordeal will experience a significant impact on their mental health.

“Effective and joined up follow-up care must be provided after discharge and mental health services must be adequately expanded to treat increasing numbers of people with PTSD symptoms.”

Data were collected in May 2020 via an online survey as part of a broader citizen science study. The researchers controlled for a range of variables, including age, gender, ethnicity, income and medical history. The inclusion criteria for participants were being aged 16 or older and reporting previously having been ill with Covid-19.