Anxiety and Depression Symptoms in ICU Survivors After COVID-19

Post-intensive care syndrome includes physical, cognitive and psychological impairments that may persist after discharge from the intensive care unit (ICU), with anxiety and depression among the most commonly reported symptoms. Evidence on these symptoms beyond the first year after discharge remains limited, particularly in patients admitted for COVID-19.

To determine the prevalence and characteristics of anxiety and depression symptoms among patients previously admitted to the ICU for COVID-19 within three years after discharge, and to examine differences according to sociodemographic and clinical variables.

A multicentre, descriptive cross-sectional study was conducted among ICU survivors in Spain using clinical records and structured telephone interviews. Sociodemographic, clinical and patient-reported outcomes were obtained. The Hospital Anxiety and Depression Scale (HADS) was used to assess symptoms of anxiety (HADS-A) and depression (HADS-D).

A total of 106 participants were included. Mean anxiety (HADS-A) and depression (HADS-D) scores were 6.5 (SD ±3.9) and 6.7 (SD ±3.8), respectively. Female sex was linked to higher anxiety (β = 1.73; 95% CI, 0.32-3.13; p = 0.016), while memory problems were associated with higher anxiety (β = 1.49; 95% CI, 0.14-2.83; p = 0.031) and depression (β = 1.65; 95% CI, 0.43-2.86; p = 0.009). Depression was also higher in participants with greater pain (β = 0.50; 95% CI, 0.15-0.84; p = 0.006). Higher quality of life (β = -0.07; 95% CI, -0.11 to -0.03; p < 0.001) was associated with lower depression scores.

Anxiety and depression were common among individuals with a history of ICU admission due to COVID-19 up to three years after discharge. Psychological symptoms should be considered alongside physical and cognitive aspects.

Incorporating psychological assessment into the long-term follow-up may facilitate identifying individuals who may benefit from further support.