Post-traumatic stress disorder following intensive care for COVID-19: a single-center retrospective follow-up study

Severe COVID-19 frequently required prolonged intensive care, including mechanical ventilation or extracorporeal membrane oxygenation (ECMO). Survivors of such critical illness may develop post-traumatic stress disorder (PTSD).

We conducted a single-center retrospective follow-up study of COVID-19 ICU survivors at Saarland University Medical Center, Germany, assessing ICD-11 trauma-related disorders using the validated International Trauma Questionnaire (ITQ) and analyzing associations with clinical factors.

Of 110 eligible patients, 42 (38.2%) valid datasets were obtained. The overall prevalence of ICD-11 trauma-related disorders (PTSD or CPTSD) was 23.8% (95% CI 12.1-39.5%; n = 10), with PTSD diagnosed in 6 participants (14.3%; 95% CI 5.4-28.5%) and CPTSD in 4 participants (9.5%; 95% CI 2.7-22.6%). No statistically significant associations were found for any of the examined variables. Exploratory subgroup analyses revealed numerically higher rates of trauma-related disorders in patients with prior psychiatric treatment (40.0% vs. 21.6%), ECMO therapy (33.3% vs. 16.7%), or renal replacement therapy (50.0% vs. 17.6%); however, these findings should be interpreted with caution given the limited sample size.

Nearly one quarter of COVID-19 ICU survivors met the diagnostic criteria for PTSD or CPTSD, a prevalence comparable to that observed in other critically ill populations. No statistically significant associations were identified, and the observed subgroup differences should be regarded as exploratory and hypothesis-generating. The reported prevalence of PTSD/CPTSD highlights the potential value of systematic screening for trauma-related disorder and the integration of psychological support into post-ICU care. Larger prospective multicenter studies are needed to confirm these findings and further characterize potential risk factors.

The study was reviewed and approved by the Ethics committee of the Medical Association of Saarland (Number 98/22).