Long-Term Mental Health Morbidity in Adult Survivors of COVID-19 Critical Illness: A Population-Based Cohort Study.

IF 8.6 1区医学 Q1 CRITICAL CARE MEDICINE Chest Pub Date : 2025-06-01 Epub Date: 2025-01-22 DOI:10.1016/j.chest.2025.01.012

Shannon M Fernando, Danial Qureshi, Robert Talarico, Eddy Fan, Daniel I McIsaac, Simone N Vigod, Manish M Sood, Daniel T Myran, Carol L Hodgson, Bram Rochwerg, Laveena Munshi, Kirsten M Fiest, O Joseph Bienvenu, Dale M Needham, Daniel Brodie, Niall D Ferguson, Robert A Fowler, Deborah J Cook, Arthur S Slutsky, Damon C Scales, Margaret S Herridge, Peter Tanuseputro, Kwadwo Kyeremanteng

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Abstract

Background: Surviving COVID-19 critical illness may be associated with important long-term sequelae, but little is known regarding mental health outcomes.

Research question: What is the association between COVID-19 critical illness and new mental health diagnoses after discharge?

Study design and methods: We conducted a population-based cohort study in Ontario, Canada (January 1, 2020-March 31, 2022). We included consecutive adult survivors (aged ≥ 18 years) of COVID-19 critical illness and compared them with consecutive adult survivors of critical illness from non-COVID-19 pneumonia. The primary outcome was a new mental health diagnosis (a composite of mood, anxiety, or related disorders; schizophrenia or psychotic disorders; and other mental health disorders) after hospital discharge. We compared patients using overlap propensity score-weighted, cause-specific proportional hazard models.

Results: We included 6,098 survivors of COVID-19 critical illness and 2,568 adult survivors of critical illness from non-COVID-19 pneumonia at 102 centers. Incidence of new mental health diagnosis among survivors of COVID-19 critical illness was 25.3 diagnoses per 100 person-years (95% CI, 24.0-26.6 diagnoses), and 25.9 diagnoses per 100 person-years (95% CI, 24.0-27.8 diagnoses) among survivors of non-COVID-19 pneumonia. After propensity weighting, COVID-19 critical illness was not associated with increased risk of new mental health diagnosis overall (hazard ratio [HR], 1.08; 95% CI, 0.96-1.23), but was associated with increased risk in the category of new mood, anxiety, or related disorders (HR, 1.21; 95% CI, 1.05-1.40). No difference was seen in psychotic disorders, other mental health diagnoses, social problems, or deliberate self-harm.

Interpretation: As compared with survival after critical illness resulting from non-COVID-19 pneumonia, survival after COVID-19 critical illness was not associated with increased risk of the composite outcome of new mental health diagnosis, but was associated with elevated risk of new mood, anxiety, or related disorders.

Clinical trial registry: Center for Open Science; URL: www.archive.org/details/osf-registrations-pfn6q-v1.

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COVID-19危重疾病成年幸存者的长期精神健康发病率——一项基于人群的队列研究

背景：2019冠状病毒病（COVID-19）危重症后的生存可能与重要的长期后遗症有关，但对心理健康结果知之甚少。研究问题：COVID-19危重疾病与新的出院后心理健康诊断之间的关联是什么？研究设计：与方法：我们在加拿大安大略省进行了一项基于人群的队列研究（2020年1月1日至2022年3月31日）。我们纳入了COVID-19危重疾病的连续成年幸存者（年龄≥18岁），并将其与非COVID-19肺炎危重疾病的连续成年幸存者进行比较。主要结果是新的心理健康诊断(情绪、焦虑或相关障碍的综合诊断；精神分裂症/精神疾病;以及其他精神疾病)我们使用重叠倾向评分加权、原因特异性比例风险模型对患者进行比较。结果：我们纳入了102个中心的6098名COVID-19危重疾病幸存者和2568名非COVID-19肺炎危重疾病成年幸存者。在COVID-19危重疾病幸存者中，新发精神健康诊断的发生率为25.3 / 100人年（95%可信区间[CI] 24.0-26.6），在非COVID-19肺炎患者中为25.9 / 100人年（95% CI: 24.0-27.8）。倾向加权后，COVID-19危重疾病与新精神健康诊断的总体风险增加无关（风险比[HR] 1.08 [95% CI: 0.96-1.23]），但与新情绪、焦虑或相关疾病类别的风险增加相关（HR 1.21 [95% CI: 1.05-1.40]）。在精神障碍、其他心理健康诊断、社会问题或故意自残方面没有发现差异。解释：与非COVID-19肺炎重症后的生存率相比，COVID-19重症后的生存率与新心理健康诊断的综合结局风险增加无关，但与新情绪、焦虑或相关疾病的风险增加相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Chest 医学-呼吸系统

CiteScore

13.70

自引率

3.10%

发文量

3369

审稿时长

15 days

期刊介绍： At CHEST, our mission is to revolutionize patient care through the collaboration of multidisciplinary clinicians in the fields of pulmonary, critical care, and sleep medicine. We achieve this by publishing cutting-edge clinical research that addresses current challenges and brings forth future advancements. To enhance understanding in a rapidly evolving field, CHEST also features review articles, commentaries, and facilitates discussions on emerging controversies. We place great emphasis on scientific rigor, employing a rigorous peer review process, and ensuring all accepted content is published online within two weeks.