Long-term Mental Health Morbidity in Adult Survivors of COVID-19 Critical Illness - A Population-based Cohort Study.

IF 9.5 1区医学 Q1 CRITICAL CARE MEDICINE Chest Pub Date : 2025-01-21 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

{"title":"Long-term Mental Health Morbidity in Adult Survivors of COVID-19 Critical Illness - A Population-based Cohort Study.","authors":"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","doi":"10.1016/j.chest.2025.01.012","DOIUrl":null,"url":null,"abstract":"Background: Survivorship after coronavirus disease 2019 (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 post-discharge mental health diagnoses.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 (age ≥ 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/psychotic disorders; and other mental health disorders) following 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 centres. Incidence of new mental health diagnosis among survivors of COVID-19 critical illness was 25.3 per 100-person years (95% confidence interval [CI] 24.0-26.6), and 25.9 per 100-person years (95% CI: 24.0-27.8) among non-COVID-19 pneumonia. Following 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 to survival after critical illness 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 for new mood, anxiety, or related disorders.","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":""},"PeriodicalIF":9.5000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chest","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.chest.2025.01.012","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Survivorship after coronavirus disease 2019 (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 post-discharge mental health diagnoses.

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 (age ≥ 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/psychotic disorders; and other mental health disorders) following 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 centres. Incidence of new mental health diagnosis among survivors of COVID-19 critical illness was 25.3 per 100-person years (95% confidence interval [CI] 24.0-26.6), and 25.9 per 100-person years (95% CI: 24.0-27.8) among non-COVID-19 pneumonia. Following 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 to survival after critical illness 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 for new mood, anxiety, or related disorders.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

求助全文

约1分钟内获得全文去求助

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.