ORIGINAL ARTICLE   

Minerva Medica 2023 April;114(2):169-77

DOI: 10.23736/S0026-4806.22.07847-8

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Post-traumatic stress disorder, depression and anxiety symptoms in COVID-19 outpatients with different levels of respiratory and ventilatory support in the acute phase undergoing three months follow-up

Marta FERRARIS ¹, Marina MAFFONI ² ✉, Vincenzo DE MARZO ³, Antonia PIEROBON ², Marinella SOMMARUGA ⁴, Cristina BARBARA ¹, Annalisa PORCILE ¹, Carmelo RUSSO ¹, Lucio GHIO ⁵, Piero CLAVARIO ¹, Italo PORTO ³

¹ Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale ASL 3 Genovese, Genoa, Italy; ² Unit of Psychology, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Montescano, Pavia, Italy; ³ Unit of Cardiology, DICATOV-Cardiothoracic and Vascular Department, IRCCS San Martino Hospital, Genoa, Italy; ⁴ Unit of Psychology, Istituti Clinici Scientifici Maugeri IRCCS, Camaldoli Institute, Milan, Italy; ⁵ Mental Health Department, ASL 3 Genovese, Genoa, Italy

BACKGROUND: The well-known COVID-19 pandemic totally transformed people’s lives, paving the way to various psychopathological symptoms. In particular, patients may experience a short- and long-term decreasing in their wellbeing. In this vein, the aim of this paper was to assess the COVID-19 patients’ psychopathological profile (post-traumatic stress disorder, distress, anxiety and depression symptoms), detecting possible differences linked to the ventilatory treatments.
METHODS: Outpatients who recovered from COVID-19 were asked to provide socio-demographic and clinical information, and to complete a brief psychological screening evaluation (Impact of Event Scale-Revised [IES-R], Depression Anxiety Stress Scale [DASS-21]).
RESULTS: Overall, after informed consent, 163 Italian patients took part in this research. Of them, 31.9% did not undergo any ventilatory therapy, 27.6% undertook oxygen therapy, 28.2% underwent noninvasive mechanical ventilation, and 12.3% received invasive mechanical ventilation. Although no statistically significant differences were revealed among patients stratified by spontaneous breathing or ventilatory therapies, they reported statistically significant more depression (4.5+5.2 vs. 3.5+3.2; P=0.017) and anxiety (4.3+4.5 vs. 2.4+2.6; P<0.00001) symptoms than normative groups. Moreover, patients experiencing COVID-19 disease as a trauma, complained statistically significant higher levels of depression, anxiety and stress symptoms than who did not describe a clinically relevant traumatic experience (P<0.001).
CONCLUSIONS: Thus, this study suggests to healthcare professionals to consider COVID-19 experience as a potential real trauma for patients, and underlines the necessity to define patients’ psychopathological profile in order to propose tailored and effective preventive and supportive psychological interventions.

KEY WORDS: Stress disorders, post-traumatic; Respiratory distress syndrome; Anxiety; Depression; COVID-19