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

BACKGROUND: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. TRIAL REGISTRATION: The study was reviewed and approved by the Ethics committee of the Medical Association of Saarland (Number 98/22).