Post-COVID-19 Consequences in Relatives of Severely Ill Patients: Results of the Prospective Multicenter NeNeSCo Study

TL;DR

This study examines the long-term psychosocial effects on relatives of severely ill COVID-19 patients, finding high levels of stress and anxiety, especially when patients were in the ICU.

Contribution

The study provides new insights into psychosocial outcomes of relatives of COVID-19 patients, highlighting the impact of ICU admission and patient cognitive complaints.

Findings

Relatives of ICU patients had higher levels of anxiety and caregiver burden compared to those of general ward patients.

Anxiety decreased over time, but caregiver burden increased in the overall group.

Relatives' passive coping was the strongest predictor of unfavorable psychosocial outcomes.

Abstract

Severe illness and intensive care treatment pose significant challenges not only for the patients but also for their relatives, known as post-intensive care syndrome in family members (PICS-F). Not much is known about psychosocial outcomes in relatives of former severely ill COVID-19 patients who were hospitalized under pandemic-related challenges. This study aimed to investigate long-term psychosocial outcomes of relatives of formerly hospitalized COVID-19 patients in relation to patient and relative characteristics. Longitudinal data on psychosocial outcomes of relatives of COVID-19 patients, admitted to the general ward or intensive care unit (ICU) in 2020 and enrolled in the multicenter prospective cohort NeNeSCo study, were collected via questionnaires, 9 and 15 months post-hospital discharge of the patient. Outcomes of interest were anxiety, depression, post-traumatic stress symptoms (PTSS), caregiver burden, and quality of life. In general, relatives scored high on PTSS, especially in the ICU group (22.5%). Relatives of ICU patients had higher levels of anxiety and caregiver burden than those of general ward patients. Over time, anxiety decreased while caregiver burden increased in the total group. Factors associated with less favorable outcomes in terms of anxiety, depression, PTSS, and caregiver burden were associated with both relative and patient variables, with relatives’ passive coping showing the strongest association across all outcome variables and time. Admission to the ICU increased the level of anxiety in relatives, while patient cognitive complaints were predictive of more severe symptoms in relatives (anxiety, depression, and caregiver burden). In conclusion, nurses providing follow-up care should be aware of the impact of severe COVID-19 on the psychosocial outcomes of relatives, comparable to other severe conditions, and offer guidance, especially to those who will not seek help themselves. Early screening for and psychoeducation on the emotional consequences of severely ill patients can guide nurses in their supportive care.

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