Regardless of mental health history, pre-existing medical conditions, and severity of illness, people hospitalized with COVID-19 had higher levels of PTSD, anxiety, and loneliness compared to those hospitalized for unrelated illnesses to COVID at the time of release, a recent report published by researchers at the University of Michigan concluded.
The study was conducted in the spring of 2020 and interviewed 178 patients after their hospitalization. Sixty-four percent of the participants had tested positive for COVID-19. The researchers examined the patients with tests for memory, anxiety, PTSD, and loneliness.
Lead author Joanna Spencer-Segal, assistant professor of internal medicine and assistant research professor at Michigan Neuroscience Institute, said her experiences at the post-COVID-19 clinic helped her design some of the questions used in the study. One of the participants with COVID-19 was in acute respiratory distress, according to Spencer-Segal, and she remembers speaking with him about his family.
“I remember asking about his child and he showed me pictures,” Spencer-Segal said. “I took the measure of the situation. I said, ‘I think it’s going to be okay. We will help you get through this and you will go home with your child. And he just relaxed. And he did. A few days later, he was released from the hospital.
Some of the survey statements written by the research team to present to participants included: “I was afraid I would never see my friends and family again” and “I was afraid of dying alone”.
Jakob McSparron, associate professor of medicine in the Division of Pulmonary and Critical Care, told the Michigan Daily he was not surprised by the study’s results. Even before the pandemic, McSparron explained that many people without a pre-existing condition had symptoms of depression, anxiety and PTSD. McSparron said he believes the absence of families during quarantine only worsened the effect on patients.
“Our visitation policies are still not what they used to be,” McSparron said. “We know that having family in the intensive care unit helps patients and their families and can alleviate some of these long-term effects. The challenges of the pandemic – specifically related to patient isolation – exacerbated those issues that were already there for hospital patients. “
LSA Junior America Mendoza said she understands why family support is important.
“Coming in as a sick person and knowing that your family probably won’t be there and will know a lot about your care is very isolating,” Mendoza said. “And the feeling of isolation can certainly worsen mental health in general.”
McSparron said hospitals and nurses were doing what they could to provide mental and social health support given the circumstances.
“All the nurses, technicians, and bedside doctors are trying to provide support, and we have social workers in the different units, but they can’t be at the bedside all the time,” McSparron said. “They are not the same as the people who know the patient. So we have people involved in their care and hopefully can help, but we don’t have the same level of social support to really help integrate that person into some of their regular aspects of life.
Robert Hyzy, medical director of the Intensive Care Medicine Unit, stressed the importance of nurses and social workers, highlighting the potential impacts the pandemic could have on both their own mental health and their patients.
“This pandemic has taken its toll on (nurses and social workers),” Hyzy said. “This matter of being essentially surrogate family members. Their job is difficult enough to begin with caring for critically ill patients. Trying to fill that gap in some way isn’t really part of their job description. It’s very hard for them.
Hyzy said family visits would benefit the recovery and well-being of patients in the hospital. As the pandemic progressed, the hospital was able to liberalize some of the visit restrictions, now allowing certain family members to visit patients. Hyzy said these measures could start to improve mental health outcomes for COVID-19 patients.
“One of the worst aspects of the pandemic which is bad in many ways was the lack of opportunity for families to visit loved ones at the bedside,” Hyzy said. “It is not only a tragic and horrible thing, but obviously problems of loneliness and so on that arise are also associated with brain dysfunction, which itself has long term cognitive sequelae.”
Dr Hyzy said he was determined to encourage family visits and support inpatients.
“I’m trying to bring down the walls to get a family center for my intensive care unit because so many families spend the night by a Lazy Boy’s bedside in the bedroom,” Hyzy said. “It’s ridiculous. But if you’re in the middle of a pandemic, all bets are off.”
In the event that hospitals have to re-implement limited visitation and quarantine policies due to the increase in COVID-19 cases, Hyzy said he would have no choice but to accept it as what is best for public health.
“I’m not saying we don’t need these rules,” Hyzy said. “We need them. It’s infection control. It’s public health. These are important rules, but the collateral damage is troubling and worrisome. In infectious diseases with little protection, other PPE and immunization, public health has to take precedence over those other things. ”That doesn’t mean I’m happy about it, but I accept it.