OBJECTIVES : Post-traumatic stress disorder (PTSD) is a mental health condition initiated by psychological trauma. The novel coronavirus disease (COVID-19) pandemic has been a source of great fear and stress. Few studies have reported on psychiatric disorders among patients with COVID-19. The goal of this study was to identify demographic and clinical factors associated with PTSD among patients with confirmed COVID-19.

METHODS : This retrospective observational study utilized the IBM® Explorys® electronic health record database. Participants included patients with a first COVID-19 diagnosis between December 1, 2019 and July 31, 2020. The outcome of interest was a diagnosis for PTSD after COVID-19 infection. COVID-19 diagnoses were determined via the Standard Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) codes or positive test results; PTSD diagnoses were identified by SNOMED-CT codes. Factors examined included age, sex, race and ethnicity, Deyo-Charlson Comorbidity Index (CCI), mental health history, COVID-19 severity (e.g. intensive care unit (ICU) admission), and lifestyle. Logistic regression models were employed to investigate the strength of the association (odds ratio (OR) and 95% confidence intervals (CI)) between each factor and PTSD. Factors with a p-value<0.20 were selected for a subsequent multivariable model.

RESULTS : Of 89,457 (mean age 47 years; 57% female) patients with a COVID-19 diagnosis, 373 developed PTSD. Age, female, race and ethnicity, CCI, mental health history, COVID-19 severity, smoking status and obesity were significantly associated with PTSD. Age (OR=0.98 [95% CI 0.97-0.99]), mental health history (4.39 [3.05-6.18]), COVID-19 severity (hospitalization (2.50 [1.81-3.42]); ICU admission (8.22 [5.33-12.32])), smoking status (1.39 [1.05-1.82]), and obesity (1.84 [1.43-2.38]) were independently associated with PTSD in a multivariable model.

CONCLUSIONS : This study identified a wide variety of factors associated with PTSD after COVID-19 infection. These findings can guide healthcare professionals to develop programs targeted at COVID-19 patients at risk for PTSD.