Regardless of mental health history, pre-existing medical conditions and illness severity, those hospitalized for COVID-19 had higher levels of PTSD, anxiety and loneliness compared to those hospitalized for non-COVID related illnesses at the time of discharge, a recent report released by University of Michigan researchers concluded.
The study was conducted in the spring of 2020 and surveyed 178 patients after their hospitalization. Sixty-four percent of participants had tested positive for COVID-19. Researchers screened the patients with memory, anxiety, PTSD and loneliness tests.
Lead author Joanna Spencer-Segal, an assistant professor of internal medicine and research assistant professor at the Michigan Neuroscience Institute, said her experiences at the post-COVID-19 clinic helped her to 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 recalled talking with him about his family.
“I remember asking about his child and he showed me some pictures,” Spencer-Segal said. “I sized up the situation. I said, ‘I think you’re going to be OK. We’re going to get you through this, and you’ll go home to your kid.’ And he just relaxed. And he did. A couple days later, he walked out of the hospital.”
Some of the survey statements written by the research team to be presented to the participants included, “I worried that I might not see my friends and family again” and “I was afraid to die alone.”
Jakob McSparron, associate professor of medicine in the Division of Pulmonary and Critical Care, told The Michigan Daily that he was not surprised by the study’s results. Even before the pandemic, McSparron explained that many people without a pre-existing condition experienced depression, anxiety and PTSD symptoms. McSparron said he believes the absence of families during quarantine only worsened the effect on patients.
“Our visitation policies are still not what they were,” McSparron said. “We know that family presence in the intensive care unit helps patients and family members and may mitigate some of these long-term sequelae. The challenges of the pandemic — specifically related to patient isolation — have exacerbated these issues that were already there for hospitalized patients.”
LSA junior America Mendoza said she understands why family support is important.
“Going in as a person who’s sick and knowing that your family probably won’t be there and know much about your care is very isolating,” Mendoza said. “And the sense of isolation can definitely make mental health worse in general.”
McSparron said the hospitals and nurses are doing what they can to provide mental health and social support given the circumstances.
“All of the bedside nurses and technicians and physicians try to be supportive, and we have social workers on the various units, but they cannot be at the bedside continuously,” McSparron said. “They are not the same as people who know the patient. So we have people who are involved in their care and hopefully can help, but we do not have the same level of social support to really help integrate that person into some of their usual aspects of life.”
Robert Hyzy, medical director of the Critical Care Medicine Unit, noted the importance of the nurses and social workers, pointing out the potential impacts the pandemic could have on both their own mental health and their patients.
“This pandemic has taken a significant toll on (nurses and social workers),” Hyzy said. “This issue of essentially being surrogate family members. Their job is tough enough caring for critically ill patients to begin with. To try and fill that gap in some ways is not really in their job description. It’s very hard for them.”
Hyzy said family visitations will benefit the recovery and well-being of patients in the hospital. As the pandemic has progressed, the hospital has been able to liberalize some of the visitation restrictions, allowing for some family members to now visit patients. Hyzy said these measures could begin to improve the mental health outcomes for the COVID-19 patients.
“One of the worst aspects of the pandemic that’s bad in so many ways was the lack of the ability to have families visit the loved ones at the bedside,” Hyzy said. “That not only is just a tragic, horrible thing, but obviously the issues of loneliness and so forth that come to bear are also associated with brain dysfunction, which itself has long term cognitive sequelae.”
Dr. Hyzy said he is committed to encouraging family visitations and supporting hospitalized patients.
“I’m trying to knock down walls to get a Family Center for my ICU because so many families spend the night at the bedside in a Lazy Boy in the room,” Hyzy said. “It’s ridiculous. But if you’re in the middle of a pandemic, all bets are off.”
In the case that hospitals need to reimplement limited visitation policies and quarantine due to increasing COVID-19 cases, Hyzy said he will have no other 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. This is infection control. This is public health. These are important rules, but the collateral damage is troubling and worrisome. In infectious disease with little protection, other PPE and vaccination, public health has to trump these other things. It doesn’t mean I’m happy about it, but I accept it.”
Daily Staff Reporter Emily Li and Daily News Contributor Ethan VanValkenburg can be reached at firstname.lastname@example.org and email@example.com.