According to a preprint study funded by Kaiser Permanente, one of the major healthcare providers in the US, about 42% of the patients infected with the novel coronavirus will end up in the Intensive Care Unit (ICU). Data obtained from nine Seattle-area hospitals showed that mortality among those who are critically ill was high and only half of those admitted into ICU will make it back out again. This is especially so for patients who have been put on a ventilator.
A traumatizing experience which does not end with recovery
Things were not better for the survivors. Their ICU experiences had taken a toll on some of them as they continuously struggle for their lives in absolute isolation; the fear that they may die at some point in time, and physical pain coming from the chest area, being intubated and shortness of breath. This would definitely be one of the most traumatizing experiences for some people. Yet, their nightmares do not end with recovery.
Some patients would still report signs of fatigue, body pain and breathlessness after they have been discharged. COVID-19 is now known to attack the body beyond the respiratory system. Physicians said patients who received large amount of sedation during their ICU stay, may be left with nerves and muscles damage, some of which are permanent particularly around the lungs and this could seriously undermine patients’ capabilities to adjust back to their normal lives and may affect their mental health in the long run.
A 2018 study examining close to 5000 recovered patients from 26 ICUs in the UK found that more than half of them developed some form of anxiety, depression, and Post-Traumatic Stress Disorder (PTSD) a year after they left the hospitals. We are still in the early days to determine the eventual number of patients who will need to be in the ICU because of COVID-19 and how the event affect their mental health.
Suggestions to tail off the trauma
Nevertheless, there has been some early clinical evidence indicating we may need to prepare for a COVID-19 mental health crisis when the pandemic is about to be over.
As reflected by a study on Chinese patients published in Psychological Medicine, 92% of the 714 patients being surveyed reported significant PTSD symptoms. It’s worthwhile to note there are differences between symptoms and an officially diagnosed condition. Some of these symptoms may eventually mount to be a clinically recognized condition if they do not wear off after a period of time.
As such, some healthcare workers suggested to keep an ICU dairy, for patients to record down the events they had experienced so that it can assist them to make sense of the whole situation in the months that follow. Other interventions include early access to medications and therapies but because all of which require additional planning and funding, it’s unsure if the healthcare systems are able to take on further pressure.
This September, AIMed will once again, gather fellow clinicians and experts to each share their insights, challenges, and journey of using artificial intelligence (AI) and related tools to bring a change in ICU. We believe technology has the potential to replace a daunting experience with one that garner better outcomes. AIMed ICU will be a virtual event taking place on 22 September and it’s free to all clinicians an accredited CME provider. Agenda and details are now available here.