Association of PTSD with COVID-19 testing and infection in the Veterans Health Administration. (November 2021)

• Record Type: Journal Article
• Authors: Haderlein, Taona P.; Wong, Michelle S.; Yuan, Anita; Llorente, Maria D.; Washington, Donna L.
• Is Part Of: Journal of psychiatric research. Volume 143(2021)
• Page Start: 504
• Page End: 507
• Publication Date: 2021-11
• Subjects: COVID-19 -- Coronavirus disease 2019 -- Post-traumatic stress disorder -- Veterans' health -- Stress disorders -- COVID-19 testing; Psychiatry -- Periodicals; Mental Disorders -- Periodicals; Maladies mentales -- Périodiques; Psychiatry; Electronic journals; Periodicals; 616.89005
• DOI: 10.1016/j.jpsychires.2020.11.033
• Languages: English
• ISSNs: 0022-3956

Abstract

Abstract: Posttraumatic stress disorder (PTSD) is associated with coronavirus disease 2019 (COVID-19) risk factors, such as hypertension and obesity. Associations between PTSD and COVID-19 outcomes may affect Veterans Health Administration (VA) services, as PTSD occurs at higher rates among veterans than the general population. While previous research has identified the potential for increased PTSD prevalence resulting from COVID-19 as a public health concern, no known research examines the effect of pre-existing PTSD on COVID-19 test-seeking behavior or infection. This study aimed to evaluate pre-existing PTSD as a predictor of COVID-19 testing and test positivity. The sample consisted of 6, 721, 407 veterans who sought VA care between March 1, 2018 and February 29, 2020. Veterans with a previous PTSD clinical diagnosis were more likely to receive COVID-19 testing than veterans without PTSD. However, among those with available COVID-19 test results (n = 168, 032), veterans with a previous PTSD clinical diagnosis were less likely to test positive than veterans without PTSD. Elevated COVID-19 testing rates among veterans with PTSD may reflect increased COVID-19 health concerns and/or hypervigilance. Lower rates of COVID-19 test positivity among veterans with PTSD may reflect increased social isolation, or overrepresentation in the tested population due to higher overall use of VA services. As the COVID-19 pandemic continues, the identification of patient-level psychiatric predictors of testing and test positivity can facilitate the targeted provision of medical and mental health services to individuals in need. Highlights: Posttraumatic stress disorder (PTSD) – more common in Veterans than non-Veterans, is associated with COVID-19 risk factors. Despite potential for COVID-19 related PTSD, no work has studied past PTSD as a predictor of COVID-19 testing or infection. We evaluated pre-existing PTSD as a predictor of COVID-19 testing and COVID-19 test positivity in 6.7 million Veterans. Veterans with prior PTSD were more likely to receive COVID-19 testing, but were less likely to test positive for COVID-19. Results may signal heightened COVID-19 concerns, hypervigilance, social isolation or overrepresentation among those tested.