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Research Article | DOI: https://doi.org/10.31579/2640-1045/213
1First Degree Specialist in Psychiatry and Family Medicine. Assistant professor. University of Medical Sciences. “Camilo Cienfuegos” General Hospital. Sancti Spiritus. Cuba.
2Second Degree Specialist in Psychiatry. Master in satisfactory longevity. Assistant teacher. University of Medical Sciences. “Camilo Cienfuegos” General Hospital. Sancti Spiritus. Cuba.
3First Degree Specialist in Psychiatry and Family Medicine. Instructor teacher. University of Medical Sciences. “Camilo Cienfuegos” General Hospital. Sancti Spiritus. Cuba.
4First Degree Specialist in Psychiatry and Family Medicine. Assistant professor. University of Medical Sciences. “Camilo Cienfuegos” General Hospital. Sancti Spiritus. Cuba.
5First Degree Specialist in Psychiatry and Family Medicine. Instructor teacher. University of Medical Sciences. Promotion Teaching Polyclinic. Sancti Spiritus. Cuba.
6Doctor in Medical Sciences. Master in Natural Medicine and Bioenergetics. Second Degree Specialist in Family Medicine. Second Degree Specialist in Physical Medicine and Rehabilitation. Holder Professor. Assistant Researcher. University of Medical Sciences Sancti Spiritus, Cuba. Multiprofile Clinic. Luanda, Angola.
*Corresponding Author: Juan Carlos Mirabal Requena, Doctor in Medical Sciences. Master in Natural Medicine and Bioenergetics. Second Degree Specialist in Family Medicine. Second Degree Specialist in Physical Medicine and Rehabilitation. Holder Professor. Assistant Researcher. U
Citation: Lidivet M. Calderón, Berkis M. Hernández, Betsy B. Sánchez, Ederlys M. García, Yarielys G. Cabrera, et al, (2025), Post-Traumatic Stress Disorder in Adults Diagnosed with Covid 19, J. Endocrinology and Disorders, 9(2); DOI:10.31579/2640-1045/213
Copyright: © 2025, Juan Carlos Mirabal Requena. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 07 May 2025 | Accepted: 21 May 2025 | Published: 30 May 2025
Keywords: COVID-19; adults; post-traumatic stress disorder; behavior
Introduction: the pandemic generated by COVID-19 is a new phenomenon. In most patients there is a high probability of negative effects occurring in their psycho-emotional reactions, including Post-Traumatic Stress Disorder (PTSD). The Sancti Spiritus municipality had a significant number of positive patients, in whom the presence of psychological sequelae was noted.
Objective: describe the behavior of Post-Traumatic Stress Disorder in adult patients diagnosed with COVID 19 in the central area of the Sancti Spíritus municipality in the defined months to be studied.
Methods: descriptive, longitudinal and prospective research. We worked with 77 patients who became ill between July and December 2021 and met the exclusion and inclusion criteria. Sociodemographic variables, Post-Traumatic Stress Disorder symptoms, dysfunction in daily life and treatment received were used. Data collection was obtained through interviews and the application of a research instrument.
Results: of the 77 patients, 28 turned out to have Post-Traumatic Stress Disorder.
Conclusions: the presence of Post-Traumatic Stress Disorder described in the study coincides with other international research.
COVID-19 disease is a new nosological entity, of an infectious nature, which can present serious clinical manifestations, even leading to death [1, 2]. It is present in 190 countries and became a threat to global health, becoming the largest outbreak of atypical pneumonia since the appearance of severe acute respiratory syndrome (SARS) in 2003 [3].
According to data published by the World Health Organization (WHO), as of November 10, 2024, more than 776 million confirmed cases of covid-19 and more than 7 million deaths had been reported in 234 different countries [4, 5]. This disease can occur asymptomatically, with less serious characteristics or in its severe form. It is common for people who suffered from it to be left with multiple consequences, among which it is necessary to highlight those that affect people's mental health [6].
In most patients there is a high probability of late effects in their psycho-emotional reactions. These can be caused by the effects of the disease itself, by the long stages or loneliness of confinement, and in many cases by the death of family members to whom they cannot say goodbye [7]
In this way, it is not uncommon for pathological grief, depression, adjustment disorders, manifestations of post-traumatic stress, abuse of alcohol or other addictive substances, and psychosomatic disorders to appear. Patterns of prolonged suffering can also be translated as sadness, generalized fear and anxiety [7]
When it is necessary to maintain health actions such as quarantine and isolation, the evaluation of the psychological impact must be based on an exhaustive review of the possible risk and vulnerability factors that may perpetuate the problem. It is necessary to take into account the patient's previous mental health status, the history of grief, the presence of a history of self-harm or suicidal behavior in both the patient and his or her family, the history of previous traumas, and the patient's socioeconomic context [8].
Many of the recovered COVID-19 patients suffered, some still suffer, from stress for several weeks as well as other psychophysical symptoms including depression, fear and anxiety, these may persist for longer. Recovery time depends on a person's age and pre-existing conditions before the onset of infection [9]
In themselves, people who are socially isolated, with restricted mobility and poor contact with others, are vulnerable to presenting psychiatric complications that range from isolated symptoms to the development of a mental disorder such as insomnia, anxiety, depression and post-traumatic stress disorder (PTSD) [10, 11], post-traumatic stress disorder arises as a delayed or delayed response to a stressful event or situation (short or long-term) of an exceptionally threatening or catastrophic nature, which would likely cause widespread distress in almost anyone [12].
The onset of the disorder follows the occurrence of the trauma, with a latency period that can last from a few weeks to a few months; its evolution is fluctuating, even though in most cases recovery can be expected. In a small proportion of cases the condition may have a chronic course lasting several years, with an eventual lasting change in personality [13]. After several studies, a prevalence of PTSD has been found between 20-40% of patients who have been diagnosed with Covid 19 throughout their recovery process, whether immediate, intermediate or late [11,14].
In the province of Sancti Spiritus, a large number of patients positive for COVID-19 occurred during the stage of the pandemic, becoming one of the provinces that reported the most cases in 2021 [15], Of the survivors, not a few were identified with sequelae compatible with PTSD. Given this situation, the authors set the objective of this research to describe the
behavior of PTSD in adult patients diagnosed with COVID 19 in the central area of the Sancti Spíritus municipality in the months between July and December 2021.
A descriptive, longitudinal and prospective research was carried out. In the present study, all adult patients who survived COVID-19 in the central area of the Sancti Spíritus municipality were included, in the period from July to December 2021. It was considered as another element to be included that at the time of conducting the interview and applying the survey they had suffered from Covid 19 between 3 and 6 months.
Those people who were part of another similar study or who did not agree to participate in the one that would be carried out were excluded. Patients whose mental status was unreliable in obtaining the necessary data were also excluded.
In the polyclinic of the Central Area of the Sancti Spíritus municipality, 121 COVID-19 positive patients who survived the disease were diagnosed between July and December 2021. Once the inclusion and exclusion criteria were applied, it was decided to work with a population of 77 patients who met the characteristics established for the study.
To obtain the information, the following research instruments were used:
• Ad hoc interview focused on data related to the traumatic event and the dysfunction that said event has produced in the person's daily life that allowed a categorical diagnosis of PTSD to be carried out.
• Post-Traumatic Stress Disorder Symptom Severity Scale (EGS-R). (16)
Sociodemographic variables were used to characterize the study population (age, sex, profession, marital status, employment situation), the symptomatic cores were taken into account for the diagnosis of PTSD according to EGS-TE (increased activation and psychophysiological reactivity, cognitive alterations and negative mood, cognitive behavioral avoidance, re-experiencing). The presence of PTSD was defined as yes or not present.
Other variables that were evaluated were the treatment received (pharmacological, psychological, psychopharmacological, none) and the areas affected by the traumatic event (deterioration of the couple relationship, deterioration of the family relationship, negative interference in work/academic life, negative interference in social life, negative interference in leisure time, global dysfunctionality). The data obtained were emptied into number and percentage tables that were used for the final analysis of the results.
All participants in this research underwent a general interview to promote communication and access to information and the EGS-R was applied individually to them on the given day, with no time limits for responding, until the items were completed. Informed consent for participation in the study was obtained from each subject, explaining the voluntariness of their contribution and its importance for the development of the research. The possibility of abandoning the study at any time was explicit; all information obtained was used only for scientific purposes.
The studied population was characterized taking into account sociodemographic variables. Table 1 shows the predominance of each one.
| Variables | Predominant scale | No | % |
| Age | 40-59 | 40 | 52 |
| Sex | Female | 56 | 72 |
| Profession | Professional | 21 | 27 |
| Marital status | Married | 27 | 35 |
| Employment Situation | Bound | 46 | 60 |
| Total | 77 | 100 | |
Table 1: Characterization of patients with COVID 19, taking into account predominant sociodemographic variables. Center Polyclinic. Santi Spiritus. July–December 2021
A greater number of patients were found between 40-59 years old, with the female sex predominating with 72% of the patients surveyed, of which the majority were professionals. Regarding marital status, it was noted that the number of married patients was greater with 27 and the employment status most evident belongs to those linked to work, representing 60% of the total.
In a study carried out in Italy by Forte et al., (14) the authors of the present research found coincidences regarding the predominance of the female sex with 74% and of professionals. There were differences in the age variable because in the aforementioned study, those studied between 18 and 29 years old predominated.
Another consulted investigation carried out in the city of Madrid, Spain, presented results with which it was agreed in terms of the predominance of the female sex, the largest number were professionals and the ages between 40 and 50 years predominated, which is very close to the one found in the current one. (17) In work carried out by Reyes et.al., (18) the predominant were women, degree of higher education and the age range between 18-70 years, the latter being a little wider in relation to that carried out in Sancti Spíritus, with which this study coincides.
When the results achieved are analyzed, both in the research presented and in the previous ones carried out by other authors already mentioned, there is a predominance of the female sex, adults up to 60 years of age and those who have a profession and were actively working at the time of the research, these being the most repeated variables and to which greater weight has been given in general. In the authors' opinion, this manifested itself in this way, due to the educational level achieved by the population, where women are more dedicated to household chores, despite their professionalism, which is why most of them were in isolation for longer than men during the pandemic period.
The family nuclei that were symptomatic were analyzed for the diagnosis of PTSD according to the results obtained after applying the EGS-TE. These results are explained in table 2.
| Scale | # of ítems | Range | Presence of the symptom | |||
| YES | % | NO | % | |||
| Reexperiencing | 5 | 0-15 | 14 | 18 | 63 | 82 |
| Cognitive behavioral avoidance | 3 | 0-9 | 12 | 16 | 65 | 84 |
| Cognitive alterations and negative mood | 7 | 0-21 | 18 | 23 | 59 | 77 |
| Increased psychophysiological activation and reactivity | 6 | 0-18 | 11 | 14 | 66 | 86 |
Table 2: Symptomatic nuclei for the diagnosis of PTSD according to EGS-TE
Source: Symptom Severity Scale
The results of the analysis of this variable show that the majority did not present symptomatic cores that framed them as having PTSD. Those who did present these nuclei, cognitive alterations and negative mood occupied first place with 18 subjects reporting their appearance.
In the previously referenced study, (17) results were found that do not coincide with those carried out by these authors, taking into account the psychometric study with the EGS-TE in patients who had experienced traumatic experiences of different kinds. In China, Cai
It is not common to find research that specifically evaluates which symptomatic core(s) are most affected in patients, since most research is limited to identifying them for the sole purpose of diagnosing PTSD without delving deeper into them. In the opinion of the authors of this research, it was considered necessary to take these factors into account because, in addition to the diagnosis of psychiatric pathology, the predominance of the nuclei guides the psychological state of the patients, finding greater specificity when describing the symptoms found in them.
The presence or not of PTSD in the subjects studied was another of the variables that was described. The results are shown in table 3
| Variable | Scale | No | % |
| Presence of PTSD | YES | 28 | 36 |
| NO | 49 | 64 | |
| Total | 77 | 100 | |
Table 3: Presence of Post-Traumatic Stress Disorder (PTSD)
Source: Symptom Severity Scale
The data presented show the presence of PTSD in 28 patients for 36% of the total participants in the study. These results agree with the research carried out in Nepal where in the studied population of COVID 19 convalescents, 32% were diagnosed with PTSD. (20) Another study with which this coincides was carried out in China, (21) where it was found that of the population studied, after 3 months of being infected with the virus, 41
In the population studied, the age range of 40-59 years, females, professionals, work-related and married predominated. The most affected symptomatic cores were cognitive alterations and negative mood. 36% of the participants had PTSD, and of them 14 needed some therapeutic modality. The sphere of daily life most affected was negative interference in leisure time. The results obtained coincide with the evidence consulted.
Conflicts of interest:
The authors declare that they have no conflicts of interest
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We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
