ABSTRACT
Topic Importance Survivors of intensive care unit (ICU) hospitalizations often experience severe and debilitating symptoms long after critical illness has resolved. Many patients experience notable psychiatric sequelae such as depression, anxiety, and post-traumatic stress disorder (PTSD) that may persist for months to years after discharge. The coronavirus disease 2019 (COVID-19) pandemic has produced large numbers of critical illness survivors, warranting deeper understanding of psychological morbidity after COVID-19 critical illness. Review Findings Many patients with critical illness due to COVID-19 experience substantial post-ICU psychological sequelae mediated by specific pathophysiologic, iatrogenic, and situational risk factors. Existing and novel interventions focused on minimizing psychiatric morbidity need to be further investigated in order to improve critical care survivorship after COVID-19 illness. Summary This review proposes a framework to conceptualize three domains of risk factors (pathophysiologic, iatrogenic, and situational) associated with psychological morbidity due to COVID-19 critical illness: (1) direct and indirect effects of the COVID-19 virus in the brain;(2) iatrogenic complications of ICU care which may disproportionately affect patients with COVID-19;and (3) social isolation that may worsen psychological morbidity. In addition, we review current interventions to minimize psychological complications after critical illness.