© 2007 Centers for Disease Control and Prevention, Atlanta, GA, USA
Canadian severe acute respiratory syndrome (SARS) survivors were still having health problems 1 year after their acute illness, according to researchers at the University of Toronto, Canada.
The SARS epidemic in Canada killed 43 people in the Toronto area, including three health-care workers, between March and August, 2003. 208 people had acute illness but survived, and 117 of them took part in a 1-year follow-up study. According to the study, pulmonary function results were in the normal range for all patients, but 18 patients walked a substantially shorter distance in 6 min (more than 50 metres less than expected) compared with age and sex-matched controls.
“SARS patients who had been critically ill had similar physical sequelae to survivors of non-epidemic acute respiratory distress syndrome but had worse psychosocial outcomes: 17% of patients had not returned to work and 51 of the 117 had made multiple visits to psychiatry or psychology practitioners”, explained lead author Margaret Herridge.
Siew Eng Chua (University of Hong Kong, Hong Kong, China) noted that SARS survivors in Asia have experienced similar problems and recommends that “recognition and management of psychosocial sequelae of infectious diseases should be a vital long-term imperative”.
In a related study, David S C Hui (The Chinese University of Hong Kong, Shatin, Hong Kong) identified significant continuing psychological problems in 55 Hong Kong survivors at 24 months, compared with the general population, even though their lung function was normal. “The results from Canada are therefore not surprising; the long period of isolation and extreme uncertainty during the initial serious SARS illness created enormous psychological stress”, he said. Chua agreed: “1 year after SARS exposure in Hong Kong, 30% of our recovered patients had moderate depression, 40·7% had moderate anxiety, and most had persistently raised stress levels compared with controls”, she said.
“The fact that Canadian and Asian studies both reveal psychological sequelae of an epidemic infectious disease, despite the different cultural contexts, shows how robust a finding this is”, commented Herridge. “In the future, it will be important to prevent the social isolation that has caused so much suffering”, she added.