Table 3.
Studies reporting post-illness psychiatric and neuropsychiatric outcomes of SARS-CoV and MERS-CoV infections
| Setting | Virus subtype | Study design | Follow-up timepoint | Special population | Sample size | Mean (SD)*age, years | Male cases (%) | Female cases (%) | Outcomes | |
|---|---|---|---|---|---|---|---|---|---|---|
| Schneider et al (2004)67 | USA | SARS-CoV | Case report | 3 months | Pregnancy | 1 case | NR | 0 | 1 | Symptoms: anxiety |
| Cheng et al (2006)45 | Hong Kong | SARS-CoV | Case series | 2, 3, 4, 5, and 6 months after discharge | .. | 57 cases | 38·1 (10·4) | 19 (33%) | 38 (67%) | Scales: BDI, BAI (SARS Appraisal Inventory), and Thriving Scale |
| Hui et al (2005)82 | Hong Kong | SARS-CoV | Cohort | 3 months, 6 months, and 12 months | .. | 97 cases; 1939 controls | 36·9 (9·5) | 39 (40%) | 58 (60%) | Scales SF-36 (and subscales) |
| Mak et al (2009)40 | Hong Kong | SARS-CoV | Cohort | 18 months | .. | 143 cases | 38·4 (12·4) | 53 (37%) | 90 (63%) | Scale: SF-36 |
| Wing et al (2012)46 | Hong Kong | SARS-CoV | Cohort | Mean 39 months (SD NR) | .. | 181 cases | No psychiatric disorder: 44·9 (15·6); lifetime or current: 44·5 (12·0); current psychiatric condition: 45·6 (12·0) | 57 (31%) | 124 (69%) | Symptoms: fatigue, frequent recall of SARS memories; diagnoses: chronic fatigue syndrome, major depressive disorder, post-traumatic stress disorder, somatoform pain disorder, panic disorder; symptoms: fatigue, and intrusive memories; scales: HADS, IES, GAF, WHOQOL (and subscales), and WSAS (implied) |
| Han et al (2003)83 | Guandong, China | SARS-CoV | Cohort | Mean 59·7 days (SD 22·8) | .. | 69 cases | NR | 29 (42%) | 40 (58%) | Symptoms: insomnia, vexation, low spirit, fear, poor concentration, poor memory, and feelings of guilt |
| Lam et al (2006)55 | Hong Kong | SARS-CoV | Cohort | Mean 60·0 days (SD 23·9) | .. | 116 cases | 45·6 (15·1) | 51 (44%) | 65 (56%) | Scale: SF-36 |
| Guo et al (2019)58 | Guandong, China | SARS-CoV | Cohort | 12 years | .. | 67 cases | Data from original cohort only | Data from original cohort only | − | Scale: SF-36 |
| Lee et al (2019)54 | South Korea | MERS-CoV | Cohort | 12 months and 18 months | .. | 52 cases | 49·7 (12·0) | 32 (62%) | 20 (38%) | Scales: PHQ-9, FSS, and IES-R |
| Mak et al (2010)41 | Hong Kong | SARS-CoV | Cohort | 30 months | .. | 90 cases | No post-traumatic stress disorder: 40·5 (11·6); post-traumatic stress disorder: 42·8 (13·4) | 34 (38%) | 56 (62%) | Diagnoses: post-traumatic stress disorder; scales: FIC, CWCQ, and MHLC |
| Yoon et al (2016)84 | South Korea | MERS-CoV | Cohort | NR | .. | 62 cases | NR | NR | NR | Other: referral for outpatient psychiatric treatment |
| Moldofsky et al (2011)85 | Toronto, ON, Canada | SARS-CoV | Cohort | Mean 19·8 months (range 13–36) | Individuals unable to return to former occupation; mainly health-care workers | 22 cases; 21 fibromyalgia controls, 7 healthy controls | 46·3 (11·0) | 3 (14%) | 19 (86%) | Scales: BDI, PCL-C, SAQ, and WPSI |
| Lam et al (2009)49 | Hong Kong | SARS-CoV | Cohort | Mean 41·3 months (range 31–51) | .. | 233 cases | 43·3 (13·7) | 69 (30%) | 164 (70%) | Diagnoses: any psychiatric illness, post-traumatic stress disorder, depression, somatoform pain disorder, panic disorder, obsessive compulsive disorder, and chronic fatigue syndrome. Scales: HADS, IES-R, and CFQ |
| Hong et al (2009)56 | Beijing, China | SARS-CoV | Cohort | Mean 53 days (SD 31), 7 months, 10 months, 20 months, and 46 months | .. | 70 cases | 38·5 (12·3) | 23 (33%) | 47 (67%) | Diagnoses: post-traumatic stress disorder; scales: IES, SAS, SCL-90, SDS, SDSS, and SF-36 |
| Mak et al (2009)86 | Hong Kong | SARS-CoV | Cohort | 30 months | .. | 90 cases;1394 controls (Hong Kong normative data) | 41·1 (12·1) | 56 (62%) | 34 (38%) | Symptoms: psychotic symptoms; diagnoses: any psychiatric disorder, post-traumatic stress disorder, anxiety disorders (and subtypes), depression (and subtypes), and substance misuse; scale: IES-R, HADS, and SF-36 |
| Bonanno et al (2008)42 | Hong Kong | SARS-CoV | Cohort | 6 months, 12, months, and 18 months | .. | 997 cases, 2410 controls (Hong Kong normative data) | 42·0 (14·0) | 389 (39%) | 608 (61%) | Scale: SF-12 |
| Lee et al (2007)53 | Hong Kong | SARS-CoV | Cohort | 12 months | .. | Two overlapping samples of 79 and 96 cases, and 145 and 112 controls | Stratified across group, year, and age range | 62 (35%) | 113 (65%) | Scales: PSS-10 (reported in 1386 participants), DASS-21, GHQ-12, and IES-R |
| Tansey et al (2007)59 | Toronto, ON, Canada | SARS-CoV | Cohort | 3 months, 6, months, and 12 months | .. | 117 cases | Median 42·0 (range 33·0–51·0) | 39 (33%) | 78 (67%) | Scale: SF-36 |
| Lau et al (2005)87 | Hong Kong | SARS-CoV | Cohort | About 2 months from onset of illness | .. | 15 cases | 35·0 (10·9) | 8 (53%) | 7 (47%) | Diagnoses: anxiety depression, and steroid psychosis; scale: WHOQOL |
| Leow et al (2005)88 | Singapore | SARS-CoV | Cohort | 3 months after recovery | .. | 61 cases | Median 36·5 (range 25·5-47·5) | 14 (23%) | 47 (77%) | Symptoms: fatigue |
| Wu et al (2005)52 | Hong Kong | SARS-CoV | Cohort | 1 month and 3 months after discharge | .. | 131 cases | 41·8 (14·0) | 57 (44%) | 74 (56%) | Scales: IES and HADS |
| Sheng et al (2005)43 | Hong Kong | SARS-CoV | Cohort | Mean 42 days (range 26–86) after discharge | .. | 102 cases | 37·6 (12·4) | 35 (34%) | 67 (66%) | Symptoms: numerous neuropsychiatric symptoms from NPSC; scales: NPSC and GHQ-28 |
| Cheng et al (2004)69 | Hong Kong | SARS-CoV | Cohort | 1 month after recovery | .. | 100 cases; 184 controls | 37·1 (12·1) | 34 (34%) | 66 (66%) | Scales: RSES, GHQ-28, and WHOQOL-BREF |
| Cheng et al (2004)44 | Hong Kong | SARS-CoV | Cohort | At least 4 weeks after discharge; mean 43·8 days (SD 13·6) | .. | 180 cases;649 healthy controls and 189 psychiatric outpatient controls | 36·9 (11·1) | 60 (33%) | 120 (67%) | Scales: BAI, BDI, and SIS |
| Ngai et al (2010)60 | Hong Kong | SARS-CoV | Cohort | 3 months, 6 months, 12 months, 18 months, and 24 months | .. | 55 cases and 538 controls (Hong Kong normative data) | 44·4 (13·2) | 19 (35%) | 36 (65%) | Scale: SF-36 |
| Hui et al (2005)89 | Hong Kong | SARS-CoV | Cohort | 3 months and 6 months | .. | 110 cases | 35·6 (9·8) | 44 (40%) | 66 (60%) | Scale: SF-36 |
| Lau et al (2005)90 | Hong Kong | SARS-CoV | Cohort | 2 weeks after discharge | .. | 171 cases and 2410 controls (Hong Kong normative data) | 37·4 (12·7) | 60 (35%) | 111 (65%) | Scale: SF-36 |
| Li et al (2006)91 | Hong Kong | SARS-CoV | Cohort | 3 months, 6 months, and 12 months | ICU admission with acute respiratory distress syndrome | 59 cases | 47·0 (16·0) | 34 (58%) | 25 (42%) | Scale: SF-36 |
| Lau et al (2005)95 | Hong-Kong | SARS-CoV | Randomised controlled trial treated as a cohort study | At least 8 weeks after discharge | Subnormal exercise tolerance | 133 cases | 37·0 (10·2) | 45 (34%) | 88 (66%) | Scale: SF-36 |
| Tso et al (2004)92 | Hong Kong | SARS-CoV | Cross-sectional | Median 6·6 weeks (SD 1·1) after onset | .. | 62 cases | 37·1 (13·0) | 28 (45%) | 34 (55%) | Symptoms: forgetfulness, depression, and insomnia |
| Lo et al (2005)93 | Singapore | SARS-CoV | Cross-sectional | 6 months | .. | 14 cases; 30 controls | Range 20–48 | 2 (14%) | 12 (86%) | Symptoms: fatigue and sleep disturbance |
| Wu et al (2005)50 | Hong Kong | SARS-CoV | Cross-sectional | 1 month | .. | 195 cases | 41·5 (14·0) | 84 (43%) | 111 (57%) | Scales: IES-R and HADS |
| Kwek et al (2006)51 | Singapore | SARS-CoV | Cross-sectional | 6 weeks and 12 weeks | .. | 63 cases; Singapore normative data as control | 34·8 (10·5) | 13 (21%) | 50 (79%) | Scales: IES, HADS, and SF-36 |
| Batawi et al (2019)57 | Saudi Arabia | MERS-CoV | Cross-sectional | Mean 13·8 months (SD 3·4) | .. | 78 cases; 57 controls (non-MERS-CoV severe acute respiratory infection) | 45·0 (13·0) | 56 (72%) | 22 (28%) | Scale: SF-36 |
| Jeong et al (2016)80 | Seoul, Gyeonggi, Chungcheong, and Gangwon, South Korea | MERS-CoV | Cross-sectional | 4, 5, and 6 months after isolation | .. | 36 cases;1656 controls without MERS who had also been isolated | 52·3 (15·0) | 18 (50%) | 18 (50%) | Scales: STAXI and GAD-7 |
| Almutairi et al (2018)34 | Saudi Arabia | MERS-CoV | Qualitative | NR | Health-care workers | 7 cases | 42·0 (16·2) | 3 (43%) | 4 (57%) | Qualitative: stigma and underestimation of illness severity |
| Siu (2016)47 | Hong Kong | SARS-CoV | Qualitative | NR | Individuals practising tai chi | 35 cases | Range 38–69 | 13 (37%) | 22 (63%) | Qualitative: emotional suffering, stigma, and passivity |
| Siu (2008)21 | Hong Kong | SARS-CoV | Qualitative | NR | .. | 30 cases | NR | NR | NR | Qualitative: stigma |
| Mok et al (2005)37 | Hong Kong | SARS-CoV | Qualitative | NR | Nurses | 10 cases | Range 20–47 | 2 (20%) | 8 (80%) | Themes: anger, guilt, unpreparedness, fear, isolation, physical symptoms, support, and changing perspective |
| Lee et al (2005)48 | Hong Kong | SARS-CoV | Qualitative | NR | .. | 47 cases; 852 controls (neighbouring residents) | Only reported for entire cohort including non-infected | Only reported for entire cohort including non-infected | .. | Symptoms: insomnia, irritability, and low mood |
| Li et al (2004)39 | Hong Kong | SARS-CoV | Qualitative | 5 months after discharge | Children | 4 cases | Range 7–13 | 2 (50%) | 2 (50%) | Symptoms: psychological distress |
Proportions might not sum to 100% as a result of rounding. BAI=Beck Anxiety Inventory. BDI=Beck Depression Inventory. CFQ=Cognitive Failures Questionnaire. CWCQ=Chinese Ways of Coping Questionnaire. DASS-21=Depression, Anxiety and Stress Scale 21 items. FIC=Functional Impairment Checklist. FSS=Fatigue Severity Scale. GAD-7=Generalised Anxiety Disorder-7. GAF=Global Assessment of Functioning. GHQ-12=General Health Questionnaire-12. GHQ-28=General Health Questionnaire-28. HADS=Hospital Anxiety and Depression Scale. ICU=intensive care unit. IES=Impact of Event Scale. IES-R=Impact of Event Scale Revised. MERS-CoV=Middle East respiratory syndrome coronavirus. MHLC=Multidimensional Health Locus of Control. NPSC=Neuropsychiatric Symptom Checklist. NR=not reported. PCL-C=PTSD Checklist, Civilian Version. PHQ-9=Patient Health Questionnaire-9. PSS-10=Perceived Stress Scale 10. RSES=Rosenberg Self-Esteem Scale. SAQ=Sleep Assessment Questionnaire. SARS-CoV=severe acute respiratory syndrome coronavirus. SAS=Zung Self-Rating Anxiety Scale. SCL-90=Symptom Checklist 90. SDS=Zung Self-Rating Depression Scale. SDSS=Social Disability Screening Schedule. SF-12=Short Form 12 Health Survey Questionnaire. SF-36=Short Form 36 Health Survey Questionnaire. SIS=SARS Impact Scale. STAXI=State-Trait Anger Expression Inventory. WHOQOL=WHO Quality of Life. WPSI=Wahler Physical Symptom Inventory. WSAS=Work and Social Adjustment Scale.
*
Data are mean (SD) unless otherwise stated.