The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status

Abstract

Background and objective: Severe acute respiratory syndrome (SARS) emerged in 2003 and its long-term sequelae remain largely unclear. This study examined the long-term outcome of pulmonary function, exercise capacity, health and work status among SARS survivors.

Methods: A prospective cohort study of SARS patients at the Prince of Wales Hospital, Hong Kong was conducted, with serial assessments of lung function, 6MWD and 36 item Short Form General Health Survey at 3, 6, 12, 18 and 24 months after disease onset. The work status was also recorded.

Results: Serial assessments were completed by 55 of the 123 (39.9%) subjects, of whom 27 were health-care workers (HCW). The mean age of the group was 44.4 (SD 13.2) years and 19 (34.5%) were males. At 24 months, 10 (18.2%), 9 (16.4%), 6 (10.9%) and 29 (52.7%) subjects had FEV(1), FVC, TLC and DL(CO) < 80% of predicted values, respectively. The mean (SD) 6MWD increased significantly from 439.0 (89.1) m at 3 months to 460.1 (102.8) m at 6 months (P 0.016) and became steady after 6 months. However, 6MWD and 36 item Short Form General Health Survey scores were lower than the normal population throughout the study. Moreover, 29.6% of HCW and 7.1% of non-HCW had not returned to work 2 years after illness onset.

Conclusions: This 2-year study of a selected population of SARS survivors, showed significant impairment of DL(CO), exercise capacity and health status persisted, with a more marked adverse impact among HCW.

Figure 1

Health status (Short Form General Health Survey—SF‐36) among survivors of severe acute respiratory syndrome at 3, 6, 12, 18 and 24 months after illness onset in comparisons with Hong Kong normative data stratified into different age groups. The vertical axis represents the SF‐36 domain score in mean (SD) ranging from 0 (minimum) to 100 (maximum), whereas the horizontal axis defines age groups in years. BP, bodily pain; GH, general health; MH, mental health; PF, physical functioning; RE, emotional problem; RP, physical problems; SF, social functioning; VT, vitality. *Significant at P < 0.01; **Significant at P < 0.03; #Significant at P < 0.01.