Most Canadians who survived SARS recovered well physically, but many had psychological problems and reported a lower quality of life one year later, finds a study in the Archives of Internal Medicine.
Catherine M. Tansey of the University Health Network in Toronto, and colleagues, evaluated 117 patients who got sick from SARS in Toronto in 2003. More than two-thirds of the subjects were female, and 65 per cent were health care workers.
The patients were evaluated three, six and 12 months after leaving the hospital and underwent physical examinations, while also reporting how often they saw a physician. Formal caregivers of survivors were also given a survey on their caregiver burden one year later.
The survey found that the survivors used health care services frequently the first year after hospitalization, with psychiatric evaluations accounting for the greatest number of visits.
"Of the patients, 74 per cent saw their primary care physician a median of five times," the authors said.
A year after leaving hospital, health-related quality of life was lower than in the general population, and patients reported decreases in mental health. General health, vitality and social functioning also remained below the normal range.
"These findings are reflected in the notable utilization of psychiatric and psychological services in the one-year follow-up period," the authors conclude.
Many patients experienced social stigmatization and loss of anonymity through the media. Some experienced death of close family members and coworkers, and were unable to be present at the time of death or attend funeral services because of quarantine, isolation, or hospitalization.
Several described the emotional strain of quarantine and isolation. Others described overwhelming fear for their physical health and a deep concern about the possibility of transmission to family or loved ones.
Those who cared for some of the survivors (most often, the spouse) also showed a decline in mental health, caused by reported lifestyle interference and loss of control, the caregiver surveys showed.
Many patients returned to work part-time after their recovery, increasing their workload over the first two months while 23 patients returned to work full-time with no need for a modified schedule.
"At one year, 17 per cent of patients had not returned to work, and a further nine per cent had not returned to their pre-SARS level of work," the authors note.
"These data may help to highlight the needs of patients and caregivers during and after an epidemic, the potential benefit of a family-centered approach to follow-up care, and the importance of exploring strategies to minimize the psychological burden of an epidemic illness as part of future pandemic planning initiatives."
