A study published in the Lancet (27/2/23) sought to characterise the long-term health outcomes of survivors of severe acute respiratory syndrome (SARS) and determine their recovery status and possible immunological basis.
We performed a clinical observational study on 14 health workers who survived SARS coronavirus infection
between Apr 20, 2003 and Jun 6, 2003 in Haihe Hospital (Tianjin, China). Eighteen years after discharge, SARS
survivors were interviewed using questionnaires on symptoms and quality of life, and received physical examination,
laboratory tests, pulmonary function tests, arterial blood gas analysis, and chest imaging. Plasma samples were
collected for metabolomic, proteomic, and single-cell transcriptomic analyses. The health outcomes were compared
18 and 12 years after discharge. Control individuals were also health workers from the same hospital but did not
infect with SARS coronavirus.
Fatigue was the most common symptom in SARS survivors 18 years after discharge, with osteoporosis and
necrosis of the femoral head being the main sequelae. The respiratory function and hip function scores of the SARS
survivors were significantly lower than those of the controls. Physical and social functioning at 18 years was improved compared to that after 12 years but still worse than the controls. Emotional and mental health were fully recovered.
Lung lesions on CT scans remained consistent at 18 years, especially in the right upper lobe and left lower lobe
lesions. Plasma multiomics analysis indicated an abnormal metabolism of amino acids and lipids, promoted host
defense immune responses to bacteria and external stimuli, B-cell activation, and enhanced cytotoxicity of CD8+ T
cells but impaired antigen presentation capacity of CD4+ T cells.
Interpretation Although health outcomes continued to improve, our study suggested that SARS survivors still suffered from physical fatigue, osteoporosis, and necrosis of the femoral head 18 years after discharge, possibly related to plasma metabolic disorders and immunological alterations.
Read the full study here.