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SARS Survivors Show Exercise Limitations, But Psychosocial Factors May Also Be at Play: Presented at CHEST

By Bonnie Darves

SEATTLE, WA -- October 28, 2004 -- Survivors of severe acute respiratory syndrome (SARS) may sustain some long-term exercise limitations as a result of respiratory impairment, but teasing out the direct effects of the disease from possible psychosocial and psychological factors might be a challenge.

In a study presented here October 26th at CHEST 2004, the 70th annual international scientific meeting of the American College of Chest Physicians, researchers from the outbreak's epicenter, Hong Kong, reported that objective measures of exercise limitation did not always match survivors' self-reported limitations.

Although most subjects reported having exercise impairment, only 43% of subjects had objective markers of -- at most mild -- exercise impairment, said lead author Veronica L. Chan, MBChB, staff physician, division of respiratory medicine, United Christian Hospital, Kowloon, Hong Kong. "Clearly, more study of the psychosocial factors in SARS survivors is needed."

To determine the long-term physical effects of SARS infection, the researchers used symptom-limited cardiopulmonary exercise testing and peak oxygen consumption (VO2max) in 16 women and 3 men who had been discharged 6 months earlier after being treated for SARS infection. Subjects had a mean age of 36.2 years.

Several of the subjects who were healthcare workers reported reduced work capacity or inability to return to work because of deconditioning and exercise limitations, Ms. Chan said.

On lung function testing, all subjects who had reported moderate to severe impairment were found to have normal lung function.

"There was a greater prevalence of reported limitation in the healthcare workers, even though there was little evidence of residual pulmonary fibrosis," she said, noting that two thirds of those subjects claimed exercise limitation severe enough to prevent their return to work.

Mean VO2max was 88% of the predicted value, and cardiopulmonary exercise testing was normal in 25% of patients. Three patients had cardiac limitation of exercise -- 2 showed ischemic changes on electrocardiogram and a third experienced arrhythmia during exercise. Only 1 patient had ventilatory limitations of exercise and 1 had steroid-induced myopathy.


[Presentation title: "Exercise Limitation in Survivors of Severe Acute Respiratory Syndrome (SARS)." Abstract 1088]

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