Neurocognitive Outcome Following Recovery from Severe Acute Respiratory Syndrome - Coronavirus-1 (SARS-CoV-1).

OBJECTIVE: Severe acute respiratory syndrome (SARS) is a highly contagious viral respiratory illness associated with hypoxia and dyspnea. Many of those who contracted and recovered from SARS during the 2002-2003 outbreak reported persistent physical, psychological, and cognitive difficulties. Here, we investigated the residual influences of SARS on cognition for a subset of healthcare professionals who recovered and were referred for neuropsychological evaluation through their workplace insurance. METHOD: Twenty-eight healthcare professionals were evaluated on neuropsychological and mood functioning approximately 1.5 years post-recovery from a severe respiratory illness. Test scores were compared with age-matched normative data, and correlations were examined between mood, self-report memory scales, subjective complaints (e.g., poor concentration, pain, fatigue), illness severity (i.e., length of hospitalization, oxygen use during hospital stay), and cognitive performance. RESULTS: Participants performed within age expectations on the majority of cognitive measures including overall memory ability. Although processing speed was generally within normal limits, 43% showed significant speed-accuracy trade-offs favoring accuracy over maintaining speed. Deficits were observed on measures of complex attention, such as working memory and the ability to sustain attention under conditions of distraction. Participants endorsed poorer memory ability than same-age peers on a meta-memory measure and mild to moderate depression and anxiety symptoms. Objective test performance was largely uncorrelated with self-reports, mood, or illness severity, except for moderate correlations between complex attention and participants' subjective ratings of Everyday Task-Oriented Memory. CONCLUSIONS: These findings demonstrate specific long-term cognitive deficits associated with SARS and provide further evidence of the cognitive effects of hypoxic illnesses.

Chronic PTSD and other psychological sequelae in a group of frontline healthcare workers who contracted and survived SARS

The Severe Acute Respiratory Syndrome (SARS) epidemic of 2003 was highly concentrated in health care settings and resulted in a high number of health care workers (HCWs) contracting the disease. The SARS epidemic has improved our understanding of how trauma impacts frontline HCWs who serve as first responders during an infectious disease outbreak. However, our insight into the trajectory of frontline HCWs' morbidity posttrauma continues to be limited, as the majority of the previous work has focused on the short-term or immediate impact of SARS on HCWs, with only a few studies dedicated to the evaluation of its long-term or sustained impact. Previous research into the long-term impact of SARS on HCWs spans 1-3 years postoutbreak. The present study extends previous research by examining HCWs up to 7 years postoutbreak. More specifically, frontline HCWs who contracted and survived SARS were evaluated at 1 year (2004), 4 years (2007), and 7 years (2010) postoutbreak by using a within-participants design. Across all three time points, frontline HCWs showed a lack of abatement in clinically significant levels of depression, anxiety, and posttraumatic stress disorder (PTSD) symptomatology. In addition, HCWs reported below average and persistent functional outcomes, such as problems with pain, reduced vitality, and reductions in physical, mental, and social functioning. Finally, we report on the particular psychiatric variables from 1 year postoutbreak that are significantly associated with functional debility at 4 and 7 years postoutbreak. Findings of this study underscore the importance of understanding the long-term sequelae of infectious disease outbreaks on frontline HCWs, in order to decrease the likelihood of chronic adverse outcomes in this population. This information is especially relevant now, given the current global outbreak of Coronavirus disease 2019 (COVID-19). (PsycInfo Database Record (c) 2021 APA, all rights reserved) Abstract (French) L'epidemie de syndrome respiratoire aigu severe (SRAS) de 2003 s'est grandement manifestee dans les milieux de soins de sante, et un grand nombre de travailleurs de la sante (TS) ont contracte la maladie. L'epidemie de SRAS a grandement ameliore notre comprehension de l'incidence d'un traumatisme parmi les TS de premiere ligne qui constituent les premiers intervenants durant les eclosions d'une maladie infectieuse. Toutefois, nos connaissances sur la trajectoire de la morbidite post-traumatique parmi les TS de premiere ligne restent limitees, car la majorite des recherches anterieures ont porte sur les effets immediats ou a court terme du SRAS sur les TS;quelques etudes seulement etaient destinees a evaluer son incidence soutenue ou a long terme. Les recherches anterieures sur les effets a long terme du SRAS sur les TS s'etendaient sur 1 a 3 ans post-epidemie. La presente etude pousse plus loin les recherches precedentes en examinant les TS jusqu'a 7 ans apres l'epidemie. Plus precisement, les TS de premiere ligne qui ont survecu a une infection au SRAS ont ete evalues a 1 an (2004), a 4 ans (2007) et a 7 ans (2010) apres l'epidemie dans le cadre d'une etude de conception intrasujet. Aux trois points, on a constate chez les TS de premiere ligne un manque de reduction des symptomes de depression, d'anxiete et du trouble de stress post-traumatique (TSPT) de niveaux cliniquement significatifs. De plus, les TS ont rapporte des resultats fonctionnels inferieurs a la moyenne et persistants, tels que de la douleur, une vitalite diminuee et une diminution du fonctionnement physique, mental et social. Finalement, nous rapportons des variables psychiatriques particulieres depuis l'annee 1 post-epidemie, qui sont significativement associees a une souffrance fonctionnelle aux annees 4 et 7 post-epidemie. Les resultats de cette etude soulignent l'importance de comprendre les sequelles a long terme des eclosions de maladies infectieuses parmi les TS, afin de reduire les probabilites de problemes chroniques parmi cette population. Cette information est particulierement pertinente aujourd'hui etant donne la pandemie de coronavirus 2019 (COVID-19). (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement <strong xmlns:lang="en">Public Significance Statement-The present study is one of a few studies that has thus far examined the long-term impact of an infectious disease outbreak on frontline healthcare workers. A group of Canadian frontline healthcare workers who contracted and survived SARS were evaluated at 1 year (2004), 4 years (2007), and 7 years (2010) postoutbreak. Across all three time points, frontline healthcare workers reported clinically significant levels of anxiety, depression, and PTSD symptomatology, in addition to adverse functional outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved)