Background: Persistent impaired pulmonary function and functional capacity are common among survivors of severe acute respiratory syndrome (SARS). Whether the impairment was caused by SARS or pre-existing physical condition remains unclear. Objective: This study investigated the influence of SARS on exercise capacity and pulmonary function of previously healthy medical staff.Methods: Pulmonary function tests, including spirometry and carbon monoxide diffusing capacity (DLCO), as well as symptom-limited cardiopulmonary exercise testing (CPET) with an incremental protocol using an electronically braked cycle ergometer, were performed by 13 previously healthy hospital workers 14 months after SARS recovery. Other 14 age- and sex-matched healthy medical workers completed CPET simultaneously, and exercise capacities of these two groups were compared. Results: Most values of spirometry performed were within normal range. Only one showed mildly restrictive abnormality with decreased forced expiratory volume in 1 s (72.2% predicted) and forced vital capacity (68.1% predicted). Eight subjects had decreased DLCO levels (mean 79.37 ± 7.73%), and low exercise capacity was noted in 9 subjects. Discordance in impairment of the measured DLCO and exercise capacity was revealed by comparison. Besides, there was no significant difference in results of CPET between subjects recovered from SARS and those never infected. Conclusions: Minor pulmonary function defects as well as decreased exercise capacity were detected in previously healthy medical staff after recovering from SARS. No significant correlation between exercise capacity and pulmonary function was found.

1.
Ksiazek TG, Erdman D, Goldsmith CS, Zaki SR, Peret T, Emery S, Tong S, Urbani C, Comer JA, Lim W, Rollin PE, Dowell SF, Ling AE, Humphrey CD, Shieh WJ, Guarner J, Paddock CD, Rota P, Fields B, DeRisi J, Yang JY, Cox N, Hughes JM, LeDuc JW, Bellini WJ, Anderson LJ: A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med 2003;348:1953–1966.
2.
Chan KS, Zheng JP, Mok YW, Li YM, Liu YN, Chu CM, Ip MS: SARS: prognosis, outcome and sequelae. Respirology 2003;8:S36–S40.
3.
Ng CK, Chan JW, Kwan TL, To TS, Chan YH, Ng FY, Mok TY: Six month radiological and physiological outcomes in severe acute respiratory syndrome (SARS) survivors. Thorax 2004;59:889–891.
4.
Hui DS, Wong KT, Ko FW, Tam LS, Chan DP, Woo J, Sung JJ: The 1-year impact of severe acute respiratory syndrome on pulmonary function, exercise capacity, and quality of life in a cohort of survivors. Chest 2005;128:2247–2261.
5.
Wang YH, Lin AS, Chao TY, Lu SN, Liu JW, Chen SS, Lin MC: A cluster of patients with severe acute respiratory syndrome in a chest ward in southern Taiwan. Intensive Care Med 2004;30:1228–1231.
6.
American Thoracic Society: Standardization of spirometry. Am J Respir Crit Care Med 1995;152:1107–1136.
7.
Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC: Lung volume and forced ventilatory flows. Official statement of the European Respiratory Society. Eur Respir J Suppl 1993;16:5–40.
8.
American Thoracic Society: Single-breath carbon monoxide diffusing capacity (transfer factor): recommendations for a standardized technique – 1995 update. Am J Respir Crit Care Med 1995;152:2185–2198.
9.
Wasserman K, Hansen JE, Sue DY, Casaburi R, Whipp BJ: Principles of interpretation: a flow chart approach; in Weinberg R (ed): Principles of Exercise Testing and Interpretation – Including Pathophysiology and Clinical Applications. Baltimore, Lippincott Williams & Wilkins, 1999, pp 165–177.
10.
American Thoracic Society/American College of Chest Physicians: ATS/ACCP statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 2003;167:211–277.
11.
Chiang CH, Shih JF, Su WJ, Perng RP: Eight-month prospective study of 14 patients with hospital-acquired severe acute respiratory syndrome. Mayo Clin Proc 2004;79:1372–1379.
12.
Herridge MS: Long-term outcomes after critical illness. Curr Opin Crit Care 2002;8:331–336.
13.
Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, Cooper AB, Guest CB, Mazer CD, Mehta S, Stewart TE, Barr A, Cook D, Slutsky AS: One-year outcome in survivors of the acute respiratory distress syndrome. N Engl J Med 2003;348:683–693.
14.
Ong KC, Ng AW, Lee LS, Kaw G, Kwek SK, Leow MK, Earnest A: Pulmonary function and exercise capacity in survivors of severe acute respiratory syndrome. Eur Respir J 2004;24:436–442.
15.
Pothoff G, Wassermann K, Ostmann H: Impairment of exercise capacity in various groups of HIV-infected patients. Respiration 1994;61:80–85.
16.
Saey D, Debigaré R, LeBlanc P, Mandor MJ, Côté CH, Jobin J, Maltais F: Contractile leg fatigue after cycle exercise. A factor limiting exercise in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2003;168:425–430.
17.
Mura M, Ferretti A, Ferro O, Zompatori M, Cavalli A, Schiavina M, Fabbri M: Functional predictors of exertional dyspnea, 6-min walking distance and HRCT fibrosis score in idiopathic pulmonary fibrosis. Respiration 2006;73:495–502.
18.
Hui DS, Joynt GM, Wong KT, Gomersall CD, Li TS, Antonio G, Ko FW, Chan MC, Chan DP, Tong MW, Rainer TH, Ahuja AT, Cockram CS, Sung JJY: Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors. Thorax 2005;60:401–409.
19.
Neff TA, Stocker R, Frey HR, Stein S, Russi EW: Long-term assessment of lung function in survivors of severe ARDS. Chest 2003;123:845–853.
20.
Myers J, Prakash M, Froelicher VF, Do D, Partington S, Atwood JE: Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 2002;346:793–801.
21.
Weiss JP, Froelicher VF, Myers JN, Heidenreich PA: Health-care costs and exercise capacity. Chest 2004;126:608–613.
22.
Babb TG, Long KA, Rodarte JR: The relationship between maximal expiratory flow and increases of maximal exercise capacity with exercise training. Am J Respir Crit Care Med 1997;156:116–121.
23.
Lau HM, Ng GY, Jones AY, Lee EW, Siu EH, Hui DS: A randomized controlled trial of the effectiveness of an exercise training program in patients recovering from severe acute respiratory syndrome. Aust J Physiother 2005;51:213–219.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.