COVID-19-Relevant Insights Into the Elevated Risk of Accidental Injuries in Survivors of SARS and Their Relatives in Taiwan: Retrospective Cohort Study.

Publication date: Jul 08, 2025

The 2003 outbreak of severe acute respiratory syndrome (SARS), caused by a novel coronavirus, heavily impacted Taiwan’s health care system, triggering clinical crises and lasting effects among affected individuals and families. The first case in Taiwan was identified on February 25, 2003, and the final case was reported on June 15, 2003. During the epidemic, 346 people were diagnosed with SARS, leading to 37 deaths. Outbreaks also occurred in China, Singapore, and Toronto (Canada), showing the vulnerability of global health systems to new zoonotic diseases. Clinically, SARS causes high fever and severe lung inflammation. Survivors often had long-term lung problems, including fibrosis, and bone issues like osteonecrosis, mostly due to high-dose steroid treatment. Although studies have looked at long-term outcomes-especially lung and bone issues-none followed patients beyond 7 years. The COVID-19 pandemic further revealed gaps in understanding how serious viral infections affect wider health areas, including unintentional and intentional injuries. Data on related hospitalizations also remain limited. This study aimed to investigate the long-term risk of both unintentional and intentional injuries among survivors of SARS and their relatives, using a nationwide population-based cohort. This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database, focused on 285 individuals diagnosed with SARS in 2003 and 699 of their relatives, matched in a 1:10 ratio with controls. Injury risks were assessed using Fine and Gray’s competing risk models, adjusting for sociodemographic and clinical covariates, over a follow-up period of up to 15 years. Survivors of SARS exhibited a significant increase in the risk of accidental injuries, with an adjusted hazard ratio (AHR) of 1. 631 (95% CI 1. 184-2. 011; P

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Concepts Keywords
Canada accidental falls
Coronavirus accidental injuries
June Adolescent
Relatives Adult
Zoonotic Aged
caregivers
Child
COVID-19
COVID-19 pandemic
Family
Female
Humans
intentional injuries
Male
Middle Aged
poisoning
population surveillance
psychological stress
psychosocial impacts
Retrospective Studies
Risk Factors
SARS
Survivors
survivors of SARS
Taiwan
Wounds and Injuries
Young Adult

Semantics

Type Source Name
disease MESH COVID-19
disease MESH severe acute respiratory syndrome
disease MESH zoonotic diseases
disease MESH causes
disease MESH lung inflammation
disease MESH fibrosis
disease MESH osteonecrosis
disease MESH viral infections
drug DRUGBANK Coenzyme M
disease MESH psychological stress

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