Elevated Risk of Accidental Injuries in SARS Survivors and Their Relatives: Insights Relevant to the COVID-19 Pandemic—A Nationwide Cohort Study in Taiwan (Preprint)

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Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: The 2003 SARS outbreak led to both acute health impacts and lasting effects on survivors and their families. Objective: Study investigates the increased risk of accidental and intentional injuries among SARS survivors and their relatives, with implications for future pandemics, including COVID-19. Methods: This retrospective cohort study utilized 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. Results: SARS survivors had a higher risk of accidental injuries (AHR = 1.631, 95% CI: 1.184–2.011, p < 0.001), as did their relatives (AHR = 1.572, 95% CI: 1.148–1.927, p < 0.001). Subgroup analysis showed elevated risks of poisoning and falls among survivors, while relatives had higher risks of traffic accidents, poisoning, medical incidents, falls, and crushing injuries. Conclusions: SARS survivors and relatives face increased injury risks, highlighting long-term physical and psychosocial vulnerabilities after severe infectious outbreaks. These findings suggest healthcare systems should provide preventive and supportive measures to mitigate long-term impacts for those affected by pandemics.

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