Severe acute respiratory syndrome (SARS) has been labelled a mental health catastrophe, an infectious atypical pneumonia condition that spread to 29 countries in 2002/2003, infecting over 8,000 people, 774 of whom died. A literature search on electronic databases, including MEDLINE, PsycINFO, CINAHL, and Cochrane Library was used to conduct a critical review of the English language literature on the psychological impact of SARS for survivors. Twenty original studies pertaining to the psychological experience of patients revealed prominent symptoms: in the acute and early recovery stages, psychotic symptomatology, fear for survival, and fear of infecting others; across all timeframes, stigmatization, reduced quality of life, and psychological distress; posttraumatic stress symptoms were prevalent across all stages post-SARS. Health care workers with SARS were found to be at increased risk. Limitations within many studies restrict the optimal usefulness of the findings. Studies included in our review consistently reported high rates of emotional distress among survivors, persisting for years postinfection. Recommendations to enhance comparability across studies for future outbreaks were proposed.

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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 . Public Significance StatementThe 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.