title: Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study.
abstract: BACKGROUND
  The long term adverse effects of Severe Acute Respiratory Syndrome (SARS), a viral disease, are poorly understood.
  
  
  METHODS
  Sleep physiology, somatic and mood symptoms of 22 Toronto subjects, 21 of whom were healthcare workers, (19 females, 3 males, mean age 46.29 yrs.+/- 11.02) who remained unable to return to their former occupation (mean 19.8 months, range: 13 to 36 months following SARS) were compared to 7 healthy female subjects. Because of their clinical similarities to patients with fibromyalgia syndrome (FMS) these post-SARS subjects were similarly compared to 21 drug free female patients, (mean age 42.4 +/- 11.8 yrs.) who fulfilled criteria for fibromyalgia.
  
  
  RESULTS
  Chronic post-SARS is characterized by persistent fatigue, diffuse myalgia, weakness, depression, and nonrestorative sleep with associated REM-related apneas/hypopneas, an elevated sleep EEG cyclical alternating pattern, and alpha EEG sleep anomaly. Post- SARS patients had symptoms of pre and post-sleep fatigue and post sleep sleepiness that were similar to the symptoms of patients with FMS, and similar to symptoms of patients with chronic fatigue syndrome. Both post-SARS and FMS groups had sleep instability as indicated by the high sleep EEG cyclical alternating pattern rate. The post-SARS group had a lower rating of the alpha EEG sleep anomaly as compared to the FMS patients. The post-SARS group also reported less pre-sleep and post-sleep musculoskeletal pain symptoms.
  
  
  CONCLUSIONS
  The clinical and sleep features of chronic post-SARS form a syndrome of chronic fatigue, pain, weakness, depression and sleep disturbance, which overlaps with the clinical and sleep features of FMS and chronic fatigue syndrome.
authors: Sleep Disorders Clinic of the Centre for Sleep and Chronobiology, 340 College St,, Suite 580, Toronto, ON M5T 3A9, Canada. h.moldofsky@utoronto.ca
authors: Harvey
authors: H
authors: Moldofsky
authors: John
authors: J
authors: Patcai
mesh_terms: D016022:Case-Control Studies; D002908:Chronic Disease; D003863:Depression / Q000209:etiology*; D005221:Fatigue / Q000209:etiology*; D015673:Fatigue Syndrome, Chronic / Q000503:physiopathology; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000209:etiology*; D010146:Pain / Q000209:etiology*; D045169:Severe Acute Respiratory Syndrome / Q000150:complications* / Q000503:physiopathology; D012893:Sleep Wake Disorders / Q000209:etiology*