{
  "schema_version": "2.0.0",
  "id": "lam-2009-sars-survivors",
  "name": "Hong Kong SARS survivors 4-year follow-up (Lam)",
  "aliases": [
    "SARS survivors long-term follow-up"
  ],
  "outbreak_event": "SARS outbreak 2003 (Hong Kong)",
  "pathogen_id": "sars-cov-1",
  "pathogen_class": "virus",
  "exposure_ascertainment": "clinical_diagnosis",
  "design": "cross_sectional",
  "denominator_defined": "partial",
  "denominator_method": "Survivors of laboratory/clinically diagnosed SARS from the 2003 Hong Kong outbreak, assessed at a single 4-year follow-up.",
  "recruitment_source": "hospital",
  "time_zero_definition": "Acute SARS illness in 2003",
  "time_zero_precision": "year",
  "control_group": "none",
  "control_matching_variables": [],
  "n_source_population": null,
  "n_enrolled": 233,
  "n_analysed": 181,
  "followups": [
    {
      "months": 48,
      "n_assessed": 181,
      "n_lost": null
    }
  ],
  "max_followup_months": 48,
  "instruments": [
    "somatic-symptom-self-report"
  ],
  "case_definition": "author_defined",
  "pem_assessed": "no",
  "objective_measures": [
    "none"
  ],
  "specimens_collected": false,
  "specimen_types": [],
  "acute_phase_specimens": "no",
  "storage": null,
  "biobank_status": "not_applicable",
  "consent_future_use": "not_applicable",
  "external_access": "not_applicable",
  "contact": null,
  "registration_id": null,
  "funders": [
    "not reported"
  ],
  "conflicts": null,
  "data_availability": null,
  "notes": "Cross-sectional 4-year follow-up of the 2003 SARS-CoV-1 survivors, showing high rates of chronic fatigue and a subset meeting CFS criteria years after the acute illness. A single-timepoint survivor survey with no acute-phase or unexposed comparison, but historically important as a coronavirus antecedent to Long COVID.",
  "publications": [
    {
      "id": "lam-2009",
      "title": "Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up",
      "authors": "Lam MH, Wing YK, Yu MW, et al.",
      "year": 2009,
      "journal": "Archives of Internal Medicine",
      "doi": "10.1001/archinternmed.2009.384",
      "pmid": "20008700",
      "url": "https://pubmed.ncbi.nlm.nih.gov/20008700/",
      "open_access": true,
      "is_primary_cohort_paper": true
    }
  ],
  "symptom_inventory_scope": "targeted_panel",
  "n_symptoms_queried": null,
  "symptom_instrument_note": null,
  "related_cohorts": [],
  "last_verified": "2026-07-20",
  "verified_by": "OSMF research-tracker (web-verified against source)",
  "harmonisation_ruleset": "pais-harmony-v1",
  "observations": [
    {
      "id": "lam-chronic-fatigue-4yr",
      "cohort_id": "lam-2009-sars-survivors",
      "publication_id": "lam-2009",
      "schema_version": "2.0.0",
      "measure_id": "sym:fatigue",
      "measure_verbatim": "chronic fatigue at ~4 years after SARS",
      "population": {
        "scope": "whole_cohort",
        "stratum": null,
        "denominator_basis": "assessed_at_timepoint",
        "n_assessed": 181
      },
      "timing": {
        "timepoint_months": 48,
        "timepoint_band": "24mo+",
        "reference_period": "not_reported",
        "is_cumulative": false
      },
      "method": {
        "ascertainment": "unclear",
        "instrument_id": null,
        "severity_threshold": null,
        "blinded_assessment": "not_reported"
      },
      "value": {
        "type": "proportion",
        "numerator": {
          "status": "measured_not_reported"
        },
        "denominator": 181,
        "percent": 40.3,
        "ci": null,
        "precision": "approximate"
      },
      "comparator": {
        "group": "none",
        "value": {
          "status": "not_applicable"
        },
        "effect": null
      },
      "harmonised": null,
      "provenance": {
        "source_locator": "Results (40.3% chronic fatigue)",
        "extracted_by": null,
        "extracted_on": null,
        "verified_by": "OSMF research-tracker (web-verified against source)",
        "verified_on": "2026-07-20",
        "extraction_method": "manual"
      }
    },
    {
      "id": "lam-cfs-4yr",
      "cohort_id": "lam-2009-sars-survivors",
      "publication_id": "lam-2009",
      "schema_version": "2.0.0",
      "measure_id": "case-def:cfs",
      "measure_verbatim": "met modified CDC criteria for chronic fatigue syndrome at ~4 years after SARS",
      "population": {
        "scope": "whole_cohort",
        "stratum": null,
        "denominator_basis": "assessed_at_timepoint",
        "n_assessed": 181
      },
      "timing": {
        "timepoint_months": 48,
        "timepoint_band": "24mo+",
        "reference_period": "not_reported",
        "is_cumulative": false
      },
      "method": {
        "ascertainment": "unclear",
        "instrument_id": null,
        "severity_threshold": null,
        "blinded_assessment": "not_reported"
      },
      "value": {
        "type": "proportion",
        "numerator": {
          "status": "measured_not_reported"
        },
        "denominator": 181,
        "percent": 27.1,
        "ci": null,
        "precision": "approximate"
      },
      "comparator": {
        "group": "none",
        "value": {
          "status": "not_applicable"
        },
        "effect": null
      },
      "harmonised": null,
      "provenance": {
        "source_locator": "Results (27.1% met CFS criteria)",
        "extracted_by": null,
        "extracted_on": null,
        "verified_by": "OSMF research-tracker (web-verified against source)",
        "verified_on": "2026-07-20",
        "extraction_method": "manual"
      }
    }
  ]
}