{
  "schema_version": "2.0.0",
  "id": "moldofsky-post-sars",
  "name": "Toronto Chronic Post-SARS Cohort (Moldofsky)",
  "aliases": [
    "chronic post-SARS syndrome case-control"
  ],
  "outbreak_event": "SARS outbreak 2003 (Toronto)",
  "pathogen_id": "sars-cov-1",
  "pathogen_class": "virus",
  "exposure_ascertainment": "clinical_diagnosis",
  "design": "case_control",
  "denominator_defined": "no",
  "denominator_method": null,
  "recruitment_source": "self_referral",
  "time_zero_definition": "Recovery from acute SARS (assessed 13–36 months later)",
  "time_zero_precision": "month",
  "control_group": "healthy_convenience",
  "control_matching_variables": [
    "sex"
  ],
  "n_source_population": null,
  "n_enrolled": 29,
  "n_analysed": 29,
  "followups": [
    {
      "months": 24,
      "n_assessed": 22,
      "n_lost": null
    }
  ],
  "max_followup_months": 36,
  "instruments": [
    "polysomnography",
    "somatic-symptom-self-report"
  ],
  "case_definition": "not_applicable",
  "pem_assessed": "no",
  "objective_measures": [
    "polysomnography"
  ],
  "specimens_collected": false,
  "specimen_types": [],
  "acute_phase_specimens": "no",
  "storage": null,
  "biobank_status": "not_applicable",
  "consent_future_use": "not_applicable",
  "external_access": "closed",
  "contact": null,
  "registration_id": null,
  "funders": [],
  "conflicts": null,
  "data_availability": null,
  "notes": "Deliberately included as a methodologically weak but historically important study: small (22 cases, 7 controls), cross-sectional case-control with a convenience control group, but the first to characterize an ME/CFS/fibromyalgia-like chronic syndrome after a coronavirus — an early precedent for Long COVID.",
  "publications": [
    {
      "id": "moldofsky-2011",
      "title": "Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study",
      "authors": "Moldofsky H, Patcai J",
      "year": 2011,
      "journal": "BMC Neurology",
      "doi": "10.1186/1471-2377-11-37",
      "pmid": "21435231",
      "url": "https://pubmed.ncbi.nlm.nih.gov/21435231/",
      "open_access": true,
      "is_primary_cohort_paper": true
    }
  ],
  "symptom_inventory_scope": "single_domain",
  "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": "postsars-fatigue",
      "cohort_id": "moldofsky-post-sars",
      "publication_id": "moldofsky-2011",
      "schema_version": "2.0.0",
      "measure_id": "sym:fatigue",
      "measure_verbatim": "persistent fatigue among post-SARS subjects unable to return to former occupation",
      "population": {
        "scope": "whole_cohort",
        "stratum": null,
        "denominator_basis": "assessed_at_timepoint",
        "n_assessed": 22
      },
      "timing": {
        "timepoint_months": 24,
        "timepoint_band": "12-24mo",
        "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": 22,
        "percent": {
          "status": "measured_not_reported"
        },
        "ci": null,
        "precision": "approximate"
      },
      "comparator": {
        "group": "none",
        "value": {
          "status": "not_applicable"
        },
        "effect": null
      },
      "harmonised": null,
      "provenance": {
        "source_locator": "Results (chronic fatigue, myalgia, weakness, depression, non-restorative sleep vs healthy controls)",
        "extracted_by": null,
        "extracted_on": null,
        "verified_by": "OSMF research-tracker (web-verified against source)",
        "verified_on": "2026-07-20",
        "extraction_method": "manual"
      }
    }
  ]
}