SARS Survivors Are Struck By Side Effects of Treatment

An increasing number of survivors of severe acute respiratory syndrome (SARS) are suffering from the horrifying side effects of a cure for the pandemic that captured the world early this year.

The Asian Wall Street Journal reported on December 23 that an irreversible disease corrupting bones struck many of the people who were treated for SARS with an overdose of an anti-inflammatory medication.

Zhang Fan, a 25-year-old Beijing resident, and his wife Zhang Xuewei, a 31-year-old nurse, began to feel increasing pain in their knees and hips not long after the celebration of their survival of SARS. Now the husband has to use crutches and the wife is wheelchair-bound.

They were struck by the aftershock of corticosteroids which they took intravenously to assuage the burning pain in their lungs while suffering from SARS. They are now stricken with vascular necrosis. Symptoms typically begin with stiffness or pain in the hip, knee, ankle, or shoulder joints, and often culminate in the crumbling of those bones, requiring grafts or joint replacements.

The spread of avascular necrosis is especially evident in China. One in every three of Beijing’s 2,521 SARS survivors fell victim to the bone disease.

In the early days of SARS’s outbreak, doctors realized that corticosteroids can be used to treat the disease. They were not – and are still not – sure how many doses they need for treatment.

Chinese doctors used more dosages of the steroid for longer periods of time. In Beijing, an average course of the steroid methylprednisolone routinely lasted more than a month, while in Canada, Singapore and Vietnam, where no outbreaks of the bone disease have been reported to date, the same course did not last more than 15 days and did not exceed cumulative doses of 2,000 milligrams of methylprednisolone.

While clinicians in other countries controlled the dosage according to the level of the seriousness of each patient, Chinese doctors used the same dosage on all patients.

While shunning public comment on the aftershock of the steroid treatment, the Chinese medical community is searching for ways to cure the bone disease, reported the AWSJ. The journal pointed out that while countries have made every effort to stop the spread of the pandemic worldwide, there was little exchange of information about the treatment.

Ki-Tae Kwon kkt@donga.com