Elevated Risk of Accidental Injuries in SARS Survivors and Their Relatives: Insights Relevant to the COVID-19 Pandemic—A Nationwide Cohort Study in Taiwan (Preprint)

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BACKGROUND The 2003 SARS outbreak led to both acute health impacts and lasting effects on survivors and their families. OBJECTIVE Study investigates the increased risk of accidental and intentional injuries among SARS survivors and their relatives, with implications for future pandemics, including COVID-19. METHODS This retrospective cohort study utilized data from Taiwan’s National Health Insurance Research Database, focused on 285 individuals diagnosed with SARS in 2003 and 699 of their relatives, matched in a 1:10 ratio with controls. Injury risks were assessed using Fine and Gray’s competing risk models, adjusting for sociodemographic and clinical covariates, over a follow-up period of up to 15 years. RESULTS SARS survivors had a higher risk of accidental injuries (AHR = 1.631, 95% CI: 1.184–2.011, p < 0.001), as did their relatives (AHR = 1.572, 95% CI: 1.148–1.927, p < 0.001). Subgroup analysis showed elevated risks of poisoning and falls among survivors, while relatives had higher risks of traffic accidents, poisoning, medical incidents, falls, and crushing injuries. CONCLUSIONS SARS survivors and relatives face increased injury risks, highlighting long-term physical and psychosocial vulnerabilities after severe infectious outbreaks. These findings suggest healthcare systems should provide preventive and supportive measures to mitigate long-term impacts for those affected by pandemics.