[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]
Clin Infect Dis. 2019 Nov 6. pii: ciz1062. doi: 10.1093/cid/ciz1062. [Epub ahead of print]
Long-Term Complications of Ebola Virus Disease: Prevalence and Predictors of Major Symptoms and the Role of Inflammation.
Tozay S1, Fischer WA2,3, Wohl DA3,4, Kilpatrick K5, Zou F5, Reeves E1, Pewu K1, DeMarco J3, Loftis AJ3,4, King K3, Grant D3, Schieffelin J3, Gorvego G1, Johnson H1, Conneh T1, Williams G1, Nelson JAE6, Hoover D7, McMillian D3, Merenbloom C3, Hawks D3, Dube K3, Brown J1.
Author information: 1 Eternal Love Winning Africa Hospital, Paynesville, Liberia. 2 Division of Pulmonary and Critical Care Medicine, The University of North Carolina, Chapel Hill, North Carolina, United States of America. 3 The Institute of Global Health and Infectious Diseases, The University of North Carolina, Chapel Hill, North Carolina, United States of America. 4 Division of Infectious Diseases, The University of North Carolina, Chapel Hill, North Carolina, United States of America. 5 Department of Biostatistics, The University of North Carolina, Chapel Hill, North Carolina, United States of America. 6 Department of Microbiology and Immunology, The University of North Carolina, Chapel Hill, North Carolina, United States of America. 7 ICON Government and Public Health Solutions (formerly Clinical RM), Leopardstown, Dublin, Ireland.
Cohort studies have reported a high prevalence of musculoskeletal, neurologic, auditory, and visual complications among Ebola Virus Disease (EVD) survivors; however, little is known about the host- and disease-related predictors of these symptoms and their etiological mechanisms.
The presence and patterns of eight cardinal symptoms that are most commonly reported following EVD survival were assessed in the 326 EVD survivors participating in the ongoing longitudinal Liberian EVD Survivor Study. At quarterly study visits, symptoms that developed since acute EVD were recorded and blood was collected for biomarkers of inflammation and immune activation.
At baseline (mean 408 days from acute EVD), 75.5% of survivors reported at least one new cardinal symptom since surviving EVD, which in 85.8% was rated as highly interfering with life. Two or more incident symptoms were reported by 61.0% of survivors with pairings of joint pain, headache, or fatigue the most frequent. Women were significantly more likely than men to report headache while older age was significantly associated with musculoskeletal and visual symptoms. In analyses adjusted for multiple comparisons, no statistically significant association was found between any symptom and 26 markers of inflammation and immune activation. Symptom frequency remained largely unchanged during study follow-up.
Post-EVD complications occur in a majority of survivors and remain present more than 4 years after acute infection. An association between markers of inflammation and immune activation and individual symptoms was not found, suggesting an alternative etiology for persistent post-EVD symptomatology.
© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: firstname.lastname@example.org.
KEYWORDS: Ebola virus disease; Inflammation; Post-EVD Complications; Survivors
PMID: 31693114 DOI: 10.1093/cid/ciz1062
Keywords: Ebola; Immunopathology.