TY - JOUR
T1 - Laboratory Findings, Compassionate Use of Favipiravir, and Outcome in Patients With Ebola Virus Disease, Guinea, 2015-A Retrospective Observational Study
AU - Kerber, Romy
AU - Lorenz, Eva
AU - Duraffour, Sophie
AU - Sissoko, Daouda
AU - Rudolf, Martin
AU - Jaeger, Anna
AU - Cisse, Sekou Ditinn
AU - Camara, Alseny Modet
AU - Miranda, Osvaldo
AU - Castro, Carlos M.
AU - Akoi Bore, Joseph
AU - Raymond Koundouno, Fara
AU - Repits, Johanna
AU - Afrough, Babak
AU - Becker-Ziaja, Beate
AU - Hinzmann, Julia
AU - Mertens, Marc
AU - Vitoriano, Ines
AU - Hugh Logue, Christopher
AU - Böttcher, Jan Peter
AU - Pallasch, Elisa
AU - Sachse, Andreas
AU - Bah, Amadou
AU - Cabeza-Cabrerizo, Mar
AU - Nitzsche, Katja
AU - Kuisma, Eeva
AU - Michel, Janine
AU - Holm, Tobias
AU - Zekeng, Elsa Gayle
AU - Cowley, Lauren A.
AU - Garcia-Dorival, Isabel
AU - Hetzelt, Nicole
AU - Baum, Jonathan Hans Josef
AU - Portmann, Jasmine
AU - Carter, Lisa
AU - Yenamaberhan, Rahel Lemma
AU - Camino, Alvaro
AU - Enkirch, Theresa
AU - Singethan, Katrin
AU - Meisel, Sarah
AU - Mazzarelli, Antonio
AU - Kosgei, Abigail
AU - Kafetzopoulou, Liana
AU - Rickett, Natasha Y.
AU - Patrono, Livia Victoria
AU - Ghebreghiorghis, Luam
AU - Arnold, Ulrike
AU - Colin, Géraldine
AU - Ippolito, Giuseppe
AU - Caro, Antonino Di
PY - 2019/6/19
Y1 - 2019/6/19
N2 - BACKGROUND: In 2015, the laboratory at the Ebola treatment center in Coyah, Guinea, confirmed Ebola virus disease (EVD) in 286 patients. The cycle threshold (Ct) of an Ebola virus-specific reverse transcription-polymerase chain reaction assay and 13 blood chemistry parameters were measured on admission and during hospitalization. Favipiravir treatment was offered to patients with EVD on a compassionate-use basis. METHODS: To reduce biases in the raw field data, we carefully selected 163 of 286 patients with EVD for a retrospective study to assess associations between potential risk factors, alterations in blood chemistry findings, favipiravir treatment, and outcome. RESULTS: The case-fatality rate in favipiravir-treated patients was lower than in untreated patients (42.5% [31 of 73] vs 57.8% [52 of 90]; P = .053 by univariate analysis). In multivariate regression analysis, a higher Ct and a younger age were associated with survival (P < .001), while favipiravir treatment showed no statistically significant effect (P = .11). However, Kaplan-Meier analysis indicated a longer survival time in the favipiravir-treated group (P = .015). The study also showed characteristic changes in blood chemistry findings in patients who died, compared with survivors. CONCLUSIONS: Consistent with the JIKI trial, this retrospective study revealed a trend toward improved survival in favipiravir- treated patients; however, the effect of treatment was not statistically significant, except for its influence on survival time.
AB - BACKGROUND: In 2015, the laboratory at the Ebola treatment center in Coyah, Guinea, confirmed Ebola virus disease (EVD) in 286 patients. The cycle threshold (Ct) of an Ebola virus-specific reverse transcription-polymerase chain reaction assay and 13 blood chemistry parameters were measured on admission and during hospitalization. Favipiravir treatment was offered to patients with EVD on a compassionate-use basis. METHODS: To reduce biases in the raw field data, we carefully selected 163 of 286 patients with EVD for a retrospective study to assess associations between potential risk factors, alterations in blood chemistry findings, favipiravir treatment, and outcome. RESULTS: The case-fatality rate in favipiravir-treated patients was lower than in untreated patients (42.5% [31 of 73] vs 57.8% [52 of 90]; P = .053 by univariate analysis). In multivariate regression analysis, a higher Ct and a younger age were associated with survival (P < .001), while favipiravir treatment showed no statistically significant effect (P = .11). However, Kaplan-Meier analysis indicated a longer survival time in the favipiravir-treated group (P = .015). The study also showed characteristic changes in blood chemistry findings in patients who died, compared with survivors. CONCLUSIONS: Consistent with the JIKI trial, this retrospective study revealed a trend toward improved survival in favipiravir- treated patients; however, the effect of treatment was not statistically significant, except for its influence on survival time.
KW - Ebola virus disease
KW - epidemic
KW - Favipiravir
KW - Filovirus
KW - Guinea
KW - mobile laboratory
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U2 - 10.1093/infdis/jiz078
DO - 10.1093/infdis/jiz078
M3 - Article
C2 - 30788508
AN - SCOPUS:85068478513
SN - 0022-1899
VL - 220
SP - 195
EP - 202
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 2
ER -