Laboratory Findings, Compassionate Use of Favipiravir, and Outcome in Patients With Ebola Virus Disease, Guinea, 2015-A Retrospective Observational Study

Romy Kerber, Eva Lorenz, Sophie Duraffour, Daouda Sissoko, Martin Rudolf, Anna Jaeger, Sekou Ditinn Cisse, Alseny Modet Camara, Osvaldo Miranda, Carlos M. Castro, Joseph Akoi Bore, Fara Raymond Koundouno, Johanna Repits, Babak Afrough, Beate Becker-Ziaja, Julia Hinzmann, Marc Mertens, Ines Vitoriano, Christopher Hugh Logue, Jan Peter BöttcherElisa Pallasch, Andreas Sachse, Amadou Bah, Mar Cabeza-Cabrerizo, Katja Nitzsche, Eeva Kuisma, Janine Michel, Tobias Holm, Elsa Gayle Zekeng, Lauren A. Cowley, Isabel Garcia-Dorival, Nicole Hetzelt, Jonathan Hans Josef Baum, Jasmine Portmann, Lisa Carter, Rahel Lemma Yenamaberhan, Alvaro Camino, Theresa Enkirch, Katrin Singethan, Sarah Meisel, Antonio Mazzarelli, Abigail Kosgei, Liana Kafetzopoulou, Natasha Y. Rickett, Livia Victoria Patrono, Luam Ghebreghiorghis, Ulrike Arnold, Géraldine Colin, Giuseppe Ippolito, Antonino Di Caro

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)195-202
Number of pages8
JournalThe Journal of infectious diseases
Volume220
Issue number2
DOIs
Publication statusPublished - Jun 19 2019

Keywords

  • Ebola virus disease
  • epidemic
  • Favipiravir
  • Filovirus
  • Guinea
  • mobile laboratory

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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    Kerber, R., Lorenz, E., Duraffour, S., Sissoko, D., Rudolf, M., Jaeger, A., Cisse, S. D., Camara, A. M., Miranda, O., Castro, C. M., Akoi Bore, J., Raymond Koundouno, F., Repits, J., Afrough, B., Becker-Ziaja, B., Hinzmann, J., Mertens, M., Vitoriano, I., Hugh Logue, C., ... Caro, A. D. (2019). Laboratory Findings, Compassionate Use of Favipiravir, and Outcome in Patients With Ebola Virus Disease, Guinea, 2015-A Retrospective Observational Study. The Journal of infectious diseases, 220(2), 195-202. https://doi.org/10.1093/infdis/jiz078