Age and Ebola viral load correlate with mortality and survival time in 288 Ebola virus disease patients

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.

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Anti–Ebola Virus Antibody Levels in Convalescent Plasma and Viral Load After Plasma Infusion in Patients With Ebola Virus Disease

The Journal of Infectious Diseases ◽

10.1093/infdis/jiy199 ◽

2018 ◽

Vol 218 (4) ◽

pp. 555-562 ◽

Cited By ~ 16

Author(s):

Jerry F Brown ◽

John M Dye ◽

Sam Tozay ◽

Gertrude Jeh-Mulbah ◽

David A Wohl ◽

...

Keyword(s):

Viral Load ◽

Ebola Virus ◽

Neutralization Test ◽

Virus Disease ◽

Ebola Virus Disease ◽

Virus Antibody ◽

Plaque Reduction Neutralization Test ◽

Plasma Infusion ◽

Antibody Levels

Enzyme-linked immunosorbent and microneutralization assays of 180 Ebola convalescent plasma specimens were highly concordant and predictive for detection of antibody by 50% plaque reduction neutralization test. Viral load decreased following infusion of antibody-containing plasma in 2 Ebola virus disease patients.

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Variation around the dominant viral genome sequence contributes to viral load and outcome in patients with Ebola virus disease

Genome Biology ◽

10.1186/s13059-020-02148-3 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Xiaofeng Dong ◽

Jordana Munoz-Basagoiti ◽

Natasha Y. Rickett ◽

Georgios Pollakis ◽

William A. Paxton ◽

...

Keyword(s):

Viral Load ◽

Genome Sequence ◽

Protein Function ◽

Viral Protein ◽

Viral Genome ◽

Rna Synthesis ◽

Ebola Virus ◽

Virus Disease ◽

Viral Rna ◽

Ebola Virus Disease

Abstract Background Viral load is a major contributor to outcome in patients with Ebola virus disease (EVD), with high values leading to a fatal outcome. Evidence from the 2013–2016 Ebola virus (EBOV) outbreak indicated that different genotypes of the virus can have different phenotypes in patients. Additionally, due to the error-prone nature of viral RNA synthesis in an individual patient, the EBOV genome exists around a dominant viral genome sequence. The minor variants within a patient may contribute to the overall phenotype in terms of viral protein function. To investigate the effects of these minor variants, blood samples from patients with acute EVD were deeply sequenced. Results We examine the minor variant frequency between patients with acute EVD who survived infection with those who died. Non-synonymous differences in viral proteins were identified that have implications for viral protein function. The greatest frequency of substitution was identified at three codon sites in the L gene—which encodes the viral RNA-dependent RNA polymerase (RdRp). Recapitulating this in an assay for virus replication, these substitutions result in aberrant viral RNA synthesis and correlate with patient outcome. Conclusions Together, these findings support the notion that in patients who survived EVD, in some cases, the genetic variability of the virus resulted in deleterious mutations that affected viral protein function, leading to reduced viral load. Such mutations may also lead to persistent strains of the virus and be associated with recrudescent infections.

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