Electrolyte and Metabolic Disturbances in Ebola Patients during a Clinical Trial, Guinea, 2015

Authors:

van Griensven J, Bah EI, Haba N, Delamou A, Camara BS, Olivier KJJ, De Clerck H, Nordenstedt H, Semple MG, Van Herp M, Buyze J, De Crop M, Van Den Broucke S, Lynen L, De Weggheleire A, the Ebola-Tx Consortium

Abstract:

By using data from a 2015 clinical trial on Ebola convalescent-phase plasma in Guinea, we assessed the prevalence of electrolyte and metabolic abnormalities at admission and their predictive value to stratify patients into risk groups. Patients underwent testing with a point-of-care device. We used logistic regression to construct a prognostic model and summarized the predictive value with the area under the receiver operating curve. Abnormalities were common among patients, particularly hypokalemia, hypocalcemia, hyponatremia, raised creatinine, high anion gap, and anemia. Besides age and PCR cycle threshold value, renal dysfunction, low calcium levels, and low hemoglobin levels were independently associated with increased risk for death. A prognostic model using all 5 factors was highly discriminatory (area under the receiver operating curve 0.95; 95% CI 0.90-0.99) and enabled the definition of risk criteria to guide targeted care. Most patients had a very low (<5%) or very high (>80%) risk for death.

Journal:

Emerging Infectious Diseases

PMID:

27869610

Research Themes:

Clinical Surveillance