Laboratory findings, compassionate use of favipiravir, and outcome in patients with Ebola virus disease, Guinea, 2015 - a retrospective observational study

Kerber, Romy; Lorenz, Eva; Duraffour, Sophie; Sissoko, Daouda; Rudolf, Martin; Jaeger, Anna; Cisse, Sekou Ditinn; Camara, Alseny-Modet; Miranda, Osvaldo; Castro, Carlos M; Akoi Bore, Joseph; Raymond Koundouno, Fara; Repits, Johanna; Afrough, Babak; Becker-Ziaja, Beate; Hinzmann, Julia; Mertens, Marc GND; Vitoriano, Ines; Hugh Logue, Christopher; Böttcher, Jan-Peter; Pallasch, Elisa; Sachse, Andreas; Bah, Amadou; Cabeza-Cabrerizo, Mar; Nitzsche, Katja; Kuisma, Eeva; Michel, Janine; Holm, Tobias; Gayle Zekeng, Elsa; Cowley, Lauren A; Garcia-Dorival, Isabel; Hetzelt, Nicole; Josef Baum, Jonathan Hans; Portmann, Jasmine; Carter, Lisa; Yenamaberhan, Rahel Lemma; Camino, Alvaro; Enkirch, Theresa; Singethan, Katrin; Meisel, Sarah; Mazzarelli, Antonio; Kosgei, Abigail; Kafetzopoulou, Liana; Rickett, Natasha Y; Patrono, Livia Victoria; Ghebreghiorghis, Luam; Arnold, Ulrike; Colin, Géraldine; Juchet, Sylvain; Marchal, Claire Levy; Kolie, Jacques Seraphin; Beavogui, Abdoul Habib; Wurr, Stephanie; Bockholt, Sabrina; Krumkamp, Ralf; May, Jürgen; Stoecker, Kilian; Fleischmann, Erna; Ippolito, Giuseppe; W Carroll, Miles; Koivogui, Lamine; Magassouba, N'Faly; Keita, Sakoba; Gurry, Céline; Drury, Patrick; Diallo, Boubacar; Formenty, Pierre; Wölfel, Roman; Caro, Antonino Di; Gabriel, Martin; Anglaret, Xavier; Malvy, Denis; Günther, Stephan

BACKGROUND:In 2015, the laboratory at the Ebola treatment center in Coyah, Guinea, confirmed Ebola virus disease (EVD) in 286 patients. Cycle threshold (Ct) in the Ebola virus RT-PCR and 13 blood chemistry parameters were measured on admission and during hospitalization. Favipiravir treatment was offered to EVD patients on compassionate use basis. METHODS:To reduce biases in the raw field data, we carefully selected 163 of the 286 EVD patients for a retrospective study to assess associations between potential risk factors, alterations in blood chemistry, favipiravir treatment, and outcome. RESULTS:The case fatality rate in favipiravir-treated patients was lower than in untreated patients (31/73 [42.5%] vs. 52/90 [57.8%], p = 0.053 in univariate analysis). In the multivariate regression analysis, higher Ct value and younger age were associated with survival (p <0.001), while favipiravir treatment showed no statistically significant effect (p = 0.11). However, Kaplan-Meier analysis indicated a longer survival time in the favipiravir-treated group (p = 0.015). The study also showed characteristic changes in blood chemistry in fatal cases vs. survivors. CONCLUSIONS:Consistent with the JIKI trial, this retrospective study reveals a trend toward improved survival in favipiravir-treated patients; however, the effect was not statistically significant except for survival time.

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Kerber, Romy / Lorenz, Eva / Duraffour, Sophie / et al: Laboratory findings, compassionate use of favipiravir, and outcome in patients with Ebola virus disease, Guinea, 2015 - a retrospective observational study. 2019.

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