This article is more than 5 years old. Information may no longer be current.
Higher viral load at admission predicts greater mortality in EVD patients
Click Here to Manage Email Alerts
Viral load at admission to a treatment facility could be a major factor in predicting Ebola virus disease mortality, according to research published in The Journal of Infectious Diseases.
Gabriel Fitzpatrick, MB, MPH, chairman of Médicins Sans Frontières (MSF) Ireland, and colleagues conducted a retrospective cohort study of 525 patients who were admitted to the Kailahun Case Management Center in Sierra Leone between June 26 and Oct. 12, 2014, to analyze factors associated with mortality. All patients had Ebola virus disease (EVD) confirmed by PCR.
The overall mortality rate for this cohort was 51%, with weekly fluctuations from 24% to 85% for the length of the study, the researchers wrote. Patients who died had a lower median cycle threshold (CT) value within 5 days of admission compared with survivors.
In multivariate analysis, the researchers found that the most influential predictor of mortality was whole blood CT value at admission of less than 25 - equivalent to more than 10 million copies/mL (OR = 10.8; 95% CI, 6.13-19.66). Age and duration of symptoms showed weaker associations with mortality.
“This finding could be used in the field to cohort patients with CT values of less than 25 into dedicated wards where they could receive enhanced medical support and palliative care if resources allow due to their much-increased risk of death,” the researchers wrote. “These high-risk patients could also be prioritized for experimental treatments under strict ethical protocol.”
Regardless of CT value at admission, if a follow up patient sample showed a higher CT value, mortality dropped to 4% compared with 58% for a lower CT value, the investigators said.
“This study documents the importance of viral load at admission on predicting mortality in a large MSF Ebola case management center in a remote jungle region of Eastern Sierra Leone,” the researchers wrote. - by David Jwanier
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts