75% of Ebola survivors reported persistent symptoms 1 year after infection
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A study of Ebola survivors showed that 75% have persistent symptoms 1 year after infection, and while these symptoms decline over time, more than half continue to report symptoms up to 5 years after infection.
“During the outbreak in West Africa in 2014, my colleagues and I were hearing from Ebola survivors that they had not returned to their normal selves,” David Alain Wohl, MD, professor at the Institute of Global Health and Infectious Diseases at the University of North Carolina (UNC) at Chapel Hill and codirector of the UNC Viral Hemorrhagic Fever Research Group, told Healio. “They had headaches, fatigue, muscle pain, and brain fog. Many asked us to study this and try to find out what was causing these long Ebola symptoms.”
Wohl and colleagues longitudinally assessed symptoms including headache, fatigue, joint pain, muscle pain, hearing loss, visual loss and numbness of hands or feet among participants in the Liberian Ebola Survivors Cohort study. According to the study, generalized linear mixed effects models were used to calculate the odds of reporting a symptom and it being rated as interfering significantly with day-to-day life.
In total, 326 survivors were enrolled a median of 389 days from acute Ebola virus infection between June 2015 and June 2016. At enrollment, 75.2% of study participants reported at least one symptom, 85.8% of which interfered significantly with life. The study showed that symptom reporting declined over a median follow-up of 5.9 years (OR for each 90 days of follow-up = 0.96; 95% CI, 0.950.97) with all symptoms declining except for numbness of hands or feet. According to the study, among 311 participants with 5 years of follow-up, 52% reported a symptom and 29% of these as interfering significantly with their lives.
These findings are not unlike what is being seen in patients who have had COVID-19 and subsequently suffer from long COVID. One recent study showed that the global estimated pooled prevalence of the post-COVID-19 condition was “substantial,” with an estimated 200 million people having had post-COVID-19 health consequences.
According to the study, the most common symptoms were fatigue (23%), memory problems (14%), shortness of breath (13%), sleep problems (11%) and joint pain (10%). The prevalence estimates of these long-term symptoms at 30, 60, 90 and 120 days after infection were 37%, 25%, 32%, and 49%, respectively.
“There is something about viruses like Ebola and SARS-CoV-2 that leads some people to experience lingering symptoms,” Wohl said.
According to Wohl, he and colleagues previously looked for evidence of inflammation in these Ebola survivors but found no difference in their levels of inflammatory markers and the levels in survivors without symptoms or in household members who never had Ebola. He added that some experts believe that people with Ebola and COVID-19 harbor the virus and that it can periodically emerge and trigger immune responses that contribute to symptoms. Unfortunately, he said, there has not been strong evidence of this so far, and it is unclear how these intermittent episodes of viral exposure would contribute to persistent symptoms.
“The care for Ebola survivors does not end when they leave the Ebola Treatment Unit. Like many who have experienced long COVID, many of those who had Ebola continue to struggle with health problems that rob them of quality of life. We need to learn more about these post-viral phenomena including their causes so we can identify appropriate treatments. What we learn from these survivors of Ebola may help us also better understand long COVID.”
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