Laboratory findings, compassionate use of Favipiravir, and outcome in patients with Ebola virus disease, guinea, 2015—a retrospective observational study

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

Research output: Contribution to journalArticlepeer-review

23 Citations (SciVal)

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.
Original languageEnglish
Pages (from-to)195-202
Number of pages8
JournalJournal of Infectious Diseases
Volume220
Issue number2
Early online date21 Feb 2019
DOIs
Publication statusPublished - 15 Jul 2019

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