Lorenzo Subissi, PhD, on Subsequent Mortality After Ebola Infection
In a new study1 published in Lancet Infectious Diseases, researchers investigated subsequent mortality among people discharged from Ebola treatment units after the 2013-2016 outbreak in West Africa.
The research team was led by Lorenzo Subissi, PhD, from the Global Outbreak Alert and Response Network (GOARN).
Among the team’s findings were that the risk of mortality was 5-fold higher among survivors than the general population of Guinea, that individuals who were hospitalized longer during primary infection had an increased risk of mortality, and that renal failure was potentially a contributing factor in 37 of the 59 reported deaths.
Infectious Diseases Consultant caught up with Dr Subissi to discuss these findings further.
ID CON: How might future programs be designed to reduce days in the hospital for patients with Ebola virus infection? Might these programs also help monitor patients’ progress post-hospitalization?
Lorenzo Subissi: Seeking health care as soon as symptoms begin is essential, as the key is to get access to new treatments as early as possible, both to increase chances of survival and to stop transmission. A program is currently ongoing in the Democratic Republic of the Congo (DRC) to monitor health of survivors of the current outbreak.
ID CON: What is known about the connection between Ebola virus and renal affects?
LS: We know that patients with prolonged Ebola virus infection may develop acute kidney failure. However, whether Ebola can affect kidney function in a later stage is still unknown and should be investigated, in light of our preliminary findings. The latter were, however, exclusively based on reported anuria, so they should be interpreted carefully.
ID CON: How might these findings impact how Ebola virus is managed?
LS: In places where resources are limited, survivors hospitalized for longer could be prioritized, as they probably had a more serious illness and may be more likely to develop sequelae. In general, all survivors should be monitored at least during the first year after recovery.
ID CON: Overall, what is the key take-home message from your study?
LS: Ebola survivors are more vulnerable than previously thought. Therefore, they should be offered improved care, with focus on available resources in the first few months and ideally up to a year after recovery.
Reference:
- Keita M, Diallo B, Mesfin S, et al. Subsequent mortality in survivors of Ebola virus disease in Guinea: a nationwide retrospective cohort study. Lancet Infect Dis. 2019 Nov;19(11):1202-1208. https://doi.org/10.1016/S1473-3099(19)30313-5.