Virus kinetics and biochemical derangements among children with Ebolavirus disease.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 36105872.
- Also identified by DOI 10.1016/j.eclinm.2022.101638 and PMC identifier 9465268.
- Licence recorded as CC BY-NC-ND.
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Abstract
A paucity of data is available on virologic and biochemical characteristics of paediatric Ebolavirus disease (EVD), compared to adults. We conducted a retrospective chart review of children (<16 years old) and a comparator group of young adults (16-44 years) from two treatment centres during the 2018-2020 EVD epidemic in Eastern Democratic Republic of the Congo. Statistical methods included chi-squared and Fisher's exact tests (dichotomous and categorical variables), Mann-Whitney U-test (continuous variables), multivariable linear regression (for determinants of admission viral load), linear mixed-effects models (for analysis of longitudinal viral load), and Cox proportional hazard models (to examine risk factors for mortality). We included 73 children and 234 adults admitted from April to October 2019. Paediatric patients commonly had electrolytes imbalances: hypokalaemia in 26/73 (36%), hyperkalaemia in 38/73 (52%), and hyponatraemia in 54/73 (74%). Hypoglycaemia occurred in 20/73 (27%), acute kidney injury in 43/73 (59%), and rhabdomyolysis in 35/73 (48%). Biochemical abnormalities were detected in a similar proportion of children and adults. The viral load (VL, log<sub>10</sub> copies/mL) at admission (7.2 versus 6.5, <i>p</i>=0.0001), the peak viral load (7.5 versus 6.7, <i>p</i>=<0.0001), and the time for viraemia clearance (16 days versus 12 days, <i>p</i>=<0.0001) were significantly different in children. The duration of hospital stay was prolonged in children (20 versus 16 days, <i>p</i>=<0.0001). Risk factors for mortality in children were: VL >7.6 log<sub>10</sub>copies/mL, alanine transaminase >525 U/L, C-reactive protein >100 mg/L, blood urea nitrogen >7.5 mmol/L, rhabdomyolysis, and.acute kidney injury. Paediatric EVD patients, like adults, experience multiorgan dysfunction with life-threatening electrolyte imbalances, hypoglycaemia, kidney injury, liver injury, and rhabdomyolysis. Paediatric patients have significantly higher VLs throughout the course of EVD than adults. This study was not funded.