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. 2023 Feb 11:14:119-132.
doi: 10.2147/JBM.S371239. eCollection 2023.

Identification of Laboratory Biomarkers for Early Detection and Clinical Management of Post-Acute Syndrome Among Survivors of the 2013-2016 West Africa Ebola Outbreak in Sierra Leone

Raoul Emeric Guetiya Wadoum #  1 , Stephen Sevalie #  2 , Maurice Baimba Kargbo  3 , Andrew Clarke  4   5 , Sherry Bangura  6 , Mariatu Kargbo  6 , Hawa Mariama Sesay  7 , Abdul H Kamara  6 , Jamil Bangura  6 , Alie F Kamara  6 , Sophie Allieu  1 , Hassan Rogers  1 , Maurizio Mattei  8 , Vittorio Colizzi  9 , Carla Montesano  8 , Edwin J J Momoh  1   3
Affiliations

Identification of Laboratory Biomarkers for Early Detection and Clinical Management of Post-Acute Syndrome Among Survivors of the 2013-2016 West Africa Ebola Outbreak in Sierra Leone

Raoul Emeric Guetiya Wadoum et al. J Blood Med. .

Abstract

Background: The clinical management of persistent medical conditions affecting Ebola survivors, generally described as a post-Ebola syndrome, remains a public health concern. We aimed to analyze Ebola survivors' laboratory biomarkers as compared to their non-infected household relatives to identify biomarkers that could guide the identification of survivors at increased risk of developing severe at odds with the non-severe post-Ebola syndrome.

Materials and methods: Data were extracted from medical records of the Ebola survivors clinic, and we included only Ebola survivor's parameters recorded during the first baseline follow-up visit 2 weeks interval after their second negative PCR result. Moreover, household non-infected family contacts of survivors visiting the clinic during the same period were recruited as community control.

Results: The mean age of survivors was 32.65 (IQR: 15.5, 38.25) years, and Ebola IgG immunoglobulin was detected in all, thus confirming their status. The statistical significance (all p < 0.05) observed in monocyte percentage (MONO%), cluster of differentiation 4 percentage (CD4%), alanine aminotransferase (ALT), creatinine (CREA), and creatinine kinase (C-kinase) proved to be clinically significant as compared to the household relatives' group. Interestingly, the linear regression analysis indicated that the duration at ETU was negatively associated with lymphocyte percentage with a 5% lymphocyte decrease per day spent at ETU. Finally, there was a significant (p < 0.05) association between hematological (Hb, PCV, MCV, MCH), biochemical (ALT, CREA, C-kinase, T-cholesterol, triglycerides) parameters and the risk of developing severe complications.

Conclusion: We recommend clinicians closely monitor Hb, PCV, MCV, MCH, ALT, CREA, C-kinase, T-cholesterol, triglycerides and lymphocytes as clinically relevant laboratory biomarkers to identify survivors at higher risk of developing severe post-acute syndrome upon discharge from Ebola treatment unit including headache, abdominal pain, chest pain, ocular complication, arthralgia, hearing difficulty and erectile dysfunction which can impact health-related quality of life among Ebola survivors.

Keywords: Ebola virus disease; biochemical; biomarkers; hematological; immunological; post-acute syndrome.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Ebola IgG antibody level in survivors and their household non-infected relatives.
Figure 3
Figure 3
Quadratic correlation representation between Ebola IgG antibody level in serum and oral fluid of survivors.
Figure 4
Figure 4
Non-parametric correlation between the duration at the ETU and haematological biomarkers of survivors.
Figure 5
Figure 5
Non-parametric correlation between the duration at the ETU and immunological biomarkers of survivors.
Figure 6
Figure 6
Non-parametric correlation between the duration at the ETU and biochemical biomarkers of survivors.
Figure 7
Figure 7
Linear regression model of the duration at the ETU and lymphocytes % of survivors.
See this image and copyright information in PMC

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