Rhabdomyolysis in Ebola Virus Disease. Results of an Observational Study in a Treatment Center in Guinea.
BACKGROUND
The pathogenesis of Ebola virus disease (EVD) remains unclear. The sporadic nature of Ebola outbreaks and their occurrence in resource-limited settings have precluded the acquisition of extensive clinical and laboratory data. Rhabdomyolysis during EVD has been suggested to occur in previous studies showing increased aspartate aminotransferase-alanine aminotransferase ratios, but, to date, has not been confirmed with creatine kinase (CK) assays.


METHODS
We performed an observational study of 38 patients admitted to an Ebola treatment center from January to April 2015. CK values from patients with confirmed EVD were compared with those in patients without confirmed EVD. A panel of other analyses were also performed. In patients with EVD, characteristics were compared between survivors and nonsurvivors.


RESULTS
High levels of CK were more frequent in patients with EVD than in those without (P = .002), and rhabdomyolysis was more frequent (59% vs 19%, respectively; P = .03). CK levels >5000 U/L were observed in 36% of patients with EVD. Also in patients with EVD, fatal outcome was significantly associated with higher creatinine and bilirubin levels, international normalized ratio, and viral load.


CONCLUSIONS
Rhabdomyolysis is a frequent disorder in EVD and seems to be more common than in other viral infections. It may contribute to the renal failure observed in nonsurviving patients. More studies are needed to determine the impact of rhabdomyolysis on EVD outcome.
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Percy Military Teaching Hospital, Clamart.
Jean Marie
JM
Cournac
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Legouest Military Teaching Hospital, Metz.
Ludovic
L
Karkowski
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Sainte Anne Military Teaching Hospital, Toulon.
Julien
J
Bordes
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Percy Military Teaching Hospital, Clamart.
Marc
M
Aletti
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea French Military Center for Epidemiology and Public Health.
Sandrine
S
Duron
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Sainte Anne Military Teaching Hospital, Toulon.
Frédéric
F
Janvier
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Percy Military Teaching Hospital, Clamart.
Vincent
V
Foissaud
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Laveran Military Teaching Hospital, Marseille.
Hélène
H
Savini
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Val De Grâce Military Teaching Hospital.
Thierry
T
de Greslan
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Clermont Tonnerre Military Teaching Hospital, Brest.
Claire
C
Rousseau
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Val De Grâce Military Teaching Hospital.
Magali
M
Billhot
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Legouest Military Teaching Hospital, Metz.
Nicolas
N
Gagnon
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Percy Military Teaching Hospital, Clamart.
Christine
C
Mac Nab
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Robert Picqué Military Teaching Hospital, Bordeaux.
Philippe
P
Dubrous
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Laveran Military Teaching Hospital, Marseille.
Sophie
S
Moroge
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea French Military Center for Health Supplies, Orléans.
Helene
H
Broto
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Sainte Anne Military Teaching Hospital, Toulon.
Jean
J
Cotte
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea French Military Health Service Surgeon General Office, Paris.
Nancy
N
Maugey
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Laveran Military Teaching Hospital, Marseille.
Pierre-Yves
PY
Cordier
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Laveran Military Teaching Hospital, Marseille.
Emmanuel
E
Sagui
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Bégin Military Teaching Hospital, Saint-Mandé, France.
Audrey
A
Merens
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Bégin Military Teaching Hospital, Saint-Mandé, France.
Christophe
C
Rapp
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea French Military Health Service Surgeon General Office, Paris.
Benoit
B
Quentin
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Clermont Tonnerre Military Teaching Hospital, Brest.
Hervé
H
Granier
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Val De Grâce Military Teaching Hospital.
Thierry
T
Carmoi
French Military Ebola Virus Disease Treatment Centre, Conakry, Guinea Sainte Anne Military Teaching Hospital, Toulon.
Gilles
G
Cellarier
D000328:Adult; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D016701:Guinea / Q000453:epidemiology; D019142:Hemorrhagic Fever, Ebola / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D063806:Myalgia; D051437:Renal Insufficiency; D012206:Rhabdomyolysis / Q000453:epidemiology* / Q000209:etiology*; D055815:Young Adult
D003402:Creatine Kinase
Ebola virus disease; renal failure; rhabdomyolysis