title: Electrolyte and Metabolic Disturbances in Ebola Patients during a Clinical Trial, Guinea, 2015.
abstract: By using data from a 2015 clinical trial on Ebola convalescent-phase plasma in Guinea, we assessed the prevalence of electrolyte and metabolic abnormalities at admission and their predictive value to stratify patients into risk groups. Patients underwent testing with a point-of-care device. We used logistic regression to construct a prognostic model and summarized the predictive value with the area under the receiver operating curve. Abnormalities were common among patients, particularly hypokalemia, hypocalcemia, hyponatremia, raised creatinine, high anion gap, and anemia. Besides age and PCR cycle threshold value, renal dysfunction, low calcium levels, and low hemoglobin levels were independently associated with increased risk for death. A prognostic model using all 5 factors was highly discriminatory (area under the receiver operating curve 0.95; 95% CI 0.90-0.99) and enabled the definition of risk criteria to guide targeted care. Most patients had a very low (<5%) or very high (>80%) risk for death.
authors.forename: Johan
authors.initials: J
authors.lastname: van Griensven
authors.forename: Elhadj Ibrahima
authors.initials: EI
authors.lastname: Bah
authors.forename: Nyankoye
authors.initials: N
authors.lastname: Haba
authors.forename: Alexandre
authors.initials: A
authors.lastname: Delamou
authors.forename: Bienvenu Salim
authors.initials: BS
authors.lastname: Camara
authors.forename: Kadio Jean-Jacques
authors.initials: KJ
authors.lastname: Olivier
authors.forename: Hilde
authors.initials: H
authors.lastname: De Clerck
authors.forename: Helena
authors.initials: H
authors.lastname: Nordenstedt
authors.forename: Malcolm G
authors.initials: MG
authors.lastname: Semple
authors.forename: Michel
authors.initials: M
authors.lastname: Van Herp
authors.forename: Jozefien
authors.initials: J
authors.lastname: Buyze
authors.forename: Maaike
authors.initials: M
authors.lastname: De Crop
authors.forename: Steven
authors.initials: S
authors.lastname: Van Den Broucke
authors.forename: Lutgarde
authors.initials: L
authors.lastname: Lynen
authors.forename: Anja
authors.initials: A
authors.lastname: De Weggheleire
mesh_terms: D000328:Adult; D015415:Biomarkers; D002986:Clinical Trials as Topic; D004573:Electrolytes / Q000097:blood / Q000378:metabolism*; D004734:Energy Metabolism; D005260:Female; D016701:Guinea; D019142:Hemorrhagic Fever, Ebola / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D010949:Plasma; D019095:Point-of-Care Systems; D011247:Pregnancy; D011379:Prognosis; D012372:ROC Curve; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004573:Electrolytes
keywords: EVD; Ebola; Guinea; clinical trial; death; electrolyte; infectious disease; metabolic; model; mortality; point of care; prediction; risk; viruses