Virus kinetics and biochemical derangements among children with Ebolavirus disease
Summary: Background: A paucity of data is available on virologic and biochemical characteristics of paediatric Ebolavirus disease (EVD), compared to adults. Methods: We conducted a retrospective chart review of children (<16 years old) and a comparator group of young adults (16–44 years) from tw...
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-11-01
|
| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022003686 |
| _version_ | 1811276724275511296 |
|---|---|
| author | Lindsey Kjaldgaard Kasereka Masumbuko Claude Daniel Mukadi-Bamuleka Richard Kitenge-Omasumbu Devika Dixit François Edidi-Atani Meris Matondo Kuamfumu Junior Bulabula-Penge Fabrice Mambu-Mbika Olivier Tshiani-Mbaya Janet Diaz Sabue Mulangu Anais Legand Placide Mbala-Kingebeni Pierre Formenty Steve Ahuka-Mundeke Jean-Jacques Muyembe-Tamfum Michael T. Hawkes |
| author_facet | Lindsey Kjaldgaard Kasereka Masumbuko Claude Daniel Mukadi-Bamuleka Richard Kitenge-Omasumbu Devika Dixit François Edidi-Atani Meris Matondo Kuamfumu Junior Bulabula-Penge Fabrice Mambu-Mbika Olivier Tshiani-Mbaya Janet Diaz Sabue Mulangu Anais Legand Placide Mbala-Kingebeni Pierre Formenty Steve Ahuka-Mundeke Jean-Jacques Muyembe-Tamfum Michael T. Hawkes |
| author_sort | Lindsey Kjaldgaard |
| collection | DOAJ |
| description | Summary: Background: A paucity of data is available on virologic and biochemical characteristics of paediatric Ebolavirus disease (EVD), compared to adults. Methods: 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). Findings: 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, log10 copies/mL) at admission (7.2 versus 6.5, p=0.0001), the peak viral load (7.5 versus 6.7, p=<0.0001), and the time for viraemia clearance (16 days versus 12 days, p=<0.0001) were significantly different in children. The duration of hospital stay was prolonged in children (20 versus 16 days, p=<0.0001). Risk factors for mortality in children were: VL >7.6 log10copies/mL, alanine transaminase >525 U/L, C-reactive protein >100 mg/L, blood urea nitrogen >7.5 mmol/L, rhabdomyolysis, and.acute kidney injury. Interpretation: 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. Funding: This study was not funded. |
| first_indexed | 2024-04-13T00:02:49Z |
| format | Article |
| id | doaj.art-cac8e90131de4e13ba663a81f3fec770 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-13T00:02:49Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-cac8e90131de4e13ba663a81f3fec7702022-12-22T03:11:19ZengElsevierEClinicalMedicine2589-53702022-11-0153101638Virus kinetics and biochemical derangements among children with Ebolavirus diseaseLindsey Kjaldgaard0Kasereka Masumbuko Claude1Daniel Mukadi-Bamuleka2Richard Kitenge-Omasumbu3Devika Dixit4François Edidi-Atani5Meris Matondo Kuamfumu6Junior Bulabula-Penge7Fabrice Mambu-Mbika8Olivier Tshiani-Mbaya9Janet Diaz10Sabue Mulangu11Anais Legand12Placide Mbala-Kingebeni13Pierre Formenty14Steve Ahuka-Mundeke15Jean-Jacques Muyembe-Tamfum16Michael T. Hawkes17Department of Paediatrics, University of Alberta, Edmonton, AB, Canada; Member, Women and Children's Research Institute, University of Alberta, Edmonton, AB, CanadaDepartment of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the CongoInstitut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the CongoProgramme National d'Urgences et Actions Humanitaires (PNUAH), Ministry of Health of the Democratic Republic of the Congo (DRC), Democratic Republic of the CongoDepartment of Medicine, Division of Infectious Diseases, University of Saskatchewan, Saskatoon, SK, CanadaInstitut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the CongoInstitut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the CongoInstitut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the CongoInstitut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the CongoInstitut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the CongoWorld Health Organization (WHO), Geneva, SwitzerlandInstitut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the CongoWorld Health Organization (WHO), Geneva, SwitzerlandInstitut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the CongoWorld Health Organization (WHO), Geneva, SwitzerlandInstitut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the CongoInstitut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of the CongoMember, Women and Children's Research Institute, University of Alberta, Edmonton, AB, Canada; Department of Paediatrics, University of Alberta, Edmonton, AB, Canada; Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada; School of Public Health, University of Alberta, Edmonton, AB, Canada; Distinguished Researcher, Stollery Science Lab, University of Alberta, Edmonton, AB, Canada; Corresponding author at: Department of Paediatrics, University of Alberta, 3-588D Edmonton Clinic Health Academy, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada.Summary: Background: A paucity of data is available on virologic and biochemical characteristics of paediatric Ebolavirus disease (EVD), compared to adults. Methods: 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). Findings: 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, log10 copies/mL) at admission (7.2 versus 6.5, p=0.0001), the peak viral load (7.5 versus 6.7, p=<0.0001), and the time for viraemia clearance (16 days versus 12 days, p=<0.0001) were significantly different in children. The duration of hospital stay was prolonged in children (20 versus 16 days, p=<0.0001). Risk factors for mortality in children were: VL >7.6 log10copies/mL, alanine transaminase >525 U/L, C-reactive protein >100 mg/L, blood urea nitrogen >7.5 mmol/L, rhabdomyolysis, and.acute kidney injury. Interpretation: 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. Funding: This study was not funded.http://www.sciencedirect.com/science/article/pii/S2589537022003686Ebolavirus diseaseChildViral loadMortality |
| spellingShingle | Lindsey Kjaldgaard Kasereka Masumbuko Claude Daniel Mukadi-Bamuleka Richard Kitenge-Omasumbu Devika Dixit François Edidi-Atani Meris Matondo Kuamfumu Junior Bulabula-Penge Fabrice Mambu-Mbika Olivier Tshiani-Mbaya Janet Diaz Sabue Mulangu Anais Legand Placide Mbala-Kingebeni Pierre Formenty Steve Ahuka-Mundeke Jean-Jacques Muyembe-Tamfum Michael T. Hawkes Virus kinetics and biochemical derangements among children with Ebolavirus disease EClinicalMedicine Ebolavirus disease Child Viral load Mortality |
| title | Virus kinetics and biochemical derangements among children with Ebolavirus disease |
| title_full | Virus kinetics and biochemical derangements among children with Ebolavirus disease |
| title_fullStr | Virus kinetics and biochemical derangements among children with Ebolavirus disease |
| title_full_unstemmed | Virus kinetics and biochemical derangements among children with Ebolavirus disease |
| title_short | Virus kinetics and biochemical derangements among children with Ebolavirus disease |
| title_sort | virus kinetics and biochemical derangements among children with ebolavirus disease |
| topic | Ebolavirus disease Child Viral load Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022003686 |
| work_keys_str_mv | AT lindseykjaldgaard viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT kaserekamasumbukoclaude viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT danielmukadibamuleka viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT richardkitengeomasumbu viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT devikadixit viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT francoisedidiatani viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT merismatondokuamfumu viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT juniorbulabulapenge viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT fabricemambumbika viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT oliviertshianimbaya viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT janetdiaz viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT sabuemulangu viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT anaislegand viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT placidembalakingebeni viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT pierreformenty viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT steveahukamundeke viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT jeanjacquesmuyembetamfum viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease AT michaelthawkes viruskineticsandbiochemicalderangementsamongchildrenwithebolavirusdisease |