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Post-Ebola Symptoms 7 Years After Infection: The Natural History of Long Ebola, 2022, Wohl et al

Discussion in ''Conditions related to ME/CFS' news and research' started by Mij, Apr 2, 2023.

  1. Mij

    Mij Senior Member (Voting Rights)

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    Long Ebola . . .

    Abstract
    Background
    Lingering symptoms have been reported by survivors of Ebola virus disease (EVD). There are few data describing the persistence and severity of these symptoms over time.

    Methods
    Symptoms of headache, fatigue, joint pain, muscle pain, hearing loss, visual loss, numbness of hands or feet were longitudinally assessed among participants in the Liberian Ebola Survivors Cohort study. Generalized linear mixed effects models, adjusted for sex and age, were used to calculate the odds of reporting a symptom and it being rated as highly interfering with life.

    Results
    From June 2015 to June 2016, 326 survivors were enrolled a median of 389 days (range 51–614) from acute EVD. At baseline 75.2% reported at least 1 symptom; 85.8% were highly interfering with life. Over a median follow-up of 5.9 years, reporting of any symptom declined (odds ratio for each 90 days of follow-up = 0.96, 95% confidence interval [CI]: .95, .97; P < .0001) with all symptoms declining except for numbness of hands or feet. Rating of any symptom as highly interfering decreased over time. Among 311 with 5 years of follow-up, 52% (n = 161) reported a symptom and 29% (n = 47) of these as highly interfering with their lives.

    Conclusions
    Major post-EVD symptoms are common early during convalescence and decline over time along with severity. However, even 5 years after acute infection, a majority continue to have symptoms and, for many, these continue to greatly impact their lives. These findings call for investigations to identify the mechanisms of post-EVD sequelae and therapeutic interventions to benefit the thousands of effected EVD survivors.

    https://academic.oup.com/cid/article-abstract/76/3/e835/6692535?redirectedFrom=fulltext
     
    Ariel, EzzieD, Lisa108 and 10 others like this.
  2. Hutan

    Hutan Moderator Staff Member

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    Mostly from a North Carolina team, one Liberia-based researcher.

    It's a shame there is a paywall. They appear to have a very high level of participant retention (311 out of 326) after 5 years.

    I wonder if the authors are familiar with ME/CFS diagnostic criteria and the concept of PEM. It would be great to screen these people against the ME/CFS diagnostic criteria. I've sent a note to the corresponding author.
     
    Ariel, Joan Crawford, EzzieD and 14 others like this.
  3. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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  4. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    No mention of ME or PEM.
     
    Ariel, Lilas, alktipping and 7 others like this.
  5. Hutan

    Hutan Moderator Staff Member

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    Reply to my email to the corresponding author:
    Unfortunately no comment on my mention of PEM. I'm not sure why the comment was made about heightened inflammation; possibly they believe that Long Covid is characterised by inflammatory cytokines?
     
    Ariel, Lilas, SNT Gatchaman and 6 others like this.
  6. Mij

    Mij Senior Member (Voting Rights)

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    From reading papers, it appears that post Ebola syndromes don't mention autonomic dysfunction or POTS.

    Wouldn't that be an indicator that they don't experience PEM?
     
    Ariel likes this.
  7. rvallee

    rvallee Senior Member (Voting Rights)

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    My guess would be addressing the encephalomyelitis part.
     
    Ariel and Hutan like this.
  8. Mij

    Mij Senior Member (Voting Rights)

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    This study was published in 2019

    Long-term Complications of Ebola Virus Disease: Prevalence and Predictors of Major Symptoms and the Role of Inflammation; Sam Tozay, William A Fischer, II, David A Wohl, Kayla Kilpatrick, Fei Zou, Edwina Reeves, Korto Pewu, Jean DeMarco, Amy James Loftis, Katie King


    https://academic.oup.com/cid/article/71/7/1749/5613876?login=false

    Abstract

    Background
    Cohort studies have reported a high prevalence of musculoskeletal, neurologic, auditory, and visual complications among Ebola virus disease (EVD) survivors. However, little is known about the host- and disease-related predictors of these symptoms and their etiological mechanisms.

    Methods
    The presence and patterns of 8 cardinal symptoms that are most commonly reported following EVD survival were assessed in the 326 EVD survivors who participated in the ongoing longitudinal Liberian EVD Survivor Study. At quarterly study visits, symptoms that developed since acute EVD were recorded and blood was collected for biomarkers of inflammation and immune activation.

    Results
    At baseline (mean 408 days from acute EVD), 75.5% of survivors reported at least 1 new cardinal symptom since surviving EVD, which in 85.8% was rated as highly interfering with life. Two or more incident symptoms were reported by 61.0% of survivors, with pairings of joint pain, headache, or fatigue the most frequent. Women were significantly more likely than men to report headache, while older age was significantly associated with musculoskeletal and visual symptoms. In analyses adjusted for multiple comparisons, no statistically significant association was found between any symptom and 26 markers of inflammation and immune activation. Symptom frequency remained largely unchanged during study follow-up.

    Conclusions
    Post-EVD complications occur in a majority of survivors and remain present more than 4 years after acute infection. An association between markers of inflammation and immune activation and individual symptoms was not found, suggesting an alternative etiology for persistent post-EVD symptomatology.
     
    RedFox and Wyva like this.

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