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Volume 22, Number 12—December 2016
CME ACTIVITY - Research

Electrolyte and Metabolic Disturbances in Ebola Patients during a Clinical Trial, Guinea, 2015

Johan van GriensvenComments to Author , Elhadj Ibrahima Bah, Nyankoye Haba, Alexandre Delamou, Bienvenu Salim Camara, Kadio Jean-Jacques Olivier, Hilde De Clerck, Helena Nordenstedt, Malcolm G. Semple, Michel Van Herp, Jozefien Buyze, Maaike De Crop, Steven Van Den Broucke, Lutgarde Lynen, Anja De Weggheleire, and the Ebola-Tx Consortium
Author affiliations: Institute of Tropical Medicine, Antwerp, Belgium (J. van Griensven, J. Buyze, M. De Crop, S. Van Den Broucke, L. Lynen, A. De Weggheleire); Donka National Hospital, Conakry, Guinea (E.I. Bah); National Blood Transfusion Center, Conakry (N. Haba, B.S. Camara, K.J.-J. Olivier); National Center for Training and Research in Rural Health of Maferinyah, Forecariah, Guinea (A. Delamou); Médecins Sans Frontières, Brussels, Belgium (H. De Clerck, H. Nordenstedt, M. Van Herp); University of Liverpool, Liverpool, United Kingdom (M.G. Semple)

Main Article

Table 2

Metabolic and electrolyte disturbances in 85 Ebola patients recruited for the Ebola-Tx trial and association with increased risk for death, Conakry, Guinea, 2015*

Analyte Value
 p value
Total Deceased Survived
Total†
 85
 27
 51
K+, mmol/L median (IQR) 3.7 (3.2–4.2) 3.9 (3–2-4.7) 3.7 (3.2–4.0) 0.21
High 4 (4.7) 3 (11.1) 0 (0)
Normal 53 (62.3) 16 (59.3) 33 (64.7)
Mild decrease 12 (14.1) 4 (14.8) 7 (13.7) 0.19
Moderate decrease 14 (16.5) 4 (14.8) 9 (17.6)
Severe decrease
 2 (2.3)
 0 (0)
 2 (3.9)
Na+, mmol/L median (range) 135 (132–137) 132 (129–138) 136 (133–137) 0.055
Low 66 (77.6) 20 (74.1) 39 (76.5)
Normal 18 (21.2) 6 (22.2) 12 (23.5) 0.52
High
 1 (1.2)
 1 (3.7)
 0 (0)
Cl–, mmol/L median (IQR) 99 (95–103) 101 (97–105) 99 (96–102) 0.41
Low
 34 (40.0)
 10 (37.0)
 18 (35.3)
 1.0
iCa2+, mmol/L median (IQR) 4.3 (4.0–4.6) 3.9 (3.5–4.2) 4.4 (4.2–4.7) <0.01
Low
 54 (63.5)
 24 (88.9)
 26 (51.0)
 <0.01
TCO2, mmol/L median (IQR 21 (18–24) 17 (16–22) 21 (19–25) <0.01
Low
 60 (70.6)
 23 (85.2)
 37 (72.5)
 0.27
Anion gap, mmol/L median (IQR) 19 (17–21) 19 (18–21) 18 (17–20) 0.26
High
 24 (28.4)
 11 (40.7)
 10 (19.6)
 0.061
Creatinine, mmol/L median (IQR), n = 84 106 (75–332) 442 (148–654) 91 (63–116) <0.01
Normal 47 (55.9) 5 (18.5) 38 (74.5)
1–3x ULN 16 (19.0) 5 (18.5) 9 (17.6) <0.01
>3x ULN
 21 (25.0)
 17 (63.0)
 4 (7.8)
BUN, mmol/L median (IQR), n = 84 16 (9–39) 50 (17–69) 11 (7–21) <0.01
Normal 53 (63.1) 9 (33.3) 38 (76.0)
1–3x ULN 26 (30.9) 13 (48.1) 12 (24.0) <0.01
>3x ULN
 5 (6.0)
 5 (18.5)
 0 (0.0)
BUN/creatinine ratio, median (IQR), n = 83 10.3 (7.4–13.9) 8.8 (6.8–13.9) 11.2 (7.7–14.0) 0.30
<10 36 (43.4) 15 (55.6) 18 (36.0)
10–20 39 (47.0) 10 (37.0) 26 (52.0) 0.27
>20
 8 (9.6)
 2 (7.4)
 6 (12.0)
Glucose, mmol/L median (IQR) 121 (104–148) 112 (88–146) 122 (106–147) 0.24
Low 5 (5.9) 4 (14.8) 1 (2.0)
Normal 72 (84.7) 19 (70.4) 47 (92.2) 0.022
High
 8 (9.4)
 4 (14.8)
 3 (5.9)
Hemoglobin, g/dL median (IQR) 14.6 (11.9–16) 13.6 (10.5–17) 14.3 (11.9–15.6) 0.90
Anemia‡ 23 (27.1) 9 (33.3) 14 (27.4) 0.61

*Values are no. (%) patients except as indicated. BUN, blood urea nitrogen; Ct, cycle threshold; iCa2+, ionized (free) calcium; IQR, interquartile range; K+, potassium; Na+, sodium; Cl–, chloride; TCO2, total dissolved carbon dioxide; ULN, upper limit of normal value.
†Denominator for deceased and survived patients combined is 78, excluding 7 patients who were transferred to another Ebola treatment unit, where they received favipiravir.
‡Definition of anemia per World Health Organization guideline (age/sex adjusted; hemoglobin levels used).

Main Article

Page created: November 17, 2016
Page updated: November 17, 2016
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