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Volume 26, Number 11—November 2020
Research

Endotheliopathy and Platelet Dysfunction as Hallmarks of Fatal Lassa Fever

Lucy E. Horton1, Robert W. Cross1, Jessica N. Hartnett, Emily J. Engel, Saori Sakabe, Augustine Goba, Mambu Momoh, John Demby Sandi, Thomas W. Geisbert, Robert F. Garry, John S. Schieffelin, Donald S. Grant, and Brian M. SullivanComments to Author 
Author affiliations: The Scripps Research Institute, La Jolla, California, USA (L.E. Horton, S. Sakabe, B.M. Sullivan); University of Texas Medical Brach, Galveston, Texas, USA (R.W. Cross, T.W. Geisbert); Tulane University School of Medicine, New Orleans, Louisiana, USA (J.N. Hartnett, E.J. Engel, R.F. Garry, J.S. Schieffelin); Kenema Government Hospital, Kenema, Sierra Leone (A. Goba, M. Momoh, J.D. Sandi, D.S. Grant); Ministry of Health and Sanitation, Freetown, Sierra Leone (A. Goba, M. Momoh, J.D. Sandi); Eastern Polytechnic Institute, Kenema (M. Momoh, D.S. Grant); Njala University, Moyamba, Sierra Leone (J.D. Sandi); University of Sierra Leone, Freetown (D.S. Grant)

Main Article

Table

Characteristics and clinical and laboratory findings of patients in a study of Lassa fever fatality, Sierra Leone during 2015–2018*

Characteristics All Lassa fever cases, n = 98 Outcomes
 Non–LF febrile controls, n = 7
Survived, n = 23 Died, n = 51
Mean age, y (range)
 23 (1–75)
 20 (3–29)
 25 (1–75)
 24 (3–60)
Sex
F 64 (65.3) 18 (78.3) 29 (56.8) 2 (22.2)
M
 34 (34.7)
 5 (21.7)
 22 (43.1)
 5 (71.4)
Clinical findings n = 70 n = 23 n = 34 n = 9
Bleeding symptoms
Bleeding gums 5 (7.1) 2 (8.7) 2 (5.9) 1
Epistaxis 4 (5.7) 1 (4.3) 2 (5.9) 1
Blood in stool 6 (8.6) 3 (13.0) 3 (8.8) 0
Blood in vomit 6 (8.6) 2 (8.7) 4 (11.8) 2
Injected conjunctiva 11 (15.7) 2 (8.7) 7 (20.6) 0
Bleeding hematoma 1 (1.4) 0 1 (2.9) 0
Blood in sputum 6 (8.6) 1 (4.3) 4 (11.8) 0
Blood in urine 3 (4.3) 2 (8.7) 1 (2.9) 1
Vaginal bleeding 3 (4.3) 1 (4.3) 2 (5.9) 1
Other bleeding 6 (8.6) 2 (8.7) 2 (5.9) 0
Edema 21 (30.0) 6 (26) 12 (35.3) 0
Other clinical symptoms
Cough 45 (64.3) 15 (65.2) 24 (70.6) 6 (66.7)
Fever 54 (77.1) 16 (69.6) 30 (88.2) 0
Rash 2 (2.9) 0 2 (5.9) 1 (11.1)
Headache 60 (85.7) 20 (87) 28 (82.4) 6 (66.7)
Vomiting 37 (52.9) 11 (47.8) 20 (58.8) 5 (55.6)
Diarrhea 32 (45.7) 8 (34.8) 24 (70.6) 1 (11.1)
Jaundice
 6 (8.6)
 0
 0
 1 (11.1)
Laboratory findings, mean (+SD)
AST, U/L 439 (+689) 423 (+651.7) 717 (+777) 76 (+78)
ALT, U/L 455 (+556) 246 (+463) 707 (+540) 41 (+35)
Alkaline phosphatase, U/L 220 (+269) 106 (+87) 313 (+339) 157 (+108)
Total bilirubin, mg/dL 1.18 (+1.38) 0.95 (+1.41) 1.44 (+1.54) 4.12 (+0.59)
Total protein, g/L 6.7 (+1.8) 7.1 (+10.0) 6.2 (+1.7) 7.3 (+0.5)
Creatinine, mg/dL 1.85 (+2.12) 0.88 (+0.40) 2.75 (+2.70) 0.5 (+0.26)
BUN, mg/dL
 24 (+32)
 10 (+5)
 31 (+27)
 17 (+11)
*Values are no. (%) except as indicated. ALT, alanine aminotransferase; AST, aspartate aminotransferase; BUN, blood urea nitrogen; LF, Lassa fever.

Main Article

1These authors contributed equally to this article.

Page created: September 09, 2020
Page updated: October 17, 2020
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