2013-2016年塞拉利昂西非埃博拉疫情幸存者急性后综合征早期检测和临床管理的实验室生物标志物鉴定

IF 2.1 Q3 HEMATOLOGY
Raoul Emeric Guetiya Wadoum, Stephen Sevalie, Maurice Baimba Kargbo, Andrew Clarke, Sherry Bangura, Mariatu Kargbo, Hawa Mariama Sesay, Abdul H Kamara, Jamil Bangura, Alie F Kamara, Sophie Allieu, Hassan Rogers, Maurizio Mattei, Vittorio Colizzi, Carla Montesano, Edwin J J Momoh
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引用次数: 0

摘要

背景:影响埃博拉幸存者的持续性医疗状况的临床管理,通常被描述为埃博拉后综合征,仍然是一个公共卫生问题。我们的目的是分析埃博拉幸存者的实验室生物标志物,将其与未感染的家庭亲属进行比较,以确定生物标志物,这些生物标志物可以指导识别发生严重后埃博拉综合征与非严重后埃博拉综合征风险增加的幸存者。材料和方法:数据来自埃博拉幸存者诊所的医疗记录,我们只包括埃博拉幸存者在第二次PCR阴性后2周间隔的第一次基线随访期间记录的参数。此外,还招募了同一时期到诊所就诊的幸存者的非感染家庭接触者作为社区对照。结果:存活者平均年龄为32.65岁(IQR: 15.5, 38.25),所有存活者均检测到埃博拉IgG免疫球蛋白。在单核细胞百分比(MONO%)、分化聚类百分比(CD4%)、丙氨酸转氨酶(ALT)、肌酐(CREA)、肌酐激酶(c -激酶)等指标上与家庭亲属组比较,差异均有统计学意义(p < 0.05)。有趣的是,线性回归分析表明,在ETU的持续时间与淋巴细胞百分比呈负相关,在ETU度过的每一天淋巴细胞减少5%。最后,血液学(Hb、PCV、MCV、MCH)、生化(ALT、CREA、c -激酶、t -胆固醇、甘油三酯)参数与发生严重并发症的风险之间存在显著(p < 0.05)相关性。结论:我们建议临床医生密切监测Hb、PCV、MCV、MCH、ALT、CREA、c -激酶、t-胆固醇、甘油三酯和淋巴细胞作为临床相关的实验室生物标志物,以识别在埃博拉治疗单位出院时出现严重急性后综合征的高风险幸存者,包括头痛、腹痛、胸痛、眼并发症、关节痛、听力困难和勃起功能障碍,这些可能影响埃博拉幸存者健康相关的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Identification of Laboratory Biomarkers for Early Detection and Clinical Management of Post-Acute Syndrome Among Survivors of the 2013-2016 West Africa Ebola Outbreak in Sierra Leone.

Identification of Laboratory Biomarkers for Early Detection and Clinical Management of Post-Acute Syndrome Among Survivors of the 2013-2016 West Africa Ebola Outbreak in Sierra Leone.

Identification of Laboratory Biomarkers for Early Detection and Clinical Management of Post-Acute Syndrome Among Survivors of the 2013-2016 West Africa Ebola Outbreak in Sierra Leone.

Identification of Laboratory Biomarkers for Early Detection and Clinical Management of Post-Acute Syndrome Among Survivors of the 2013-2016 West Africa Ebola Outbreak in Sierra Leone.

Background: The clinical management of persistent medical conditions affecting Ebola survivors, generally described as a post-Ebola syndrome, remains a public health concern. We aimed to analyze Ebola survivors' laboratory biomarkers as compared to their non-infected household relatives to identify biomarkers that could guide the identification of survivors at increased risk of developing severe at odds with the non-severe post-Ebola syndrome.

Materials and methods: Data were extracted from medical records of the Ebola survivors clinic, and we included only Ebola survivor's parameters recorded during the first baseline follow-up visit 2 weeks interval after their second negative PCR result. Moreover, household non-infected family contacts of survivors visiting the clinic during the same period were recruited as community control.

Results: The mean age of survivors was 32.65 (IQR: 15.5, 38.25) years, and Ebola IgG immunoglobulin was detected in all, thus confirming their status. The statistical significance (all p < 0.05) observed in monocyte percentage (MONO%), cluster of differentiation 4 percentage (CD4%), alanine aminotransferase (ALT), creatinine (CREA), and creatinine kinase (C-kinase) proved to be clinically significant as compared to the household relatives' group. Interestingly, the linear regression analysis indicated that the duration at ETU was negatively associated with lymphocyte percentage with a 5% lymphocyte decrease per day spent at ETU. Finally, there was a significant (p < 0.05) association between hematological (Hb, PCV, MCV, MCH), biochemical (ALT, CREA, C-kinase, T-cholesterol, triglycerides) parameters and the risk of developing severe complications.

Conclusion: We recommend clinicians closely monitor Hb, PCV, MCV, MCH, ALT, CREA, C-kinase, T-cholesterol, triglycerides and lymphocytes as clinically relevant laboratory biomarkers to identify survivors at higher risk of developing severe post-acute syndrome upon discharge from Ebola treatment unit including headache, abdominal pain, chest pain, ocular complication, arthralgia, hearing difficulty and erectile dysfunction which can impact health-related quality of life among Ebola survivors.

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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
94
审稿时长
16 weeks
期刊介绍: The Journal of Blood Medicine is an international, peer-reviewed, open access, online journal publishing laboratory, experimental and clinical aspects of all topics pertaining to blood based medicine including but not limited to: Transfusion Medicine (blood components, stem cell transplantation, apheresis, gene based therapeutics), Blood collection, Donor issues, Transmittable diseases, and Blood banking logistics, Immunohematology, Artificial and alternative blood based therapeutics, Hematology including disorders/pathology related to leukocytes/immunology, red cells, platelets and hemostasis, Biotechnology/nanotechnology of blood related medicine, Legal aspects of blood medicine, Historical perspectives. Original research, short reports, reviews, case reports and commentaries are invited.
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