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Understanding Long-term Evolution and Predictors of Sequelae of Ebola Virus Disease Survivors in Guinea: A 48-Month Prospective, Longitudinal Cohort Study (PostEboGui)

2021; Oxford University Press; Volume: 73; Issue: 12 Linguagem: Inglês

10.1093/cid/ciab168

1537-6591

Mamadou Saliou Kalifa Diallo, Abdoulaye Touré, Mamadou Sow, Cécé Kpamou, Alpha Kabinet Keïta, Bernard Taverne, Martine Peeters, Philippe Msellati, Thierno Alimou Barry, Jean-François Étard, René Écochard, Éric Delaporte, Ahidjo Ayouba, Sylvain Baize, Kaba Bangoura, A BARRY, Moumié Barry, Mamoudou Cissé, Mohammed Cissé, Eric Delaporte, Jean-François Delfraissy, Christelle Delmas, Alice Desclaux, Saliou Bella Diallo, Mamadou Safiatou Diallo, Mariama Sadjo Diallo, Jean-François Étard, Cécile Etienne, Ousmane Faye, Ibrahima Fofana, Bruno Granouillac, Suzanne Izard, Djenaba Kassé, Alpha Kabinet Keïta, Alpha Kabinet Keïta, Lamine Koivogui, Cécé Kpamou, Christine Lacarabaratz, Laura March, Yves Lévy, N’Fally Magassouba, Laura March, Vincent Mendiboure, Philippe Msellati, Harissatou Niane, Martine Peeters, Yves‐Marie Pers, Hervé Raoul, Sidi Lamine Sacko, Ibrahima Savané, Mamadou Saliou Sow, Bernard Taverne, Abdoulaye Touré, Fodé Amara Traore, Falaye Traoré, Yamoussa Youla, Yazdan Yazdanpanah,

COVID-19 epidemiological studies

Abstract Background Longitudinal analyses are needed to better understand long-term Ebola virus disease (EVD) sequelae. We aimed to estimate the prevalence, incidence, and duration of sequelae and to identify risk factors associated with symptom occurrence among EVD survivors in Guinea. Methods We followed 802 EVD survivors over 48 months and recorded clinical symptoms with their start/end dates. Prevalence, incidence, and duration of sequelae were calculated. Risk factors associated with symptom occurrence were assessed using an extended Cox model for recurrent events. Results Overall, the prevalence and incidence of all symptoms decreased significantly over time, but sequelae remained present 48 months after Ebola treatment center discharge with a prevalence of 30.68% (95% confidence interval [CI] 21.40–39.96) for abdominal, 30.55% (95% CI 20.68–40.41) for neurologic, 5.80% (95% CI 1.96–9.65) for musculoskeletal, and 4.24% (95% CI 2.26–6.23) for ocular sequelae. Half of all patients (50.70%; 95% CI 47.26–54.14) complained of general symptoms 2 years’ postdischarge and 25.35% (95% CI 23.63–27.07) 4 years’ post-discharge. Hemorrhage (hazard ratio [HR], 2.70; P = .007), neurologic (HR 2.63; P = .021), and general symptoms (HR 0.34; P = .003) in the EVD acute phase were significantly associated with the further occurrence of ocular sequelae, whereas hemorrhage (HR 1.91; P = .046) and abdominal (HR 2.21; P = .033) symptoms were significantly associated with musculoskeletal sequelae. Conclusions Our findings provide new insight into the long-term clinical complications of EVD and their significant association with symptoms in the acute phase, thus reinforcing the importance of regular, long-term follow-up for EVD survivors.