Association of clinical signs and symptoms of Ebola viral disease with case fatality

Added January 8, 2019

Citation: Moole H, Chitta S, Victor D, Kandula M, Moole V, Ghadiam H, Akepati A, Yerasi C, Uppu A, Dharmapuri S, Boddireddy R. Association of clinical signs and symptoms of Ebola viral disease with case fatality: a systematic review and meta-analysis. Journal of community hospital internal medicine perspectives. 2015 Jan 1;5(4):28374.

Summary: This meta-analysis assesses the utility of clinical signs, symptoms, and laboratory data in predicting mortality in Ebola virus disease (EVD). Sixty-seven articles covering EVD with more than 35 cases were used in identifying bleeding events, vomiting, diarrhea, abdominal pain, cough, sore throat and conjunctivitis.

Information from articles across multiple outbreaks has been used to support the triage of EVD patients based on clinical features and laboratory values, in the hope of improving prognosis. All included articles are observational studies, as there were no randomized controlled trials. Symptoms and signs noted above were more often present in the pooled proportion of fatal cases compared to the pooled proportion of EVD survivors. Meaningful association of fevers, fatigue, headache, dyspnea, arthralgia, myalgia, elevated aspartame transaminase (AST), alanine transaminase (ALT), blood urea nitrogen (BUN), and creatinine could not be made with case fatality. Symptoms varied between the different outbreaks.

Analysis was hampered because detailed clinical data was only available in about 50-60% of the total patient population; presentation in African outbreaks may be, on average, later after symptoms appear than in the West.

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on Ebola but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about Ebola on the basis of this summary alone.

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