Table 1. Clinical manifestations of investigational findings in Ebola virus disease, reported by studies done during the west Africa epidemic.
Signs and symptoms13 reported in more than 10% of patients with acute Ebola virus disease | Investigational findings that have been reported during acute Ebola virus disease | Signs and symptoms during survivor syndrome from Ebola virus disease | |
---|---|---|---|
General | Fever, fatigue, hiccups | Raised pro-inflammatory markers, including CRP; elevated lactate34 | Fatigue,35–37 depression,36–39 anxiety,36,37,39 insomnia35,36,38 |
Neurological and visual | Headache, confusion | Detectable Ebola virus RNA in the cerebrospinal fluid;40,41 diffuse swelling, microvascular occlusions as observed by MRI42 | Difficulty concentrating, mood changes, and memory loss;38,39 headaches;35,36,38,43 dizziness;38 difficulties hearing;35,37–39,44 visual disturbances;35–37,39,43,44 peripheral paraesthesia or dysaethesia37 |
Cardiovascular | Chest pain | Bradycardia,45 arrhythmias as shown by electrocardiogram;46 myocarditis shown during MRI47 | Chest pain,36,38,43 palpitations35,37,38 |
Pulmonary | Cough, dyspnoea, sore throat | Pulmonary oedema and pulmonary effusion as observed on x-ray and USS46 | Dyspnoea37 |
Gastrointestinal | Anorexia, vomiting, diarrhoea, abdominal pain, odynophagia | Paralytic ileus and bowel wall oedema shown by USS29,48 | Anorexia,35,38 abdominal pain,35,36,38,43 constipation38 |
Hepatobiliary | Jaundice | Transaminitis with high AST:ALT ratio34,49 | ·· |
Renal, urological, and electrolytes | ·· | Acute kidney injury,34,50,51 raised creatine kinase,34 hypokalaemia34,49,51 or hyperkalaemia,34 hyponatraemia,34 hypocalcaemia,49 hypoglycaemia16 | Decreased libido; sexual dysfunction and testicular pain36,38 |
Haematological | Clinically significant haemorrhage uncommon, likely to be more frequent in pregnant women. | Leucopenia, thrombocytopenia, raised INR, haematoconcentration34 | Anaemia35 |
Skin and musculoskeletal | Myalgia, arthralgia, conjunctivitis | ·· | Arthralgia;35,36,39,43,44 myalgia;36 alopecia, skin peeling, and pruritus35,36,38,39,43 |
USS=ultrasound scan. ALT=alanine transaminase. AST=aspartate transaminase. CRP=C-reactive protein. INR=international normalised ratio.