Laboratory Findings, Compassionate Use of Favipiravir, and Outcome in Patients with Ebola Virus Disease, Guinea, 2015 - A Retrospective Observational Study

Background: In 2015, the laboratory at the Ebola treatment center in Coyah, Guinea, confirmed Ebola virus disease (EVD) in 286 patients. The cycle threshold (Ct) of an Ebola virus-specific reverse transcription-polymerase chain reaction assay and 13 blood chemistry parameters were measured on admission and during hospitalization. Favipiravir treatment was offered to patients with EVD on a compassionate-use basis. Methods: To reduce biases in the raw field data, we carefully selected 163 of 286 patients with EVD for a retrospective study to assess associations between potential risk factors, alterations in blood chemistry findings, favipiravir treatment, and outcome. Results: The case-fatality rate in favipiravir-treated patients was lower than in untreated patients (42.5% [31 of 73] vs 57.8% [52 of 90]; P =. 053 by univariate analysis). In multivariate regression analysis, a higher Ct and a younger age were associated with survival (P <. 001), while favipiravir treatment showed no statistically significant effect (P =. 11). However, Kaplan-Meier analysis indicated a longer survival time in the favipiravir-treated group (P =. 015). The study also showed characteristic changes in blood chemistry findings in patients who died, compared with survivors. Conclusions: Consistent with the JIKI trial, this retrospective study revealed a trend toward improved survival in favipiravir- treated patients; however, the effect of treatment was not statistically significant, except for its influence on survival time.