Medical Team of Assistance to Sierra Leone, 302 Hospital, Beijing, China.
Clin Infect Dis. 2015 Aug 15;61(4):491-5. doi: 10.1093/cid/civ319. Epub 2015 May 20.
Clinical and laboratory data available on patients with Ebola virus disease (EVD) remain extremely limited. We summarized the clinical characteristics of patients with EVD and analyzed the factors related to their death.
Patients admitted for care at the Freetown China-Sierra Leone Friendship Hospital during 1 October-14 November 2014 were enrolled in this study. The clinical data of these patients were retrospectively analyzed.
Sixty-one patients were confirmed to have EVD; 28 of them (45.9%) were male and 33 (54.1%) were female. Their median age was 28 years (range, 1.17-67 years). The median duration from symptom onset to clinic visit time was 5 days (range, 1-16 days). Among these patients, 42 of them (68.9%) died. Of the confirmed cases, 18.0% did not present with fever. Patients aged >30 years had a higher fatality rate than those <30 years (87.0% vs 57.9%; P = .0175). The mean duration from symptom onset to clinic presentation of the survivors (4.57 ± 2.79 days) was shorter than that of the nonsurvivors (6.34 ± 3.33 days). Clinical factors associated with a fatal outcome included weakness, extreme fatigue, vomiting, diarrhea, mental symptoms, bleeding, and loss of appetite. No statistical difference in the case fatality rate between males and females was found (P = .2061).
The mortality of patients with EVD was closely associated with age and duration from symptom onset to presentation for care. Patients with EVD identified in the current outbreak did not necessarily have fever. Early diagnosis of the disease and timely symptomatic treatment may greatly contribute to the reduction of fatality rate of patients with EVD.
目前可获得的埃博拉病毒病(EVD)患者的临床和实验室数据极为有限。我们总结了 EVD 患者的临床特征,并分析了与死亡相关的因素。
本研究纳入了 2014 年 10 月 1 日至 11 月 14 日期间在弗里敦中塞友好医院接受治疗的患者。回顾性分析这些患者的临床数据。
61 例患者被确诊为 EVD;其中 28 例(45.9%)为男性,33 例(54.1%)为女性。中位年龄为 28 岁(范围为 1.17-67 岁)。从症状出现到就诊的中位时间为 5 天(范围为 1-16 天)。这些患者中,42 例(68.9%)死亡。确诊病例中,18.0%无发热。30 岁以上患者的病死率高于 30 岁以下患者(87.0%比 57.9%;P =.0175)。幸存者(4.57±2.79 天)从症状出现到就诊的平均时间短于非幸存者(6.34±3.33 天)。与死亡结局相关的临床因素包括虚弱、极度疲劳、呕吐、腹泻、精神症状、出血和食欲不振。男女病死率无统计学差异(P =.2061)。
EVD 患者的死亡率与年龄和从症状出现到就诊的时间密切相关。此次暴发中发现的 EVD 患者不一定有发热。早期诊断疾病和及时对症治疗可能会极大地降低 EVD 患者的病死率。