Department of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo.
School of Public Health, University of Alberta, Edmonton, Canada.
J Infect Dis. 2024 Aug 16;230(2):e465-e473. doi: 10.1093/infdis/jiae224.
Skeletal muscle injury in Ebola virus disease (EVD) has been reported, but its association with morbidity and mortality remains poorly defined.
This retrospective study included patients admitted to 2 EVD treatment units over an 8-month period in 2019 during an EVD epidemic in the Democratic Republic of the Congo.
An overall 333 patients (median age, 30 years; 58% female) had at least 1 creatine kinase (CK) measurement (n = 2229; median, 5/patient [IQR, 1-11]). Among patients, 271 (81%) had an elevated CK level (>380 U/L); 202 (61%) had rhabdomyolysis (CK >1000 IU/L); and 45 (14%) had severe rhabdomyolysis (≥5000 U/L). Among survivors, the maximum CK level was a median 1600 (IQR, 550-3400), peaking 3.4 days after admission (IQR, 2.3-5.5) and decreasing thereafter. Among fatal cases, the CK rose monotonically until death, with a median maximum CK level of 2900 U/L (IQR, 1500-4900). Rhabdomyolysis at admission was an independent predictor of acute kidney injury (adjusted odds ratio, 2.2 [95% CI, 1.2-3.8]; P = .0065) and mortality (adjusted hazard ratio, 1.7 [95% CI, 1.03-2.9]; P = .037).
Rhabdomyolysis is associated with acute kidney injury and mortality in patients with EVD. These findings may inform clinical practice by identifying laboratory monitoring priorities and highlighting the importance of fluid management.
已有研究报道埃博拉病毒病（EVD）患者存在骨骼肌损伤，但该病与发病率和死亡率的关系仍未明确。
本回顾性研究纳入了 2019 年刚果民主共和国 EVD 流行期间在 2 个 EVD 治疗中心住院的 8 个月期间的患者。
共有 333 例患者（中位年龄 30 岁，58%为女性）至少进行了 1 次肌酸激酶（CK）检测（n=2229；中位数为 5 次/患者[IQR，1-11]）。患者中，271 例（81%）CK 水平升高（＞380 U/L）；202 例（61%）发生横纹肌溶解症（CK＞1000 U/L）；45 例（14%）发生严重横纹肌溶解症（≥5000 U/L）。幸存者中，CK 的最高值为中位数 1600（IQR，550-3400），在入院后第 3.4 天（IQR，2.3-5.5）达到峰值，此后逐渐下降。在死亡病例中，CK 持续升高直至死亡，CK 的最高值中位数为 2900 U/L（IQR，1500-4900）。入院时发生横纹肌溶解症是急性肾损伤（校正比值比，2.2[95%CI，1.2-3.8]；P=.0065）和死亡（校正风险比，1.7[95%CI，1.03-2.9]；P=.037）的独立预测因素。
EVD 患者的横纹肌溶解症与急性肾损伤和死亡率相关。这些发现可能通过确定实验室监测重点并强调液体管理的重要性，为临床实践提供信息。
