Related Experiment Video
Updated: Aug 28, 2025
Modeling The Lifecycle Of Ebola Virus Under Biosafety Level 2 Conditions With Virus-like Particles Containing Tetracistronic Minigenomes
Published on: September 27, 2014
Virus kinetics and biochemical derangements among children with Ebolavirus disease
Lindsey Kjaldgaard1,2, Kasereka Masumbuko Claude3, Daniel Mukadi-Bamuleka4
1Department of Paediatrics, University of Alberta, Edmonton, AB, Canada.
Insights
Children with Ebolavirus disease (EVD) show similar biochemical abnormalities as adults but have higher viral loads. Higher viral loads and specific biochemical markers predict mortality in pediatric EVD cases.
Area of Science:
- Infectious Diseases
- Virology
- Pediatrics
Background:
- Limited data exists on the virologic and biochemical profiles of pediatric Ebolavirus disease (EVD).
- Understanding these characteristics is crucial for effective management of EVD in children.
Purpose of the Study:
- To compare the virologic and biochemical features of pediatric EVD with those in young adults.
- To identify risk factors for mortality in children with EVD.
Main Methods:
- Retrospective chart review of children (<16 years) and young adults (16-44 years) during the 2018-2020 EVD epidemic.
- Statistical analysis including chi-squared, Mann-Whitney U-test, linear regression, mixed-effects models, and Cox proportional hazard models.
Main Results:
- Pediatric EVD patients exhibited significant electrolyte imbalances, hypoglycemia, acute kidney injury, and rhabdomyolysis.
- Children had significantly higher admission viral loads, peak viral loads, and longer viral clearance times compared to adults.
- Higher viral load, elevated liver enzymes, C-reactive protein, blood urea nitrogen, rhabdomyolysis, and acute kidney injury were risk factors for mortality in children.
Conclusions:
- Pediatric EVD presents with multiorgan dysfunction similar to adults, but with higher viral loads.
- Prompt identification of risk factors is essential for improving outcomes in pediatric EVD.
Background:
A paucity of data is available on virologic and biochemical characteristics of paediatric Ebolavirus disease (EVD), compared to adults.
Methods:
We conducted a retrospective chart review of children (<16 years old) and a comparator group of young adults (16-44 years) from two treatment centres during the 2018-2020 EVD epidemic in Eastern Democratic Republic of the Congo. Statistical methods included chi-squared and Fisher's exact tests (dichotomous and categorical variables), Mann-Whitney U-test (continuous variables), multivariable linear regression (for determinants of admission viral load), linear mixed-effects models (for analysis of longitudinal viral load), and Cox proportional hazard models (to examine risk factors for mortality).
Findings:
We included 73 children and 234 adults admitted from April to October 2019. Paediatric patients commonly had electrolytes imbalances: hypokalaemia in 26/73 (36%), hyperkalaemia in 38/73 (52%), and hyponatraemia in 54/73 (74%). Hypoglycaemia occurred in 20/73 (27%), acute kidney injury in 43/73 (59%), and rhabdomyolysis in 35/73 (48%). Biochemical abnormalities were detected in a similar proportion of children and adults. The viral load (VL, log10 copies/mL) at admission (7.2 versus 6.5, p=0.0001), the peak viral load (7.5 versus 6.7, p=<0.0001), and the time for viraemia clearance (16 days versus 12 days, p=<0.0001) were significantly different in children. The duration of hospital stay was prolonged in children (20 versus 16 days, p=<0.0001). Risk factors for mortality in children were: VL >7.6 log10copies/mL, alanine transaminase >525 U/L, C-reactive protein >100 mg/L, blood urea nitrogen >7.5 mmol/L, rhabdomyolysis, and.acute kidney injury.
Interpretation:
Paediatric EVD patients, like adults, experience multiorgan dysfunction with life-threatening electrolyte imbalances, hypoglycaemia, kidney injury, liver injury, and rhabdomyolysis. Paediatric patients have significantly higher VLs throughout the course of EVD than adults.
Funding:
This study was not funded.
