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  • Writer's pictureHarsha Moole, MD, MBBS

Ebola Virus Disease (EVD), clinical symptoms and associated disease outcomes

Updated: Oct 21, 2018

Clinical features of EVD that may be associated with higher mortality include bleeding events, vomiting, diarrhea, abdominal pain, cough, sore throat, and conjunctivitis. These patients should be identified promptly, and appropriate management should be instituted immediately.

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Ebola virus disease (EVD) is a public health emergency of international concern. There is limited laboratory and clinical data available on patients with EVD. This is a meta-analysis to assess the utility of clinical signs, symptoms, and laboratory data in predicting mortality in EVD.


To assess the utility of clinical signs, symptoms, and laboratory data in predicting mortality in EVD.

This is a research article published in Journal of Community Hospital Internal Medicine Perspectives.


Study selection criterion: EVD articles with more than 35 EVD cases that described the clinical features were included. Data collection and extraction: Articles were searched in Medline, PubMed, Ovid journals, and CDC and WHO official websites.


Pooled proportions were calculated using DerSimonian Laird method (random effects model).

Coauthors of this paper are: Swetha Chitta, MD, Darlyn Victor, MD, Manasa Kandula, MD, Vishnu Moole, MBBS, Harshavardhan Ghadiam, MD, Anusha Akepati, MD, Charan Yerasi, MD, Achuta Uppu, MD, Sowmya Dharmapuri, MBBS, Raghuveer Boddireddy, MBBS, Jacqueline Fischer, MD, and Teresa Lynch, MD


Initial search identified 634 reference articles, of which 67 were selected and reviewed. Data were extracted from 10 articles (N=5,792) of EVD which met the inclusion criteria. Bleeding events (64.5% vs. 25.1%), abdominal pain (58.3% vs. 37.5%), vomiting (60.8% vs. 31.7%), diarrhea (69.9% vs. 37.8%), cough (31.6% vs. 22.3%), sore throat (47.7% vs. 19.8%), and conjunctivitis (39.3% vs. 20.3%) were more often present in pooled proportion of fatal cases as compared to EVD survivors.

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In EVD, the presenting clinical features of vomiting, diarrhea, bleeding events, abdominal pain, cough, sore throat, and conjunctivitis may be associated with the increased risk of mortality. EVD with such features should promptly be identified, and rigorous management options should be pursued emergently. Although prior studies have shown that increased AST, BUN, and creatinine have been associated with high mortality, we could not synthesize meaningful outcomes in this regard due to the limited available data.

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