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ICU-like Care of Nonhuman Primates with Ebola Virus Disease

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Title

ICU-like Care of Nonhuman Primates with Ebola Virus Disease

Subject

Research

Description

Ebola virus disease (EVD) supportive care strategies are largely guided by retrospective observational research. This study investigated the effect of EVD supportive care algorithms on duration of survival in a controlled nonhuman primate (NHP) model.

Date

2020-12-25

Citation

Blair, P. W., M. G. Kortepeter, L. G. Downey, C. S. Madar, I. L. Downs, K. A. Martins, F. Rossi, J. A. Williams, A. Madar, C. W. Schellhase, J. J. Bearss, X. Zeng, S. Bavari, V. Soloveva, J. B. Wells, K. S. Stuthman, N. L. Garza, S. A. Vantongeren, G. C. Donnelly, J. Steffens, J. Kalapaca, P. Wiseman, J. Henry, S. Marko, M. Chappell, L. Lugo-Roman, E. Ramos-Rivera, C. Hofer, E. Blue, J. Moore, J. Fiallos, D. Wetzel, W. D. Pratt, T. Unangst, A. Miller, J. J. Sola, R. B. Reisler, and A. P. Cardile. 2020. "ICU-like Care of Nonhuman Primates with Ebola Virus Disease." The Journal of infectious diseases.

Abstract

Background: Ebola virus disease (EVD) supportive care strategies are largely guided by retrospective observational research. This study investigated the effect of EVD supportive care algorithms on duration of survival in a controlled nonhuman primate (NHP) model.

Methods: Fourteen rhesus macaques were challenged intramuscularly (IM) with a target dose of 1000 PFU Zaire ebolavirus (Kikwit). NHPs were allocated to intensive care unit (ICU)-like algorithms (n=7), intravenous fluids (IVF) plus levofloxacin (n=2), or a control group (n=5). The primary outcome measure was duration of survival, and secondary outcomes included changes in clinical laboratory values.

Results: Duration of survival was not significantly different between the pooled ICU-like algorithm and control groups (8.2 vs 6.9 days of survival, hazard ratio 0.50, p = 0.25). Norepinephrine was effective in transiently maintaining baseline blood pressure. NHPs treated with ICU-like algorithms had delayed onset of liver and kidney injury.

Conclusions: While an obvious survival difference was not observed with ICU-like care, clinical observations from this model may aid in EVD supportive care NHP model refinement.

Keywords: Ebola virus disease; animal; filoviridae; hemorrhagic fevers; intensive care; models; mononegavirales; viral.

Accessibility

Available online on Oxford Academic

Collection