Intensive Care Unit–Like Care of Nonhuman Primates with Ebola Virus Disease

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 maca...

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Published in:	The Journal of infectious diseases Vol. 224; no. 4; pp. 632 - 642
Main Authors:	Blair, Paul W, Kortepeter, Mark G, Downey, Lydia G, Madar, Cristian S, Downs, Isaac L, Martins, Karen A, Rossi, Franco, Williams, Janice A, Madar, Annie, Schellhase, Christopher W, Bearss, Jeremy J, Zeng, Xiankun, Bavari, Sina, Soloveva, Veronica, Wells, Jay B, Stuthman, Kelly S, Garza, Nicole L, Vantongeren, Sean A, Donnelly, Ginger C, Steffens, Jesse, Kalapaca, Jennifer, Wiseman, Perry, Henry, Joseph, Marko, Shannon, Chappell, Mark, Lugo-Roman, Luis, Ramos-Rivera, Elliot, Hofer, Christian, Blue, Eugene, Moore, Joshua, Fiallos, Jimmy, Wetzel, Darrel, Pratt, William D, Unangst, Tami, Miller, Adele, Sola, James J, Reisler, Ronald B, Cardile, Anthony P
Format:	Journal Article
Language:	English
Published:	US Oxford University Press 16-08-2021
Subjects:	Algorithms Animals Antibiotics Blood pressure Critical Care Disease Models, Animal Ebola virus Ebolavirus Hemorrhagic Fever, Ebola - therapy Intensive care Intensive Care Units Intravenous administration Kidneys Levofloxacin Macaca mulatta Major and Brief Reports Norepinephrine Primates Retrospective Studies Survival Viruses models Mononegavirales hemorrhagic fevers intensive care Filoviridae animal viral Ebola virus disease
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Summary:	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 with a target dose of Ebola virus (1000 plaque-forming units; Kikwit). NHPs were allocated to intensive care unit (ICU)–like algorithms (n = 7), intravenous fluids 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 = .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. We investigated supportive care algorithms for Ebola virus disease (EVD) in nonhuman primates (NHPs). Although no obvious survival difference was observed with intensive care unit–like care, clinical observations may aid in refining an NHP model for EVD supportive care.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0022-1899 1537-6613
DOI:	10.1093/infdis/jiaa781