Clinical Scorecard: Evaluating Musculoskeletal Complications in Ebola Virus Survivors Seven Years Post-Hospital Discharge in Eastern Sierra Leone

At a Glance

Key Highlights

• Musculoskeletal sequelae including joint pain and tenderness are common in Ebola survivors up to 7 years post-discharge.
• Survivors aged 15–40 years demonstrate the highest rates of musculoskeletal signs and symptoms.
• Musculoskeletal sequelae generally decrease over time but show fluctuations during follow-up.

Guideline-Based Recommendations

Diagnosis

• Assess for current joint or muscle pain and perform physical examination for joint tenderness, decreased range of motion, and joint edema/effusion.
• Include abdominal tenderness assessment due to its association with musculoskeletal phenotype in post-Ebola syndrome.

Management

• Recognize the need for targeted treatment for survivors presenting with musculoskeletal sequelae.
• Consider longitudinal monitoring to track symptom progression and fluctuations.

Monitoring & Follow-up

• Follow survivors longitudinally for up to 7 years post-discharge to evaluate persistence or resolution of musculoskeletal symptoms.
• Monitor especially survivors aged 15–40 years who have higher odds of musculoskeletal complications.

Risks

• Higher risk of musculoskeletal sequelae in survivors with shorter time from discharge and those reporting pre-Ebola musculoskeletal issues or depression.
• No significant occupational risk factors identified after controlling for age, sex, and time from discharge.

Patient & Prescribing Data

Ebola virus disease survivors with post-Ebola musculoskeletal sequelae

Survivors with musculoskeletal symptoms may require specific and possibly prolonged treatment approaches; however, targeted therapies are not yet established.

Clinical Best Practices

• Perform comprehensive musculoskeletal and abdominal examinations during survivor follow-up visits.
• Use longitudinal data to inform individualized management plans for post-Ebola musculoskeletal sequelae.
• Pay particular attention to survivors aged 15–40 years due to their higher prevalence of symptoms.
• Incorporate mental health screening as depression is associated with reported musculoskeletal symptoms.

References

• Post-Ebola syndrome and musculoskeletal sequelae studies
• R software and statistical packages used in analysis