Endotheliopathy and Platelet Dysfunction as Hallmarks of Fatal Lassa Fever
Lucy E. Horton1
, Robert W. Cross1
, Jessica N. Hartnett, Emily J. Engel, Saori Sakabe, Augustine Goba, Mambu Momoh, John Demby Sandi, Thomas W. Geisbert, Robert F. Garry, John S. Schieffelin, Donald S. Grant, and Brian M. Sullivan
Author affiliations: The Scripps Research Institute, La Jolla, California, USA (L.E. Horton, S. Sakabe, B.M. Sullivan); University of Texas Medical Brach, Galveston, Texas, USA (R.W. Cross, T.W. Geisbert); Tulane University School of Medicine, New Orleans, Louisiana, USA (J.N. Hartnett, E.J. Engel, R.F. Garry, J.S. Schieffelin); Kenema Government Hospital, Kenema, Sierra Leone (A. Goba, M. Momoh, J.D. Sandi, D.S. Grant); Ministry of Health and Sanitation, Freetown, Sierra Leone (A. Goba, M. Momoh, J.D. Sandi); Eastern Polytechnic Institute, Kenema (M. Momoh, D.S. Grant); Njala University, Moyamba, Sierra Leone (J.D. Sandi); University of Sierra Leone, Freetown (D.S. Grant)
Figure 6. P-selectin and adhesion molecule levels in patients with acute LF, NLFCs, and healthy controls (HCs), Sierra Leone, 2015–2018. A) Differences in soluble P-selectin (CD62P) were statistically significant (Kruskal-Wallis p = 0.0358), but we found no statistically significant differences when comparing groups to each other using Dunn’s multiple comparisons test (left, middle); no statistically significant correlation was observed between P-selectin and LASV-Ag levels (n = 15). B) Statistically significant differences in soluble ICAM levels were noted across all groups (Kruskal-Wallis p<0.0001). ICAM was statistically significantly elevated (****p<0.0001) in acute LF (n = 34) compared with HCs (n = 41) and NLFCs (n = 44; **p = 0.0036). No statistically significant correlation was found between ICAM and LASV antigen (n = 14) C) Statistically significant differences in soluble VCAM levels were observed across all groups (Kruskal-Wallis p = 0.0052). VCAM was statistically significantly elevated (*p = 0.0127) in acute LF (n = 34) compared with HCs (n = 41). No statistically significant differences were observed in acute LF patients who survived (n = 6) compared with those who died (n = 21) and no statistically significant correlation was found between VCAM and LASV-Ag (n = 14). Limits of detection are indicated by dashed lines and gray shading below. Error bars show SDs; horizontal lines indicate means. D, died; HC, healthy controls; ICAM, intercellular adhesion molecule; LF, Lassa fever; LASV, Lassa fever virus; LASV-Ag, Lassa fever virus antigen; NLFC, non–LF febrile controls; S, survived; VCAM, vascular cell adhesion molecule.
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