Complications

Complication
Timeframe
Likelihood
short term
high

Common in severe disease with or without frank shock due to dehydration and ongoing fluid losses through vomiting and diarrhoea as well as poor oral intake and possible haemorrhage.[9]

short term
high

Nearly all pregnancies complicated by Ebola or Marburg virus diseases end in spontaneous abortion or stillbirth.[4][9]

short term
medium

Nearly half of Ebola virus disease survivors in one study from Sierra Leone reported difficulty concentrating at follow-up visits.[66] This may apply to Marburg virus disease survivors as well.

short term
low

Has been reported in severe disease. May be caused by dehydration initially, but may be a consequence of disseminated intravascular coagulation or direct damage to the kidneys by Marburg virus in later stages.[21] Early recognition by monitoring urine output and blood biochemistry enables prompt action to be taken.

variable
high

Nearly 75% of Ebola virus disease survivors reported ongoing musculoskeletal pain at follow-up visits.[61][62] This has been found in Marburg virus disease survivors as well.[9]

variable
high

Nearly half of Ebola virus disease survivors reported ongoing headaches at follow-up visits.[61] This has been found in Marburg virus disease survivors as well.[9]

variable
high

14% to 60% of Ebola virus disease survivors reported ocular symptoms including eye pain, clear discharge, red eyes, and blurred vision, or were found to have uveitis at follow-up visits.[61][62] This has been found in Marburg virus disease survivors as well.[9] The central nervous system and globe are thought to be filovirus sanctuary sites where disease can be persistent.[13]

variable
high

Headache, confusion, seizures, memory loss, headaches, cranial nerve abnormalities, and tremor may occur, and neurological symptoms have been documented in both acute illness and among Ebola virus survivors.[63] The central nervous system and globe are thought to be filovirus sanctuary sites where disease can be persistent.[13]

variable
high

75% of Ebola virus disease survivors reported lethargy or fatigue at follow-up visits.[64] This may apply to Marburg virus disease survivors as well.

variable
high

Psychological distress was common among Ebola virus disease survivors in the 2014 to 2016 West Africa Ebola virus disease outbreak.[65] Exposure to death in the treatment units and stigma in the community induced post-traumatic stress reactions and symptoms of depression.[65] These symptoms are also common among Marburg virus disease survivors, and would be expected to be especially prevalent in outbreak settings.[9]

variable
high

Nearly all Ebola virus disease survivors in one study from Sierra Leone reported anorexia at follow-up visits.[66] This may apply to Marburg virus disease survivors as well.

variable
medium

Seen in severe disease with transaminitis predominant. Acute liver failure has been reported and hepatitis has also been noted among survivors during follow-up.[9][21] This may be due to viral hepatic tropism or hypotensive liver injury.

variable
medium

Approximately 1 in 4 of Ebola virus disease survivors reported auditory symptoms including tinnitus, aural fullness, or hearing loss at follow-up visits.[61][62] This may apply to Marburg virus disease survivors as well.

variable
medium

Asthenia has been reported among Marburg disease survivors.[9]

variable
low

A small percentage of Ebola virus disease survivors in the United States reported insomnia at follow-up visits.[64] This may apply to Marburg virus disease survivors as well.

variable
low

38% of Ebola virus disease survivors in the United States reported paraesthesias or dysaesthesia at follow-up visits.[64] This may apply to Marburg virus disease survivors as well.

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