Impact of Most Promising Ebola Therapies on Survival: A Secondary Analysis during the Tenth Outbreak in the Democratic Republic of Congo

Abstract: Background: MAb114, REGN-EB3, Remdesivir, and ZMapp, which are monoclonal antibody-based treatments, have been compared and shown to be promising therapies against the Ebola Virus Disease (EVD). There has been no comparison between these med-ications and standard treatment (without antiviral). Our study aimed to examine the con-tribution of each regimen compared to standard treatment on the survival of EVD patients and assess whether this association was modified by EVD vaccination (rVSV-ZEBOV Ebola vaccine) status. Methodology: We performed a secondary analysis of data obtained from four EVD treatment centers located in Katwa, Mangina, Butembo, and Beni in the North Kivu region. The main outcome measure was mortality within a 28-day period. A Cox model was used to identify predictors of survival in hospitalized EVD patients. Results: Vaccinated EVD patients were 1.7 times less likely to die compared to unvac-cinated patients (3.70 days vs. 5.00 days; p=0.0002). Delaying care and treatment at EVD treatment centres increased mortality risk by 5% for each day following symptom onset. Compared to the standard treatment group, adjusted mortality rates were significantly re-duced in the groups receiving MAb114 (0.29, p