909. Clinical features and management of a human monkeypox outbreak: a retrospective observational study in Harlem New York

BACKGROUND: In this paper, we report the descriptive, epidemiological, virologic and clinical features of the response to the investigational antiviral Tecovirimat, during the last Human Monkeypox outbreak in New City. METHODS: This is a retrospective observational study, based on data obtained from a convenient sample of patients evaluated for monkeypox infection at Harlem Hospital Infectious Diseases Clinic, from June 30(th) 2022 to September 1(st) 2022. Outbreak analysis was completed using grid-like/mapping approach to evaluate the distribution of the lesions. Statistical analysis was conducted using binary logistic and Chi-square analysis. Mapping of lesions [Figure: see text] [Figure: see text] RESULTS: 44 patients were included in the study 16 (36%) patients were immunocompromised with HIV with an absolute CD4 count ranging from 22 to 1048. Of the 44 patients, 30 (68%) were prescribed oral tecovirimat. Follow up showed that 13(43.3%) and 3 (3%) patients who received tecovirimat had complete resolution of symptoms at 7 days and 14 days respectively. 4 (9%) patients were lost to follow up and 2 (4.5%) were hospitalized for worsening symptoms. Overall medication was well tolerated with no reported events that were felt to be related to the medication. Symptoms grid mapping showed a higher prevalence of lesions at the genital and rectal area, highly significant in the treatment group. We were not able to establish a significant statistical correlation between HIV status/CD4 count and resolution of symptoms. However statistical analysis showed a significant positive correlation between treatment with Tecovirimat and resolution of symptoms at 14 days (P = 0.047). CONCLUSION: The results published in the abstract are mostly descriptive of the sample and the general management including the use of Tecovirimat. Most patients who received tecovirimat had a complete resolution of symptoms n= (53%) at 14 days. It is not clear whether this difference was attributable to the efficacy of the treatment versus the natural course of disease. Indeed, several patients in the non-treatment group were lost to follow up. Further studies are needed to define the effect of severe immunosuppression and the efficacy of available antiviral drugs on the course of disease. DISCLOSURES: All Authors: No reported disclosures