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Clinical characteristics and comparison of longitudinal qPCR results from different specimen types in a cohort of ambulatory and hospitalized patients infected with monkeypox virus.
BACKGROUND: The ongoing monkeypox virus outbreak includes at least 7553 confirmed cases in previously non-endemic countries worldwide as of July 2022. Clinical presentation has been reported as highly variable, sometimes lacking classically described systemic symptoms, and only small numbers of cuta...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier B.V.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9528238/ https://www.ncbi.nlm.nih.gov/pubmed/36057206 http://dx.doi.org/10.1016/j.jcv.2022.105254 |
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author | Nörz, Dominik Brehm, Thomas Theo Tang, Hui Ting Grewe, Ilka Hermanussen, Lennart Matthews, Hanna Pestel, Julia Degen, Olaf Günther, Thomas Grundhoff, Adam Fischer, Nicole Addo, Marylyn M. Jordan, Sabine Hertling, Sandra Unger, Stephan Schäfer, Guido Schewe, Knud Hoffmann, Christian Aepfelbacher, Martin Pfefferle, Susanne Schulze zur Wiesch, Julian Schmiedel, Stefan Lütgehetmann, Marc |
author_facet | Nörz, Dominik Brehm, Thomas Theo Tang, Hui Ting Grewe, Ilka Hermanussen, Lennart Matthews, Hanna Pestel, Julia Degen, Olaf Günther, Thomas Grundhoff, Adam Fischer, Nicole Addo, Marylyn M. Jordan, Sabine Hertling, Sandra Unger, Stephan Schäfer, Guido Schewe, Knud Hoffmann, Christian Aepfelbacher, Martin Pfefferle, Susanne Schulze zur Wiesch, Julian Schmiedel, Stefan Lütgehetmann, Marc |
author_sort | Nörz, Dominik |
collection | PubMed |
description | BACKGROUND: The ongoing monkeypox virus outbreak includes at least 7553 confirmed cases in previously non-endemic countries worldwide as of July 2022. Clinical presentation has been reported as highly variable, sometimes lacking classically described systemic symptoms, and only small numbers of cutaneous lesions in most patients. The aim of this study was to compare clinical data with longitudinal qPCR results from lesion swabs, oropharyngeal swabs and blood in a well characterized patient cohort. METHODS: 16 male patients (5 hospitalized, 11 outpatients) were included in the study cohort and serial testing for monkeypox virus-DNA carried out in various materials throughout the course of disease. Laboratory analysis included quantitative PCR, next-generation sequencing, immunofluorescence tests and virus isolation in cell culture. RESULTS: All patients were male, between age 20 and 60, and self-identified as men having sex with men. Two had a known HIV infection, coinciding with an increased number of lesions and viral DNA detectable in blood. In initial- and serial testing, lesion swabs yielded viral DNA-loads at, or above 10(6) cp/ml and only declined during the third week. Oropharyngeal swabs featured lower viral loads and returned repeatedly negative in some cases. Viral culture was successful only from lesion swabs but not from oropharyngeal swabs or plasma. DISCUSSION: The data presented underscore the reliability of lesion swabs for monkeypox virus-detection, even in later stages of the disease. Oropharyngeal swabs and blood samples alone carry the risk of false negative results, but may hold value in pre-/asymptomatic cases or viral load monitoring, respectively. |
format | Online Article Text |
id | pubmed-9528238 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier B.V. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95282382022-10-07 Clinical characteristics and comparison of longitudinal qPCR results from different specimen types in a cohort of ambulatory and hospitalized patients infected with monkeypox virus. Nörz, Dominik Brehm, Thomas Theo Tang, Hui Ting Grewe, Ilka Hermanussen, Lennart Matthews, Hanna Pestel, Julia Degen, Olaf Günther, Thomas Grundhoff, Adam Fischer, Nicole Addo, Marylyn M. Jordan, Sabine Hertling, Sandra Unger, Stephan Schäfer, Guido Schewe, Knud Hoffmann, Christian Aepfelbacher, Martin Pfefferle, Susanne Schulze zur Wiesch, Julian Schmiedel, Stefan Lütgehetmann, Marc J Clin Virol Short Communication BACKGROUND: The ongoing monkeypox virus outbreak includes at least 7553 confirmed cases in previously non-endemic countries worldwide as of July 2022. Clinical presentation has been reported as highly variable, sometimes lacking classically described systemic symptoms, and only small numbers of cutaneous lesions in most patients. The aim of this study was to compare clinical data with longitudinal qPCR results from lesion swabs, oropharyngeal swabs and blood in a well characterized patient cohort. METHODS: 16 male patients (5 hospitalized, 11 outpatients) were included in the study cohort and serial testing for monkeypox virus-DNA carried out in various materials throughout the course of disease. Laboratory analysis included quantitative PCR, next-generation sequencing, immunofluorescence tests and virus isolation in cell culture. RESULTS: All patients were male, between age 20 and 60, and self-identified as men having sex with men. Two had a known HIV infection, coinciding with an increased number of lesions and viral DNA detectable in blood. In initial- and serial testing, lesion swabs yielded viral DNA-loads at, or above 10(6) cp/ml and only declined during the third week. Oropharyngeal swabs featured lower viral loads and returned repeatedly negative in some cases. Viral culture was successful only from lesion swabs but not from oropharyngeal swabs or plasma. DISCUSSION: The data presented underscore the reliability of lesion swabs for monkeypox virus-detection, even in later stages of the disease. Oropharyngeal swabs and blood samples alone carry the risk of false negative results, but may hold value in pre-/asymptomatic cases or viral load monitoring, respectively. Elsevier B.V. 2022-10 2022-08-11 /pmc/articles/PMC9528238/ /pubmed/36057206 http://dx.doi.org/10.1016/j.jcv.2022.105254 Text en © 2022 Elsevier B.V. All rights reserved. Elsevier has created a Monkeypox Information Center (https://www.elsevier.com/connect/monkeypox-information-center) in response to the declared public health emergency of international concern, with free information in English on the monkeypox virus. The Monkeypox Information Center is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its monkeypox related research that is available on the Monkeypox Information Center - including this research content - immediately available in publicly funded repositories, with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the Monkeypox Information Center remains active. |
spellingShingle | Short Communication Nörz, Dominik Brehm, Thomas Theo Tang, Hui Ting Grewe, Ilka Hermanussen, Lennart Matthews, Hanna Pestel, Julia Degen, Olaf Günther, Thomas Grundhoff, Adam Fischer, Nicole Addo, Marylyn M. Jordan, Sabine Hertling, Sandra Unger, Stephan Schäfer, Guido Schewe, Knud Hoffmann, Christian Aepfelbacher, Martin Pfefferle, Susanne Schulze zur Wiesch, Julian Schmiedel, Stefan Lütgehetmann, Marc Clinical characteristics and comparison of longitudinal qPCR results from different specimen types in a cohort of ambulatory and hospitalized patients infected with monkeypox virus. |
title | Clinical characteristics and comparison of longitudinal qPCR results from different specimen types in a cohort of ambulatory and hospitalized patients infected with monkeypox virus. |
title_full | Clinical characteristics and comparison of longitudinal qPCR results from different specimen types in a cohort of ambulatory and hospitalized patients infected with monkeypox virus. |
title_fullStr | Clinical characteristics and comparison of longitudinal qPCR results from different specimen types in a cohort of ambulatory and hospitalized patients infected with monkeypox virus. |
title_full_unstemmed | Clinical characteristics and comparison of longitudinal qPCR results from different specimen types in a cohort of ambulatory and hospitalized patients infected with monkeypox virus. |
title_short | Clinical characteristics and comparison of longitudinal qPCR results from different specimen types in a cohort of ambulatory and hospitalized patients infected with monkeypox virus. |
title_sort | clinical characteristics and comparison of longitudinal qpcr results from different specimen types in a cohort of ambulatory and hospitalized patients infected with monkeypox virus. |
topic | Short Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9528238/ https://www.ncbi.nlm.nih.gov/pubmed/36057206 http://dx.doi.org/10.1016/j.jcv.2022.105254 |
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