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Clinical and Epidemiological Features of Hospitalized and Ambulatory Patients with Human Monkeypox Infection: A Retrospective Observational Study in Portugal

Monkeypox, a neglected and re-emergent zoonotic disease caused by monkeypox virus (MPXV) infection, has been endemic in Central and Western Africa for decades. More recently, an outbreak has spread to a global level, occurring in sites with no previous reported cases and being clustered among men wh...

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Autores principales: Caria, João, Pinto, Raquel, Leal, Ema, Almeida, Vasco, Cristóvão, Gonçalo, Gonçalves, Ana Catarina, Torres, Margarida, Santos, Maria Beatriz, Pinheiro, Hélder, Póvoas, Diana, Seixas, Diana, Lino, Sara, Cardoso, Orlando, Manata, Maria José, Virgolino, Ana, Maltez, Fernando
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9680313/
https://www.ncbi.nlm.nih.gov/pubmed/36412741
http://dx.doi.org/10.3390/idr14060083
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author Caria, João
Pinto, Raquel
Leal, Ema
Almeida, Vasco
Cristóvão, Gonçalo
Gonçalves, Ana Catarina
Torres, Margarida
Santos, Maria Beatriz
Pinheiro, Hélder
Póvoas, Diana
Seixas, Diana
Lino, Sara
Cardoso, Orlando
Manata, Maria José
Virgolino, Ana
Maltez, Fernando
author_facet Caria, João
Pinto, Raquel
Leal, Ema
Almeida, Vasco
Cristóvão, Gonçalo
Gonçalves, Ana Catarina
Torres, Margarida
Santos, Maria Beatriz
Pinheiro, Hélder
Póvoas, Diana
Seixas, Diana
Lino, Sara
Cardoso, Orlando
Manata, Maria José
Virgolino, Ana
Maltez, Fernando
author_sort Caria, João
collection PubMed
description Monkeypox, a neglected and re-emergent zoonotic disease caused by monkeypox virus (MPXV) infection, has been endemic in Central and Western Africa for decades. More recently, an outbreak has spread to a global level, occurring in sites with no previous reported cases and being clustered among men who have sex with men, suggesting new modes of transmission. There is an urgent need for research for a better understanding of the genomic evolution and changing epidemiology of the Orthopoxvirus group. Our work aimed to characterize the clinical and epidemiological features of a cohort of patients with MPXV infection in a Portuguese hospital, admitted between 5 May and 26 July 2022. In this retrospective observational study, aggregate data of a case series on the presentation, clinical course, and outcomes of confirmed MPXV infections are reported. The study included 40 men and 1 woman, with a mean age of 37.2 years old; 92.7% identified as men who have sex with men, 90.2% had unprotected sex or sex with multiple or anonymous partners in the previous month, and 39.0% reported to have had sex with an MPXV-confirmed case; 59.5% had previously known human immunodeficiency virus (HIV) infection, all of whom were under antiretroviral therapy, and no patients had acquired immunodeficiency syndrome (AIDS) criteria. About a quarter of patients were observed only a week after symptom onset. All patients had skin or mucosal lesions and the anogenital region was the most frequent lesion site. There were no statistically significant clinical differences between HIV-positive and negative individuals. Four patients were admitted to the inpatient clinic, two of whom had proctitis with difficult-to-manage anal pain. There were no reported deaths. Our findings suggest the sexual route as a relevant mode of transmission of MPXV and confirm the mostly benign presentation of this disease.
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spelling pubmed-96803132022-11-23 Clinical and Epidemiological Features of Hospitalized and Ambulatory Patients with Human Monkeypox Infection: A Retrospective Observational Study in Portugal Caria, João Pinto, Raquel Leal, Ema Almeida, Vasco Cristóvão, Gonçalo Gonçalves, Ana Catarina Torres, Margarida Santos, Maria Beatriz Pinheiro, Hélder Póvoas, Diana Seixas, Diana Lino, Sara Cardoso, Orlando Manata, Maria José Virgolino, Ana Maltez, Fernando Infect Dis Rep Article Monkeypox, a neglected and re-emergent zoonotic disease caused by monkeypox virus (MPXV) infection, has been endemic in Central and Western Africa for decades. More recently, an outbreak has spread to a global level, occurring in sites with no previous reported cases and being clustered among men who have sex with men, suggesting new modes of transmission. There is an urgent need for research for a better understanding of the genomic evolution and changing epidemiology of the Orthopoxvirus group. Our work aimed to characterize the clinical and epidemiological features of a cohort of patients with MPXV infection in a Portuguese hospital, admitted between 5 May and 26 July 2022. In this retrospective observational study, aggregate data of a case series on the presentation, clinical course, and outcomes of confirmed MPXV infections are reported. The study included 40 men and 1 woman, with a mean age of 37.2 years old; 92.7% identified as men who have sex with men, 90.2% had unprotected sex or sex with multiple or anonymous partners in the previous month, and 39.0% reported to have had sex with an MPXV-confirmed case; 59.5% had previously known human immunodeficiency virus (HIV) infection, all of whom were under antiretroviral therapy, and no patients had acquired immunodeficiency syndrome (AIDS) criteria. About a quarter of patients were observed only a week after symptom onset. All patients had skin or mucosal lesions and the anogenital region was the most frequent lesion site. There were no statistically significant clinical differences between HIV-positive and negative individuals. Four patients were admitted to the inpatient clinic, two of whom had proctitis with difficult-to-manage anal pain. There were no reported deaths. Our findings suggest the sexual route as a relevant mode of transmission of MPXV and confirm the mostly benign presentation of this disease. MDPI 2022-10-27 /pmc/articles/PMC9680313/ /pubmed/36412741 http://dx.doi.org/10.3390/idr14060083 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Caria, João
Pinto, Raquel
Leal, Ema
Almeida, Vasco
Cristóvão, Gonçalo
Gonçalves, Ana Catarina
Torres, Margarida
Santos, Maria Beatriz
Pinheiro, Hélder
Póvoas, Diana
Seixas, Diana
Lino, Sara
Cardoso, Orlando
Manata, Maria José
Virgolino, Ana
Maltez, Fernando
Clinical and Epidemiological Features of Hospitalized and Ambulatory Patients with Human Monkeypox Infection: A Retrospective Observational Study in Portugal
title Clinical and Epidemiological Features of Hospitalized and Ambulatory Patients with Human Monkeypox Infection: A Retrospective Observational Study in Portugal
title_full Clinical and Epidemiological Features of Hospitalized and Ambulatory Patients with Human Monkeypox Infection: A Retrospective Observational Study in Portugal
title_fullStr Clinical and Epidemiological Features of Hospitalized and Ambulatory Patients with Human Monkeypox Infection: A Retrospective Observational Study in Portugal
title_full_unstemmed Clinical and Epidemiological Features of Hospitalized and Ambulatory Patients with Human Monkeypox Infection: A Retrospective Observational Study in Portugal
title_short Clinical and Epidemiological Features of Hospitalized and Ambulatory Patients with Human Monkeypox Infection: A Retrospective Observational Study in Portugal
title_sort clinical and epidemiological features of hospitalized and ambulatory patients with human monkeypox infection: a retrospective observational study in portugal
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9680313/
https://www.ncbi.nlm.nih.gov/pubmed/36412741
http://dx.doi.org/10.3390/idr14060083
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