Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from BrazilResearch in context

• Main Authors: Mayara Secco Torres Silva (Author), Carolina Coutinho (Author), Thiago Silva Torres (Author), Eduardo Peixoto (Author), Ronaldo Ismério (Author), Flavia Lessa (Author), Estevão Portela Nunes (Author), Brenda Hoagland (Author), Amanda Dolores Echeverria Guevara (Author), Matheus Oliveira Bastos (Author), Isabel Cristina Ferreira Tavares (Author), Maria Pia Diniz Ribeiro (Author), Maria Roberta Meneguetti Seravalli Ramos (Author), Hugo Boechat Andrade (Author), Ana Paula Lovetro Santana (Author), Marilia Santini-Oliveira (Author), Juliana Barbosa Santos Netto (Author), Paula Reges (Author), Monica Avelar Magalhães (Author), Leonardo Azevedo Silva Rosadas (Author), Sandro Nazer (Author), Luciane Velasque (Author), Sandra Wagner Cardoso (Author), Edson Elias da Silva (Author), Valdilea Gonçalves Veloso (Author), Mayumi Duarte Wakimoto (Author), Beatriz Grinsztejn (Author), André Miguel Japiassu (Author), Marcel Trepow (Author), Italo Guariz Ferreira (Author), Larissa Villela (Author), Rafael Teixeira Fraga (Author), Mariah Castro de Souza Pires (Author), Rodrigo Otavio da Silva Escada (Author), Leonardo Paiva de Sousa (Author), Gabriela Lisseth Umaña Robleda (Author), Desirée Vieira Santos (Author), Luiz Ricardo Siqueira Camacho (Author), Pedro Amparo (Author), João Victor Jaegger de França (Author), Felipe de Oliveira Heluy Correa (Author), Bruno Ivanovinsky Costa de Sousa (Author), Bernardo Vicari do Valle (Author), João Paulo Bortot Soares (Author), Livia Cristina Fonseca Ferreira (Author), Pedro da Silva Martins (Author), Maira Braga Mesquita (Author), José Ricardo Hildebrant Coutinho (Author), Raissa de Moraes Perlingeiro (Author), Priscila Peixoto de Castro Oliveira (Author), Hugo Perazzo Pedroso Barbosa (Author), André Figueiredo Accetta (Author), Marcelo Cunha (Author), Rosangela Vieira Eiras (Author), Ticiana Martins dos Santos (Author), Wladmyr Davila da Silva (Author), Monique do Vale Silveira (Author), Tania de Souza Brum (Author), Guilherme Amaral Calvet (Author), Rodrigo Caldas Menezes (Author), Sandro Antônio Pereira (Author)
• Format: Book
• Published: Elsevier, 2023-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Summary: Background: By October 30, 2022, 76,871 cases of mpox were reported worldwide, with 20,614 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed mpox cases at a referral infectious diseases center in Rio de Janeiro, Brazil. Methods: This was a single-center, prospective, observational cohort study that enrolled all patients with suspected mpox between June 12 and August 19, 2022. Mpox was confirmed by a PCR test. We compared characteristics of confirmed and non-confirmed cases, and among confirmed cases according to HIV status using distribution tests. Kernel estimation was used for exploratory spatial analysis. Findings: Of 342 individuals with suspected mpox, 208 (60.8%) were confirmed cases. Compared to non-confirmed cases, confirmed cases were more frequent among individuals aged 30-39 years, cisgender men (96.2% vs. 66.4%; p < 0.0001), reporting recent sexual intercourse (95.0% vs. 69.4%; p < 0.0001) and using PrEP (31.6% vs. 10.1%; p < 0.0001). HIV (53.2% vs. 20.2%; p < 0.0001), HCV (9.8% vs. 1.1%; p = 0.0046), syphilis (21.2% vs. 16.3%; p = 0.43) and other STIs (33.0% vs. 21.6%; p = 0.042) were more frequent among confirmed mpox cases. Confirmed cases presented more genital (77.3% vs. 39.8%; p < 0.0001) and anal lesions (33.1% vs. 11.5%; p < 0.0001), proctitis (37.1% vs. 13.3%; p < 0.0001) and systemic signs and symptoms (83.2% vs. 64.5%; p = 0.0003) than non-confirmed cases. Compared to confirmed mpox HIV-negative, HIV-positive individuals were older, had more HCV coinfection (15.2% vs. 3.7%; p = 0.011), anal lesions (45.7% vs. 20.5%; p < 0.001) and clinical features of proctitis (45.2% vs. 29.3%; p = 0.058). Interpretation: Mpox transmission in Rio de Janeiro, Brazil, rapidly evolved into a local epidemic, with sexual contact playing a crucial role in its dynamics and high rates of coinfections with other STI. Preventive measures must address stigma and social vulnerabilities. Funding: Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz).

Item Description

2667-193X
10.1016/j.lana.2022.100406