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Sociodemographic, Clinical and Laboratorial Characteristics of Ambulatory and Hospitalized Patients with Suspected and Confirmed Monkeypox Virus Infection: An Observational Cohort Study from Brazil

2022; RELX Group (Netherlands); Linguagem: Inglês

10.2139/ssrn.4216694

1556-5068

Mayara Secco Torres Silva, Carolina Coutinho, Thiago S. Torres, Eduardo Mesquita Peixoto, Ronaldo Ismério, Flávia Lessa, Estêvão Portela Nunes, Brenda Hoagland, Amanda Dolores Echeverria Guevara, Matheus Oliveira Bastos, Maria Pia Diniz Ribeiro, Maria Roberta Meneguetti Sera Ramos, Hugo Boechat Andrade, Ana Paula Lovetro Santana, Isabel Cristina Teixeira Tavares, Marília Santini-Oliveira, Juliana Barbosa dos Santos Netto, Paula Reges, Mônica Avelar Figueiredo Mafra Magalhães, Leonardo Azevedo da Silva Rosadas, Sandro Nazer, Luciane Velasque, Sandra Wagner Cardoso, Edson Elias Silva, Valdiléa G. Veloso, Mayumi Duarte Wakimoto, Beatriz Grinsztejn, The INI-Fiocruz Monkeypox Study Group,

Viral Infections and Outbreaks Research

Background: By September 6, 2022, 52,997 cases of monkeypox were reported worldwide, with 8,556 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed monkeypox 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 monkeypox between June 12 and August 19, 2022. Monkeypox 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 monkeypox, 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=0.431) and other STIs (33.0%vs.21.6%;p=0.042) were more frequent among confirmed monkeypox 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 monkeypox HIV-negative, HIV-positive individuals were older, had more HCV coinfection (16.3%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: Sexual contact plays a crucial role in the transmission dynamics of monkeypox in Rio de Janeiro, Brazil, highlighting the importance of comprehensive sexual health screenings for suspected cases.Funding Information: Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INIFiocruz).Declaration of Interests: All authors declare no competing interests.Ethics Approval Statement: This study was approved by the Ethics Review Board at INI-Fiocruz (CAAE # 61290422.0.0000.5262). All study participants provided either oral or written informed consent to participate. Written consent for images were obtained as well. Individuals who required hospitalization were prospectively followed at the INI-Fiocruz Inpatient care Unit. If hospitalization occurred outside our institution, data were retrospectively collected.