دورية أكاديمية
أعرض في EDS

Clinical features and management of individuals admitted to hospital with monkeypox and associated complications across the UK: a retrospective cohort study.

التفاصيل البيبلوغرافية
العنوان: Clinical features and management of individuals admitted to hospital with monkeypox and associated complications across the UK: a retrospective cohort study.
المؤلفون: Fink DL; Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London, UK; Division of Infection and Immunity, University College London, London, UK. Electronic address: douglas.fink@nhs.net., Callaby H; Rare and Imported Pathogens Laboratory, UK Health Security Agency, Porton Down, Wiltshire, UK., Luintel A; Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London, UK., Beynon W; Department of Infectious Diseases, Belfast Health and Social Care Trust, Belfast, UK., Bond H; Department of Infectious Diseases, Belfast Health and Social Care Trust, Belfast, UK., Lim EY; Department of Infectious Diseases, Cambridge University Hospitals, Cambridge, UK., Gkrania-Klotsas E; Department of Infectious Diseases, Cambridge University Hospitals, Cambridge, UK., Heskin J; Department of HIV/GUM, Chelsea and Westminster Hospital, London, UK., Bracchi M; Department of HIV/GUM, Chelsea and Westminster Hospital, London, UK., Rathish B; Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK., Milligan I; Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK., O'Hara G; Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK., Rimmer S; Department of Infectious Diseases, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK., Peters JR; Department of Infectious Diseases, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK., Payne L; Department of Sexual Health and HIV, King's College Hospital NHS Foundation Trust, London, UK., Mody N; Department of Sexual Health and HIV, King's College Hospital NHS Foundation Trust, London, UK., Hodgson B; Department of Infectious Diseases, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Lewthwaite P; Department of Infectious Diseases, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Lester R; Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK., Woolley SD; Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK., Sturdy A; Department of Infectious Diseases, London North West University Healthcare NHS Trust, UK., Whittington A; Department of Infectious Diseases, London North West University Healthcare NHS Trust, UK., Johnson L; Department of Infectious Diseases, North Manchester General Hospital, Manchester, UK., Jacobs N; Department of Infectious Diseases, North Manchester General Hospital, Manchester, UK., Quartey J; Department of Infection and Tropical Medicine, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, UK., Ai Payne B; Department of Infection and Tropical Medicine, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, UK., Crowe S; Department of Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Elliott IA; Department of Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Harrison T; Department of Infectious Diseases, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK., Cole J; Department of Infectious Diseases, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK., Beard K; Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Cusack TP; Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Jones I; Infection Care Group, St George's University Hospitals NHS Foundation Trust, London, UK., Banerjee R; Infection Care Group, St George's University Hospitals NHS Foundation Trust, London, UK., Rampling T; Rare and Imported Pathogens Laboratory, UK Health Security Agency, Porton Down, Wiltshire, UK; Hospital for Tropical Diseases, Division of Infection, University College London Hospitals NHS Foundation Trust, London UK., Dunning J; Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London, UK; Division of Infection and Immunity, University College London, London, UK; Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
مؤلفون مشاركون: Specialist and High Consequence Infectious Diseases Centres Network for Monkeypox
المصدر: The Lancet. Infectious diseases [Lancet Infect Dis] 2023 May; Vol. 23 (5), pp. 589-597. Date of Electronic Publication: 2022 Dec 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Science Country of Publication: United States NLM ID: 101130150 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1474-4457 (Electronic) Linking ISSN: 14733099 NLM ISO Abbreviation: Lancet Infect Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Elsevier Science ; The Lancet Pub. Group, 2001-
مواضيع طبية MeSH: Mpox (monkeypox)*, Humans ; Female ; Male ; Adult ; Retrospective Studies ; Cohort Studies ; Hospitals ; Pain ; Benzamides ; United Kingdom/epidemiology
مستخلص: Background: The scale of the 2022 global mpox (formerly known as monkeypox) outbreak has been unprecedented. In less than 6 months, non-endemic countries have reported more than 67 000 cases of a disease that had previously been rare outside of Africa. Mortality has been reported as rare but hospital admission has been relatively common. We aimed to describe the clinical and laboratory characteristics and outcomes of individuals admitted to hospital with mpox and associated complications, including tecovirimat recipients.
Methods: In this cohort study, we undertook retrospective review of electronic clinical records and pathology data for all individuals admitted between May 6, and Aug 3, 2022, to 16 hospitals from the Specialist and High Consequence Infectious Diseases Network for Monkeypox. The hospitals were located in ten cities in England and Northern Ireland. Inclusion criteria were clinical signs consistent with mpox and MPXV DNA detected from at least one clinical sample by PCR testing. Patients admitted solely for isolation purposes were excluded from the study. Key outcomes included admission indication, complications (including pain, secondary infection, and mortality) and use of antibiotic and anti-viral treatments. Routine biochemistry, haematology, microbiology, and virology data were also collected. Outcomes were assessed in all patients with available data.
Findings: 156 individuals were admitted to hospital with complicated mpox during the study period. 153 (98%) were male and three (2%) were female, with a median age of 35 years (IQR 30-44). Gender data were collected from electronic patient records, which encompassed full formal review of clincian notes. The prespecified options for data collection for gender were male, female, trans, non-binary, or unknown. 105 (71%) of 148 participants with available ethnicity data were of White ethnicity and 47 (30%) of 155 were living with HIV with a median CD4 count of 510 cells per mm 3 (IQR 349-828). Rectal or perianal pain (including proctitis) was the most common indication for hospital admission (44 [28%] of 156). Severe pain was reported in 89 (57%) of 156, and secondary bacterial infection in 82 (58%) of 142 individuals with available data. Median admission duration was 5 days (IQR 2-9). Ten individuals required surgery and two cases of encephalitis were reported. 38 (24%) of the 156 individuals received tecovirimat with early cessation in four cases (two owing to hepatic transaminitis, one to rapid treatment response, and one to patient choice). No deaths occurred during the study period.
Interpretation: Although life-threatening mpox appears rare in hospitalised populations during the current outbreak, severe mpox and associated complications can occur in immunocompetent individuals. Analgesia and management of superimposed bacterial infection are priorities for patients admitted to hospital.
Funding: None.
Competing Interests: Declaration of interests We declare no competing interests.
(Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
التعليقات: Comment in: Lancet Infect Dis. 2023 May;23(5):516-517. (PMID: 36566770)
Erratum in: Lancet Infect Dis. 2023 Apr;23(4):e121. (PMID: 36967699)
معلومات مُعتمدة: MR/X001598/1 United Kingdom MRC_ Medical Research Council
فهرسة مساهمة: Investigator: J Dunning; DL Fink; ID Milligan; A Luintel; AJ Rodger; SR Bhagani; LE Lamb; RC Moores; SFK Lee; CS Brown; S Hopkins; S Mepham; S Warren; A Molloy; I Cropley; A Kew; N Karunaharan; A Scobie; J Hart; D Irish; T Haque; H Jalal; R Smith; D Mack; T Barber; F Burns; R Miller; E Hamlyn; P Simoes; B Athan; J Abrahamsen; J Joyce; C Taylor; S Reddecliffe; C Miller; B Reeve; H Kingston; T Crocker-Buque; N Massie; A Dhariwal; A Jayakumar; R Hammond; A Bramley; T Kanitkar; L Maynard-Smith; E Gil; C O'Connor; D Cocker; W Spicer; M Lanzman; M Thacker; ZO Anorson; D Patel; A Williams; CF Houlihan; D Wakerley; CN Gordon; H Callaby; DJ Bailey; J Furneaux; AM Bown; EJ Truelove; MJ Killip; D Jackson; TLB Beetar-King; UMV Arnold; RM Strachan; J Matthew; HJ Matthew; JC Osborne; T Rampling; R Vipond; B Gibney; J Owen; H Bond; W Beynon; M Hunter; L McCorry; C Emerson; S Quah; S Todd; E McCarty; E Walker; S Feeney; T Curran; K Li; JD Mullan; K Jackson; P Nelson; K Lewis; M McNicol; M Pratt; A Smith; E Vos; F Alsalemee; D O Leary; J Canny; K McGinnity; C Culbert; C McDowell; C McQuillan; E Jeong; L Glass; J Dyche; P McClean; R Stewart; H Ursolino; M Perry; H McCormick; EY Lim; E Gkrania-Klotsas; M Bracchi; J Heskin; N Brown; T Juniper; B Mora-Peris; A Dalla-Pria; N Mackie; L Garvey; A Winston; G Cooke; M Nelson; E Kilbride; A Elbishi; W Kerrigan; J Silva; J Gohil; S Payagala; Y Walters; J Smith; J Goodfellow; K Lyons; H Tung; K Patel; M Henderson; M Butler; E Peres; T Silva Carvalho; A Joly; M Dickinson; LSP Moore; N Mughal; S Hughes; S Chitlangia; P Viramgana; R Byrne; P Randell; L Strangis; N Poveda; D Bovey; P Richardson; V Heaslip; C Higgs; M Boffito; N Girometti; G Whitlock; V Tittle; R Jones; M Rayment; C Scott; D Asboe; M Pond; D Muir; B Rathish; G O'Hara; M Abeywickrema; SL Bailey; SE Boyd; D Da Silva Fontoura; A Daunt; CY Mason; J Murphy; VV Naidu; A Patel; C Pley; E Redmore; K Sharrocks; LB Snell; R Sundramoorthi; JCH Tam; A Brown; S Douthwaite; A Goodman; G Nebbia; W Newsholme; N Price; E Shaw; A Salam; C van Nispen Tot Pannerden; H Winslow; J Bilinska; S Keegan; H Coleman; J Doctor; N Moini; D Chilton; G Haidari; R Simons; R Kulasegaram; N Larbalestier; A Nori; JR Potter; C Tuudah; P Wade; A Travers; S Dunford; J Greenwood; G Oledimmah; L Gyampo; P Sa Pinto; A Muse; Z Parker; C Alexander; A Khan; M Ajayi; A Baltazar; D Sharella; N Hersi; T Nguyen; R Timbo; I Jalloh; S Bryan; P Clarke; M Kerr; F Amedu; M BohoBonaba; S Haque; M Howson; N Tambilawan; S Yupanqui Estay; H Bangura; T Gideon; D Jerome-Oboh; L Tetteh; C Nwagu; V Agbaglah; N Narag; M Zaveri; M Ni Luanaigh; P Keane; JR Peters; S Rimmer; A Abbara; B Mora-Peris; O Dosekun; L Garvey; M Bolland; A Stafford; D Saleh; R Sheridan; E Davies; K Sun; M Gilchrist; P Kukadia; M Embrahimsa; C Chiu; M Butler; K Patel; L Taylor; C Short; J Alagratnam; I Jayaweera; K Gundugola; LVS Payne; N Mody; K Quinn; C Nic Fhogartaigh; N Kaur; S Bholah; K Kantha; J Youngs; T Lampejo; N Pitto; DS Lawrence; H Middleditch; L Dominguez-Dominguez; A Ratnappuli; S Al-Hashimi; A Oliveira; Z Ottaway; L Mulka; B Hodgson; P Lewthwaite; AM Neary; MR Downey; DC Lucy; CI McCallum; M Beadsworth; L Ratcliffe; TE Fletcher; G Davies; N Wong; S Aston; TE Wingfield; T Blanchard; P Hine; R Lester; SD Woolley; S Gould; C Smith; M Abouyannis; A Atomode; J Cruise; M Samual; N Scott; V Srirathan; J Lewis; L Richards; MA Cummings; E Gillan; R Peers; A Tickle; G Keating; T Chinyanda; M Sanchez; D Harrison; Hoyle; B Metcalfe; J Taylor; N Johnson; N Kelle; K McDowell; I Richardson; M Saguidan; N Farmer; A Gillespie; S Willoughby; S Parker; S Avulan; S Arif; S Marshall; D Carlisle; M Rezaei; A Booth; J Watts; L Tremarco; P Jeyanayagam; O Ubochi; D Vagianos; M Richardson; A Jarvis; K Gow; J Walmsley; A O'keefe; A Smielewska; M Hopkins; F Balane; S Bradley; T Corrah; V Daquiz; C Dugan; J Elliot; F Foley; D Friday; M Gamit; D Garner; K Gokani; L John; D Joseph; N Khan; C Mamuyac; A McGregor; J McSorley; V Parris; L Rubinstein; J Rycroft; K Salinas; J Salinas; J Sebatian; M Smith; M Tejero Garcia; U Ume; M Vicentine; G Wallis; A Sturdy; A Whittington; N Jacobs; L Johnson; A Bonington; A Uriel; A Ustianowski; B Dancso; C Hogan; C van Halsema; FJ Vilar; K Devine; K Ajdukiewicz; R Rajendran; S Ghosh; M Riste; N Machin; C Babu; S Ahmad; D Obeng; F Dave; G Conolley; J Thompson; M Tickell-Painter; P Chakravorty; R Pringle; MR Zafar; S Lawrence; A Sanchez-Gonzalez; C Fernandez; L Goodwin; D Carey; M Howarth-Maddison; S Moody; R Upton; C Apthorp; C Murray; K Salthouse; S Nadeem; G Ridley; F White; A Brown; M Lawless; M Mohamed; R Mulligan; A Belfield; J Brolly; M Calderon; J Cheveau; M Cullinan; S Garrad; W Griffiths; A Ireland; P Ireland; C Milne; P Nwajiugo; J Quartey; B Ghavami-Kia; C Duncan; A Evans; E Hunter; A Price; M Schmid; U Schwab; Y Taha; B Payne; IAM Elliott; S Crowe; CJ Woodrow; DE Karageorgopoulos; PJ Davis; E Lord; OJ Bannister; AB Dagens; T Harrison; J Cole; A Tunbridge; S Choudry; A Telfer; I Jhibril; SN Atta; B Stone; C Evans; M Ankcorn; S Akili; M Yavuz; V Goodall; S Farrow; G Mountford; TP Cusack; K Beard; J Sutton; T Clark; A Mason; M Vickers; D Macallan; T Bicanic; A Houston; C Pope; N Tan; C Ward; I Jones; R Banerjee; J Cohen; M Emonts-le Clercq; D Porter; A Riordan; R Sinha; E Whittaker
المشرفين على المادة: 0 (Benzamides)
تواريخ الأحداث: Date Created: 20221225 Date Completed: 20230425 Latest Revision: 20240313
رمز التحديث: 20240313
DOI: 10.1016/S1473-3099(22)00806-4
PMID: 36566771
قاعدة البيانات: MEDLINE
الوصف
تدمد:1474-4457
DOI:10.1016/S1473-3099(22)00806-4