Clinical characteristics and comparison of longitudinal qPCR results from different specimen types in a cohort of ambulatory and hospitalized patients infected with monkeypox virus.


Journal

Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology
ISSN: 1873-5967
Titre abrégé: J Clin Virol
Pays: Netherlands
ID NLM: 9815671

Informations de publication

Date de publication:
10 2022
Historique:
received: 09 07 2022
revised: 03 08 2022
accepted: 06 08 2022
pubmed: 4 9 2022
medline: 9 9 2022
entrez: 3 9 2022
Statut: ppublish

Résumé

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. 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. 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 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.

Sections du résumé

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
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.

Identifiants

pubmed: 36057206
pii: S1386-6532(22)00186-X
doi: 10.1016/j.jcv.2022.105254
pmc: PMC9528238
pii:
doi:

Substances chimiques

DNA, Viral 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105254

Informations de copyright

Copyright © 2022. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest ML and DN received speaker honoraria and related travel expenses from Roche Diagnostics.All other authors declare no conflict of interest.

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Auteurs

Dominik Nörz (D)

University Medical Center Hamburg-Eppendorf (UKE), Institute of Medical Microbiology, Virology and Hygiene, Hamburg, Germany. Electronic address: d.noerz@uke.de.

Thomas Theo Brehm (TT)

University Medical Center Hamburg-Eppendorf (UKE), I. Department of Medicine, Division of Infectious Diseases, Hamburg, Germany; German Center for Infection Research, Partner site Hamburg-Lübeck-Borstel-Riems, Germany.

Hui Ting Tang (HT)

University Medical Center Hamburg-Eppendorf (UKE), Institute of Medical Microbiology, Virology and Hygiene, Hamburg, Germany.

Ilka Grewe (I)

University Medical Center Hamburg-Eppendorf (UKE), I. Department of Medicine, Division of Infectious Diseases, Hamburg, Germany.

Lennart Hermanussen (L)

University Medical Center Hamburg-Eppendorf (UKE), I. Department of Medicine, Division of Infectious Diseases, Hamburg, Germany.

Hanna Matthews (H)

Ambulance Center of the UKE GmbH, Department of Infectious Diseases, Hamburg, Germany.

Julia Pestel (J)

Ambulance Center of the UKE GmbH, Department of Infectious Diseases, Hamburg, Germany.

Olaf Degen (O)

Ambulance Center of the UKE GmbH, Department of Infectious Diseases, Hamburg, Germany.

Thomas Günther (T)

Leibniz Institute for Virology (LIV), Hamburg, Germany.

Adam Grundhoff (A)

Leibniz Institute for Virology (LIV), Hamburg, Germany.

Nicole Fischer (N)

University Medical Center Hamburg-Eppendorf (UKE), Institute of Medical Microbiology, Virology and Hygiene, Hamburg, Germany.

Marylyn M Addo (MM)

University Medical Center Hamburg-Eppendorf (UKE), I. Department of Medicine, Division of Infectious Diseases, Hamburg, Germany; University Medical Center Hamburg-Eppendorf (UKE), Institute for Infection research and Vaccine development (IIRVD), Hamburg, Germany; Bernhard-Nocht Institute for Tropical Medicine (BNI), Department of Clinical Immunology of Infectious Diseases, Hamburg, Germany; German Center for Infection Research, Partner site Hamburg-Lübeck-Borstel-Riems, Germany.

Sabine Jordan (S)

University Medical Center Hamburg-Eppendorf (UKE), I. Department of Medicine, Division of Infectious Diseases, Hamburg, Germany.

Sandra Hertling (S)

Praxisgemeinschaft Dr. Dirk Berzow, Andreas Christl und Dr. Sandra Hertling, Hamburg, Germany.

Stephan Unger (S)

Institute for interdisciplinary medicine (ifi), Hamburg, Germany.

Guido Schäfer (G)

ICH Hamburg-Stendal, Hamburg, Germany.

Knud Schewe (K)

ICH Hamburg-Stendal, Hamburg, Germany.

Christian Hoffmann (C)

ICH Hamburg-Stendal, Hamburg, Germany.

Martin Aepfelbacher (M)

University Medical Center Hamburg-Eppendorf (UKE), Institute of Medical Microbiology, Virology and Hygiene, Hamburg, Germany.

Susanne Pfefferle (S)

University Medical Center Hamburg-Eppendorf (UKE), Institute of Medical Microbiology, Virology and Hygiene, Hamburg, Germany; Bernhard-Nocht institute for tropical medicine (BNITM), Molecular Biology and Immunology, Virology Department, Hamburg, Germany.

Julian Schulze Zur Wiesch (J)

University Medical Center Hamburg-Eppendorf (UKE), I. Department of Medicine, Division of Infectious Diseases, Hamburg, Germany; German Center for Infection Research, Partner site Hamburg-Lübeck-Borstel-Riems, Germany.

Stefan Schmiedel (S)

University Medical Center Hamburg-Eppendorf (UKE), I. Department of Medicine, Division of Infectious Diseases, Hamburg, Germany.

Marc Lütgehetmann (M)

University Medical Center Hamburg-Eppendorf (UKE), Institute of Medical Microbiology, Virology and Hygiene, Hamburg, Germany. Electronic address: mluetgeh@uke.de.

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