A Cross-Sectional Evaluation of the Virtual Outpatient Management of People With Mpox.

high consequence infectious disease (HCID) monkeypox virus mpox telemedicine virtual ward

Journal

Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045

Informations de publication

Date de publication:
Aug 2024
Historique:
received: 07 06 2024
accepted: 23 07 2024
medline: 8 8 2024
pubmed: 8 8 2024
entrez: 8 8 2024
Statut: epublish

Résumé

To report on the implementation and outcomes of a virtual ward established for the management of mpox during the 2022 outbreak, we conducted a 2-center, observational, cross-sectional study over a 3-month period. All patients aged ≥17 years with laboratory polymerase chain reaction-confirmed monkeypox virus managed between 14 May and 15 August 2022, at the Hospital for Tropical Diseases at University College London Hospitals National Health Service (NHS) Foundation Trust and sexual health services at Central North and West London NHS Foundation Trust, were included. Main outcomes included the proportion of patients managed exclusively on the virtual ward, proportion of patients requiring inpatient admission, proportion of patients with human immunodeficiency virus, and duration of lesion reepithelialization. Among confirmed cases (N = 221), 86% (191/221) were managed exclusively on the virtual ward, while 14% (30/221) required admission. Treatment for concomitant sexually transmitted infections was provided to 25% (55/221) of patients, antibiotics for other infective complications to 16% (35/221), and symptomatic relief to 27% (60/221). The median time from onset to complete lesion reepithelialization and de-isolation was 18 days (range, 8-56 days). Eleven percent (24/221) of individuals disengaged from services within 4 days of testing. The virtual ward model facilitated safe and holistic outpatient management of mpox, while minimizing admissions. This approach could serve as a model for future outbreak responses.

Sections du résumé

Background UNASSIGNED
To report on the implementation and outcomes of a virtual ward established for the management of mpox during the 2022 outbreak, we conducted a 2-center, observational, cross-sectional study over a 3-month period.
Methods UNASSIGNED
All patients aged ≥17 years with laboratory polymerase chain reaction-confirmed monkeypox virus managed between 14 May and 15 August 2022, at the Hospital for Tropical Diseases at University College London Hospitals National Health Service (NHS) Foundation Trust and sexual health services at Central North and West London NHS Foundation Trust, were included. Main outcomes included the proportion of patients managed exclusively on the virtual ward, proportion of patients requiring inpatient admission, proportion of patients with human immunodeficiency virus, and duration of lesion reepithelialization.
Results UNASSIGNED
Among confirmed cases (N = 221), 86% (191/221) were managed exclusively on the virtual ward, while 14% (30/221) required admission. Treatment for concomitant sexually transmitted infections was provided to 25% (55/221) of patients, antibiotics for other infective complications to 16% (35/221), and symptomatic relief to 27% (60/221). The median time from onset to complete lesion reepithelialization and de-isolation was 18 days (range, 8-56 days). Eleven percent (24/221) of individuals disengaged from services within 4 days of testing.
Conclusions UNASSIGNED
The virtual ward model facilitated safe and holistic outpatient management of mpox, while minimizing admissions. This approach could serve as a model for future outbreak responses.

Identifiants

pubmed: 39113827
doi: 10.1093/ofid/ofae413
pii: ofae413
pmc: PMC11304594
doi:

Types de publication

Journal Article

Langues

eng

Pagination

ofae413

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Déclaration de conflit d'intérêts

Potential conflicts of interest. All authors: No reported conflicts.

Auteurs

Clare E Warrell (CE)

Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
Rare and Imported Pathogens Laboratory, UK Health Security Agency, Wiltshire, United Kingdom.

Zain Chaudhry (Z)

Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
Division of Infection and Immunity, University College London, London, United Kingdom.

Marianne Shawe-Taylor (M)

Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

Evanthia Mastoraki (E)

Department of Sexual Health and HIV, Central and North West London NHS Trust, London, United Kingdom.

Ashwin Delmonte Sen (A)

Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

Hannah Rafferty (H)

Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

Angus De Wilton (A)

Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

Naomi Mescall (N)

Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

Catherine Houlihan (C)

Rare and Imported Pathogens Laboratory, UK Health Security Agency, Wiltshire, United Kingdom.
Division of Infection and Immunity, University College London, London, United Kingdom.
Department of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

Philip Gothard (P)

Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

Eva Jungmann (E)

Department of Sexual Health and HIV, Central and North West London NHS Trust, London, United Kingdom.

Sarah Logan (S)

Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

Tommy Rampling (T)

Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
Rare and Imported Pathogens Laboratory, UK Health Security Agency, Wiltshire, United Kingdom.
Division of Infection and Immunity, University College London, London, United Kingdom.
National Institute for Health and Care Research, University College London Hospitals Biomedical Research Centre, London, United Kingdom.

Laura Waters (L)

Department of Sexual Health and HIV, Central and North West London NHS Trust, London, United Kingdom.

Rita Browne (R)

Department of Sexual Health and HIV, Central and North West London NHS Trust, London, United Kingdom.

Michael Marks (M)

Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
Division of Infection and Immunity, University College London, London, United Kingdom.
Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.

Emily Shaw (E)

Division of Infection, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

Classifications MeSH