Assessment of clinical traits and treatment options for human monkeypox

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Created On: 06/10/2022

A retrospective observational study sought to portray the longitudinal medical course of monkeypox in a high-income population, and also examined viral dynamics and potential side effects of the latest antiviral treatments.

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Key take away

Tecovirimat-treated patient experienced symptoms and upper respiratory tract virus shedding for a shorter period of time when compared to other patients. Brincidofovir failed to demonstrate any clear therapeutic benefits.

Background

Method

In seven individuals with monkeypox identified in the United Kingdom, the response to off-label antivirals, longitudinal virological results, and clinical characteristics were described. All patients who were treated at specialized high consequence infectious diseases (HCID) centres through a national HCID network were included in this research.

Result

After reviewing every case that has occurred since the HCID (airborne) network was established, seven patients (4 men, 3 women) were identified. Four men and three ladies made up the seven patients. Three people were infected with monkeypox in the UK: one patient who travelled overseas and got infected with the virus later spread it to an adult and kid in their family cluster, and one was a health care professional who got infected nosocomially.

Reactive poor mood, extended monkeypox viral DNA detection in upper respiratory tract swabs, viraemia, and polymerase chain reaction (PCR)-positive deep tissue abscess caused by the virus in one patient were notable clinical characteristics. Because of persistent PCR positivity, 5 subjects were isolated for > 3 weeks (range: 22–39 days). Brincidofovir was consistently linked to abnormal liver function tests and did not show any clear therapeutic benefits.

After receiving 200 mg of Brincidofovir once a week orally, 3 patients had to stop their treatment due to high liver enzyme levels. Contrasted to the other six patients, one patient who received oral Tecovirimat (600 mg twice daily for two weeks) had a shorter period of sickness and viral shedding (10 days hospitalization) and suffered no side effects. Notably, 6 weeks post-discharge from the hospital, one patient had a slight recurrence.

Conclusion

Even for well-equipped medical care systems with HCID networks, human monkeypox presents particular difficulties. Following the healing of a skin lesion, the upper respiratory tract viral DNA continued to shed, challenging conventional infection prevention and management recommendations. Prospective investigations of antivirals for this condition are urgently required.