Monkeypox, can you predict the severity of the form? The value to check –

While attention remains high on monkeypox (for which the WHO has declared an international emergency), an Italian study has highlighted some associated factors that could allow us to understand in time if the patient will develop a serious form of the Mpox virus and that could guide doctors in the management of cases. Is there a way to predict it? One of the points on which the authors shine the spotlight is the viral load. “High values ​​in the upper respiratory tract in the first week of infection”, they suggest, are “a possible predictor of serious infection by Mpox”. The study by the Mpox-Icona group, which involves experts from various centers and universities in Italy, from the Lazzaro Spallanzani Institute in Rome to the Sacco hospital in Milan, from the San Martino Polyclinic in Genoa to the Paolo Giaccone Polyclinic in Palermo, from San Raffaele to Niguarda in Milan, and also Aorn Ospedali dei Colli in Naples, San Gerardo in Monza, Gemelli University Polyclinic in Rome and the Icona Foundation in Milan, evaluated the predictors of the duration of Mpox, analyzed the kinetics of inflammatory markers and described the detection of Mpxv virus DNA in body fluids after clinical recovery. The work published in ‘eBioMedicine’, as infectious disease specialist Matteo Bassetti also explains in X, “demonstrates that the higher the quantity of virus in the body, the greater the probability of having severe forms”.

Other aspects observed are that “Caucasian race and presentation with fever, sore throat, lymphadenopathy and perianal lesions could” also “predict the severe evolution of the disease”. But in particular, precisely “elevated Ct values ​​of the upper respiratory tract in the first week of infection”. These results could help to develop a laboratory strategy with measurable parameters of unfavorable clinical evolution in the very early stages of the infection, even in patients who do not present skin lesions. The authors started from the fact that in the 2022-2023 epidemic, severe and prolonged courses of Mpox were described. The multicenter historical cohort study therefore took into consideration adults with laboratory-confirmed diagnosis between May 2022 and September 2023 in 15 Italian centers. The cases were followed from the day of diagnosis until clinical recovery. A total of 541 patients were enrolled, including 4 women. The severe form was reported in 215 patients (39.7%).