Viral Dynamics in Patients with Monkeypox Infection: A Prospective Cohort Study in Spain

• DOI: 10.2139/ssrn.4248017
• Publication Date: 2022-10-22T01:23:39Z
• Authors: Clara Suñer; Maria Ubals; Eloy José Tarín-V...; Adrià Mendoza; Andrea Alemany; Águeda Hernández-...; Cristina Casañ; Vicente Descalzo; Dan Ouchi; Aurelien Marc; Ángel Rivero; Pep Coll; Xènia Oller; José Miguel Cabrera; Martí Vall-Mayans; María Dolores Fol...; María de los Ánge...; Manuel Agud-Dios; Elena Gil-Cruz; Alexia Paris de León; Aída Ramirez; Vira Buhiichyk; Cristina Galván-C...; Roger Paredes; Nuria Prat; Maria-Rosa Sala F...; Josep Maria Bonet...; Magí Farré; Pablo L. Ortiz-Ro...; Bonaventura Clotet; Jeremie Guedj; Pere-Joan Cardona; Ignacio Blanco; Michael Marks; Oriol Mitja; The Movie Group G...
• Keywords: Viral Shedding; Monkeypox; Sex organ

Background:,Monkeypox DNA has been detected in skin lesions, saliva, oropharynx, urine, semen, and stool of patients infected during the 2022 outbreak; however, viral dynamics within these compartments remain unknown. We investigated clearance over course illness.Methods: This was an observational, prospective, multicentre study including individuals diagnosed with monkeypox hospitals sexual health clinics Spain. Participants collected swabs from their rectum, a dried blood spot, either semen or vaginal specimens periodically up to day 57. Samples were analysed by quantitative PCR subset cell culture. The primary endpoint time clearance. Secondary endpoints variation load at each body location infectivity based on culture.Findings: Overall, 74 participants enrolled study; 72 (97·3%) male, median age 35·0 years (IQR 29·0–46·0), 38 (51·4%) living HIV. longest lesions (25 days symptom onset; 95% CI 22–28), followed pharyngeal (16 days; 13–19), rectal (14 11–22), (11 8–16), (5 0–9). In 90% cases, not detectable 41 (95% 34-50). higher baseline (7.11 IQR 5.42–7.91, log10 copies/mL) compared 4.37, 4.04, 3.99 3.2 copies/mL rectal, blood, specimens, respectively, it decreased markedly all samples time. Infective virus isolated but only 15 onset high levels (>6 copies/mL).Conclusions: Skin showed qPCR requiring 3 weeks for 50% 6 have undetectable virus. Whilst may be prolonged periods absence culture viability after suggests infectious period shorter.Funding: funded emergency response funds University Hospital Germans Trias i Pujol YoMeCorono crowdfunding campaign.Declaration Interest: declare no competing interests.Ethical Approval: protocol approved Ethics Committee written informed consent obtained before enrolment.