Hospitalization risk among patients with Mpox infection-a propensity score matched analysis

Andrés F Henao-Martínez; Chloe M Orkin; Boghuma K Titanji; Alfonso J Rodriguez-Morales; Jorge L Salinas; Carlos Franco-Paredes; Jose Tuells; Daniel B Chastain

doi:10.1177/20499361231196683

Hospitalization risk among patients with Mpox infection-a propensity score matched analysis

Ther Adv Infect Dis. 2023 Aug 30:10:20499361231196683. doi: 10.1177/20499361231196683. eCollection 2023 Jan-Dec.

Authors

Andrés F Henao-Martínez¹, Chloe M Orkin^{2

3}, Boghuma K Titanji⁴, Alfonso J Rodriguez-Morales^{5

6}, Jorge L Salinas⁷, Carlos Franco-Paredes^{8

9}, Jose Tuells¹⁰, Daniel B Chastain¹¹

Affiliations

¹ University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Mail Stop B168, Aurora, CO 80045, USA.
² SHARE Collaborative, Queen Mary University of London, London, UK.
³ Department of Infection and Immunity, Barts Health NHS Trust, London, UK.
⁴ Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
⁵ Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru.
⁶ Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon.
⁷ Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA.
⁸ Hospital Infantil de México, Ciudad de México, Mexico.
⁹ Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Panama.
¹⁰ Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Universidad de Alicante, Alicante, Spain.
¹¹ Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Albany, GA, USA.

Abstract

Background: Monkeypox (Mpox) is a reemerging, neglected viral disease. By May 2023, worldwide Mpox cases surpassed 87,000. Predictive factors for hospitalization with Mpox are lacking.

Objective: We aim to compare clinical characteristics and outcomes in hospitalized and nonhospitalized patients with Mpox infection.

Design: A multicenter retrospective case-control cohort of patients with Mpox infection.

Methods: We performed a propensity score match analysis from a global health network (TrinetX). We compare clinical characteristics and outcomes between hospitalized and nonhospitalized patients with Mpox.

Results: Of 1477 patients, 6% were hospitalized, 52% required an ED visit, and 29% received treatment at urgent care. After propensity score matching, 80 patients remained in each group. Hospitalizations were more common among Black persons (51% versus 33%, p = 0.01), people with HIV (50% versus 20%, p < 0.0001), and those with proctitis (44% versus 12.5%, p < 0.001).

Conclusion: Independent predictive factors of hospitalization in our cohort for Mpox included people who are Black with a diagnosis of HIV, severe proctitis, pain requiring opioids, and elevated lactate dehydrogenase. Greater recognition of factors associated with increased risk of Mpox severity and hospitalization is paramount.

Keywords: HIV/AIDS; Monkeypox virus; Mpox; hospitalization.