Clinical Characterization and Outcomes of Human Clade IIb Mpox Virus Disease : A European Multicenter Mpox Observational Cohort Study (MOSAIC)

Article Article scientifique Article Clinical Characterization and Outcomes of Human Clade IIb Mpox Virus Disease : A European Multicenter Mpox Observational Cohort Study (MOSAIC) eng 2025-06-04 author Pesonel Elise 0009-0009-0133-5009 International Severe Acute Respiratory and Emerging Infection Consortium-Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom. author Laouénan Cédric Department of Epidemiology Biostatistics and Clinical Research, Assistance Publique-Hôpitaux de Paris (AP-HP) Nord, Hôpital Bichat, Paris, France.,Infections, Antimicrobials, Modelling, Evolution (IAME) Research Centre, Unité mixte de recherche(UMR) 1137,Université Paris Cité, Institut national de la santé et de la recherche médicale (INSERM), Paris, France. author Guiraud Laëtitia 0000-0002-3230-934X HIV/AIDS Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland. 405620 Département de médecine (DEMED) author Bourner Josephine 0000-0003-4687-8380 International Severe Acute Respiratory and Emerging Infection Consortium-Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom. author Hoffmann Isabelle 0000-0002-3861-8768 Department of Epidemiology Biostatistics and Clinical Research, Assistance Publique-Hôpitaux de Paris (AP-HP) Nord, Hôpital Bichat, Paris, France. author Molino Diana 0000-0002-2188-3880 INSERM, National Agency for Research on AIDS and Viral Hepatitis-Emerging Infectious Diseases, Paris, France. author Tardivon Coralie 0000-0002-2304-9910 Department of Epidemiology Biostatistics and Clinical Research, Assistance Publique-Hôpitaux de Paris (AP-HP) Nord, Hôpital Bichat, Paris, France. author Bachelet Delphine 0000-0003-0547-008X Department of Epidemiology Biostatistics and Clinical Research, Assistance Publique-Hôpitaux de Paris (AP-HP) Nord, Hôpital Bichat, Paris, France. author Mentré France 0000-0002-7045-1275 Department of Epidemiology Biostatistics and Clinical Research, Assistance Publique-Hôpitaux de Paris (AP-HP) Nord, Hôpital Bichat, Paris, France.,Infections, Antimicrobials, Modelling, Evolution (IAME) Research Centre, Unité mixte de recherche(UMR) 1137,Université Paris Cité, Institut national de la santé et de la recherche médicale (INSERM), Paris, France. author Amstutz Alain 0000-0003-1716-993X Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.,Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom. author Merson Laura 0000-0002-4168-1960 International Severe Acute Respiratory and Emerging Infection Consortium-Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom. author Rojek Amanda 0000-0002-3948-0756 International Severe Acute Respiratory and Emerging Infection Consortium-Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom. author Cervantes Gonzalez Minerva 0000-0003-2813-2219 Department of Epidemiology Biostatistics and Clinical Research, Assistance Publique-Hôpitaux de Paris (AP-HP) Nord, Hôpital Bichat, Paris, France.,Infections, Antimicrobials, Modelling, Evolution (IAME) Research Centre, Unité mixte de recherche(UMR) 1137,Université Paris Cité, Institut national de la santé et de la recherche médicale (INSERM), Paris, France. author Antinori Andrea 0000-0003-2121-4684 National Institute for Infectious Diseases Lazzaro Spallanzani, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy. author Castagna Antonella 0000-0001-6481-4570 Infectious Diseases Unit, Vita-Salute University, Milan, Italy.,Infectious Diseases Unit, IRCCS, San Raffaele Scientific Institute, Milan, Italy. author Nozza Silvia 0000-0002-2673-2731 Infectious Diseases Unit, Vita-Salute University, Milan, Italy.,Infectious Diseases Unit, IRCCS, San Raffaele Scientific Institute, Milan, Italy. author Pourcher Valérie 0000-0002-3879-1480 Infectious Diseases Department, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Pierre-Louis Epidemiology and Public Health Institute, INSERM U1136, Paris, France. author Libois Agnès 0000-0002-6078-878X Department of Infectious Diseases, Centre hospitalier universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium. author Dunning Jake 0000-0002-4035-4562 International Severe Acute Respiratory and Emerging Infection Consortium-Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom. author Tacconelli Evelina 0000-0003-2010-4977 Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Italy. author Hites Maya 0000-0001-6961-6039 Hôpital Universitaire de Bruxelles-Érasme, Université Libre de Bruxelles, Brussels, Belgium. author De La Calle Prieto Fernando 0000-0003-2544-3492 National Reference Centre for Imported Diseases and International Health, High-Level Isolation Unit, La Paz-Carlos III University Hospital, CIBERINFEC, Madrid, Spain. author Horby Peter 0000-0002-9822-1586 International Severe Acute Respiratory and Emerging Infection Consortium-Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom. author Yazdanpanah Yazdan 0009-0004-2402-643X INSERM, National Agency for Research on AIDS and Viral Hepatitis-Emerging Infectious Diseases, Paris, France. author Calmy Alexandra 0000-0002-1137-6826 HIV/AIDS Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland. 41032 Département de médecine (DEMED) author Lescure François-Xavier 0000-0002-2828-125X Infections, Antimicrobials, Modelling, Evolution (IAME) Research Centre, Unité mixte de recherche(UMR) 1137,Université Paris Cité, Institut national de la santé et de la recherche médicale (INSERM), Paris, France.,Infectious and Tropical Diseases Department, AP-HP, Bichat Hospital, Paris, France. author Olliaro Piero 0000-0003-1426-3680 International Severe Acute Respiratory and Emerging Infection Consortium-Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom. Mpox ObServAtIonal Cohort (MOSAIC) Study Group collaborator Fedeli Chiara collaborator Gosmain Yvan 628086 collaborator Segeral Olivier 405677 Département de médecine (DEMED) collaborator Yerly Ferrillo Sabine 23752 1060-1073 10.1093/cid/ciae657 39749987 1058-4838 PMC12135908 https://academic.oup.com/cid/article/80/5/1060/7942253 Background: The global mpox outbreak that started in May 2022 was caused by a novel clade IIb variant of the mpox virus (Orthopoxvirus monkeypox, MPXV). It differed from the traditional Western and Central Africa disease in transmission patterns and clinical presentation. Methods: To address the need for detailed clinical and virologic data, we conducted an observational cohort study (MOSAIC) during May 2022-July 2023 in individuals with confirmed MPXV infection enrolled in 6 European countries. Case management decisions were left to the attending physician. Participants were monitored for up to 6 months for clinical signs/symptoms and clinical and virologic outcomes through hospital visits, phone interviews, and self-administered questionnaires. Outcomes included time to lesion resolution, clinical status, and virus clearance. Results: The 518 participants not receiving any specific treatment ("untreated") were diagnosed a median 5 days from symptom onset; 90% were managed as outpatients. Lesions were mostly cutaneous (88%) and perigenital (74%). By day 14 from the first polymerase chain reaction (PCR)-positive sample, 39% had resolved lesions. Time to 95% unculturable virus was longest in cutaneous lesions (52 days). A putative systemic antiviral was available for 57 participants, 44% as inpatients; 34% and 58% had resolved lesions by day 14 from the first PCR-positive sample and from treatment start, respectively. Time to 95% unculturable virus was 60 days in skin and oropharynx. No death or recrudescence occurred by day 180. Conclusions: MOSAIC provides comprehensive insights into the clinical and virologic characteristics of mpox caused by the clade IIb variant. The study forms the basis of clinical characterization for ongoing mpox outbreaks. Clade IIb Lesion resolution Mpox Observational cohort Viral load Humans Male Female Europe / epidemiology Adult Middle Aged Cohort Studies Mpox, Monkeypox / epidemiology Mpox, Monkeypox / virology Mpox, Monkeypox / diagnosis Mpox, Monkeypox / pathology Adolescent Young Adult Aged Monkeypox virus / genetics Monkeypox virus / classification Child Disease Outbreaks Child, Preschool Dewey 616 Bill & Melinda Gates Foundation OPP1209135 Wellcome 215091/Z/18/Z European Commission A clinical research network to improve the management of Monkeypox virus disease 101115188 MPX-RESPONSE EU HE 56 Département de médecine 221 false 587 VIH/SIDA 930 Clinical infectious diseases 80 5 f3dbe119-60fc-49c7-852b-9024fc26eca7 Article (Published version) Public Article_scientifique_from_europePmc.pdf 1149073 application/pdf CC BY-4.0 6b26fb1ea8487228919c0b3b49982adc942ea86e61417cfcf840af4bd58a67df b0335999-cbf5-49d0-8b20-40b3beaa2269 Appendix Public ciae657_supplementary_data.docx 8032254 application/vnd.openxmlformats-officedocument.wordprocessingml.document 195ad148a8a1f1c716c66ba5c22ec0bcbb91566aaad6292de8464fb1cd49444b openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

Title	Published in	Access level	OA Policy	Year	Views	Downloads

Clinical Characterization and Outcomes of Human Clade IIb Mpox Virus Disease : A European Multicenter Mpox Observational Cohort Study (MOSAIC)	Clinical infectious diseases			2025	17	92

Archive ouverte UNIGE

Guiraud, Laëtitia