{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:30:45Z","timestamp":1787009445331,"version":"build-2736575974"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T00:00:00Z","timestamp":1701734400000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017035","name":"Johns Hopkins University Center for AIDS Research","doi-asserted-by":"crossref","award":["P30AI094189"],"award-info":[{"award-number":["P30AI094189"]}],"id":[{"id":"10.13039\/100017035","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR003099)"],"award-info":[{"award-number":["KL2TR003099)"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Johns Hopkins University Clinical Characterization Protocol for Severe Emerging Infections"},{"DOI":"10.13039\/100000030","name":"US Centers for Disease Control and Prevention","doi-asserted-by":"crossref","award":["U01CK000589"],"award-info":[{"award-number":["U01CK000589"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>During the 2022 mpox outbreak most patients were managed as outpatients, but some required hospitalization. Uncontrolled human immunodeficiency virus (HIV) has been identified as a risk factor for severe mpox.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with mpox diagnosed or treated within the Johns Hopkins Health System between 1 June and 15 December 2022 were included. The primary outcome of interest was risk of hospitalization. Demographic features, comorbid conditions, treatment, and clinical outcomes were determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 353 patients were tested or treated for mpox; 100 had mpox diagnosed or treated (median age, 35.3 years; 97.0% male; 57.0% black and 10.0% Hispanic; 46.0% people with HIV [PWH]). Seventeen patients (17.0%) required hospitalization, 10 of whom were PWH. Age &amp;gt;40 years, race, ethnicity, HIV status, insurance status, and body mass index &amp;gt;30 (calculated as weight in kilograms divided by height in meters squared) were not associated with hospitalization. Eight of 9 patients (88.9%) with immunosuppression were hospitalized. Immunosuppression was associated with hospitalization in univariate (odds ratio, 69.3 [95% confidence interval, 7.8\u2013619.7]) and adjusted analysis (adjusted odds ratio, 94.8 [8.5\u20131060.1]). Two patients (11.8%) who were hospitalized required intensive care unit admission and died; both had uncontrolled HIV infection and CD4 T-cell counts &amp;lt;50\/\u00b5L. Median cycle threshold values for the first positive mpox virus sample did not differ between those who were hospitalized and those who were not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immunosuppression was a significant risk factor for hospitalization with mpox. PWH with CD4 T-cell counts &amp;lt;50\/\u00b5L are at high risk of death due to mpox infection. Patients who are immunosuppressed should be considered for early and aggressive treatment of mpox, given the increased risk of hospitalization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofad533","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T20:07:01Z","timestamp":1698696421000},"source":"Crossref","is-referenced-by-count":17,"title":["Risk Factors for Hospitalization and Effect of Immunosuppression on Clinical Outcomes Among an Urban Cohort of Patients With Mpox"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1849-1640","authenticated-orcid":false,"given":"William M","family":"Garneau","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Hospital Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5882-0907","authenticated-orcid":false,"given":"Joyce L","family":"Jones","sequence":"additional","affiliation":[{"name":"Departent of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella M","family":"Dashler","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heba H","family":"Mostafa","sequence":"additional","affiliation":[{"name":"Department of Pathology, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9911-7839","authenticated-orcid":false,"given":"Seth D","family":"Judson","sequence":"additional","affiliation":[{"name":"Departent of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew M","family":"Hamill","sequence":"additional","affiliation":[{"name":"Departent of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A","family":"Gilliams","sequence":"additional","affiliation":[{"name":"Departent of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S","family":"Rudolph","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne C","family":"Keruly","sequence":"additional","affiliation":[{"name":"Departent of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amary","family":"Fall","sequence":"additional","affiliation":[{"name":"Department of Pathology, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eili Y","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhakti","family":"Hansoti","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4010-398X","authenticated-orcid":false,"given":"Kelly A","family":"Gebo","sequence":"additional","affiliation":[{"name":"Departent of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,5]]},"reference":[{"key":"2023122900453141000_ofad533-B1","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1038\/s41577-022-00775-4","article-title":"Monkeypox: disease epidemiology, host immunity and clinical 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Med"},{"key":"2023122900453141000_ofad533-B20","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/S0140-6736(23)00273-8","article-title":"Mpox in people with advanced HIV infection: a global case series","volume":"401","author":"Mitj\u00e0","year":"2023","journal-title":"Lancet Lond Engl"},{"key":"2023122900453141000_ofad533-B21","doi-asserted-by":"crossref","first-page":"642","DOI":"10.7326\/M22-3132","article-title":"Tecovirimat treatment of people with HIV during the 2022 mpox outbreak : a retrospective cohort study","volume":"176","author":"McLean","year":"2023","journal-title":"Ann Intern Med"},{"key":"2023122900453141000_ofad533-B22","doi-asserted-by":"crossref","first-page":"101710","DOI":"10.1016\/j.eclinm.2022.101710","article-title":"Global monkeypox case hospitalisation rates: a rapid systematic review and 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2022","volume":"29","author":"Edman-Wall\u00e9r","year":"2023","journal-title":"Emerg Infect Dis"}],"container-title":["Open Forum Infectious 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