Development and Pilot of an Mpox Severity Scoring System

Area of Science:

• Virology
• Epidemiology
• Clinical Medicine

Background:

• Clinical severity scores are crucial for understanding risk factors in infectious disease outbreaks.
• The 2022 multinational mpox (monkeypox) outbreak, caused by clade IIb virus, necessitated tools for assessing disease severity.

Purpose of the Study:

• To develop and validate a clinical severity scoring system for mpox.
• To identify risk factors associated with severe mpox illness using the developed scoring system.

Main Methods:

• Development of a 7-item Mpox Severity Scoring System (MPOX-SSS) using initial variables.
• Refinement of variables based on data availability and parameter correlation.
• Application of MPOX-SSS to the first 200 mpox patients and serial evaluations.

Main Results:

• The MPOX-SSS showed higher scores in patients treated with tecovirimat.
• Higher scores were associated with symptom onset >3 days after presentation and CD4 counts <200 cells/mm3.
• Serial MPOX-SSS scores correlated with clinical observations and demonstrated good discrimination over time.

Conclusions:

• The pilot MPOX-SSS effectively distinguishes severity and identifies patients at higher risk.
• The scoring system aids in understanding risk factors for severe mpox illness.
• MPOX-SSS demonstrates utility in clinical assessment and monitoring of mpox patients.