{"doi":"10.1093/ofid/ofad533","title":"Risk Factors for Hospitalization and Effect of Immunosuppression on Clinical Outcomes Among an Urban Cohort of Patients With Mpox","abstract":"Background: 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. Methods: 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. Results: 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 >40 years, race, ethnicity, HIV status, insurance status, and body mass index >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, 7.8-619.7]) and adjusted analysis (adjusted odds ratio, 94.8 [8.5-1060.1]). Two patients (11.8%) who were hospitalized required intensive care unit admission and died; both had uncontrolled HIV infection and CD4 T-cell counts <50/µL. Median cycle threshold values for the first positive mpox virus sample did not differ between those who were hospitalized and those who were not. Conclusions: Immunosuppression was a significant risk factor for hospitalization with mpox. PWH with CD4 T-cell counts <50/µL 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.","journal":"Open Forum Infectious Diseases","year":2023,"id":340437,"datarank":0.42498200160843247,"base_score":2.833213344056216,"endowment":2.833213344056216,"self_citation_contribution":0.42498200160843247,"citation_network_contribution":0.0,"self_endowment_contribution":0.42498200160843247,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":16,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9204,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":815544,"name":"Joyce Jones","orcid":"0000-0001-5882-0907","position":1,"is_corresponding":false},{"id":1075518,"name":"Gabriella M Dashler","orcid":null,"position":2,"is_corresponding":false},{"id":251887,"name":"Heba H. Mostafa","orcid":"0000-0002-0274-8966","position":3,"is_corresponding":false},{"id":237184,"name":"Seth D. Judson","orcid":"0000-0001-9911-7839","position":4,"is_corresponding":false},{"id":1075519,"name":"Nathan Kwon","orcid":null,"position":5,"is_corresponding":false},{"id":335314,"name":"Matthew M. Hamill","orcid":"0000-0002-1277-819X","position":6,"is_corresponding":false},{"id":676994,"name":"Elizabeth A. Gilliams","orcid":"0000-0003-1713-5107","position":7,"is_corresponding":false},{"id":1075520,"name":"David Rudolph","orcid":null,"position":8,"is_corresponding":false},{"id":286356,"name":"Jeanne Keruly","orcid":"0000-0002-8489-435X","position":9,"is_corresponding":false},{"id":250727,"name":"Amary Fall","orcid":"0000-0002-6890-7915","position":10,"is_corresponding":false},{"id":310734,"name":"Eili Klein","orcid":"0000-0002-1304-5289","position":11,"is_corresponding":false},{"id":342202,"name":"Bhakti Hansoti","orcid":"0000-0003-0188-9764","position":12,"is_corresponding":false},{"id":311291,"name":"Kelly A. Gebo","orcid":"0000-0003-4010-398X","position":13,"is_corresponding":false},{"id":600737,"name":"William M. Garneau","orcid":"0000-0002-1849-1640","position":0,"is_corresponding":true}],"reference_count":20,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:10:54.145367Z","pmid":"38058459","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}