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The Lancet ; 400(10367):1903-1905, 2022.
Article in English | ProQuest Central | ID: covidwho-2150849


In 2022, amid the COVID-19 pandemic, monkeypox re-emerged globally as a new and additional infectious threat for countries outside Africa, and it was declared a Public Health Emergency of International Concern by WHO.1,2 During this multicountry monkeypox outbreak, which has comprised more than 80 488 cases to Nov 21, 2022 according to the US Centers for Disease Control and Prevention, new epidemiological and clinical features have been observed, including genital primary presentation, an association with sexual activity, and a predominance among men, particularly adult men who have sex with men.3,4 Although epidemiological data and various studies have shown that the disease occurs primarily in men,5 monkeypox can also affect other groups, including children,6 older populations, and women.7,8 In The Lancet,9 John P Thornhill and colleagues report a series of 136 cases of monkeypox virus infection in women and non-binary individuals from 15 countries, showing its clinical importance. 62 individuals in the case series were transgender (trans) women, 69 were cisgender (cis) women, and five were non-binary individuals assigned female at birth (the latter two groups were pooled to form a group of 74 people assigned female at birth for the purpose of comparison). Collecting data from this population is especially important because of the higher rates of HIV and other sexually transmitted infections in trans women.2,9,13–14 Co-infections of this type could influence the acquisition and clinical course of monkeypox virus infection, especially in people who are immunosuppressed, and in some cases could lead to fatal outcomes (42 deaths have so far been reported in 12 countries where monkeypox was not previously endemic as of Nov 21, 2022, according to the US Centers for Disease Control and Prevention, with evidence that HIV or other STI co-infection was an important factor in some of these deaths).14 The current case series showed a high prevalence of HIV among infected individuals and particularly trans women (31 [50%], compared with six [8%] cis women and non-binary individuals). [...]prioritisation should consider discussing vaccination and other preventive measures for women and non-binary individuals.

Travel Med Infect Dis ; 48: 102334, 2022.
Article in English | MEDLINE | ID: covidwho-1799699


BACKGROUND: It has been found that patients recovered from COVID 19 may still test Reverse Transcriptase- Polymerase Chain Reaction (RT- PCR) positive without being infectious; the reasons are unclear. The occurrence of false-negative results of RT- PCR interferes with a proper diagnosis. The objectives of that work were to determine factors associated with persistently detectable SARS-CoV-2 RNA among recovered hospitalized patients and to determine the incidence of false-negative RT-PCR results and associated factors. METHODS: Relevant data were collected from 482 COVID 19 patients hospitalized in six referral centers from four countries. RESULTS: The median duration of RT- PCR conversion to negative was 20 days. Out of 482 studied patients, 8.7% tested positive after more than four weeks and were considered prolonged convertors. Binary logistic regression analysis revealed headache as an independent risk factor for short conversion time while fever, hypertension, chronic obstructive pulmonary disease, lymphopenia, elevated erythrocyte sedimentation rate, and the number of lobes affected, and bilateralism were found to be independent risk factors for prolonged positivity. Eighteen patients had initial negative results then turned positive after 24-48 h. Associated factors and outcomes were identified. CONCLUSION: Identifying patients with a high likelihood of COVID-19 despite a negative RT-PCR is critical for effective clinical care. However, patient isolation resumption depending on positive RT-PCR despite clinical and radiological recovery is an overrating that greatly burdens the health sector.

COVID-19 , SARS-CoV-2 , COVID-19/diagnosis , Humans , RNA, Viral , Respiratory System , Reverse Transcriptase Polymerase Chain Reaction