Title: New MPOX Severity Scoring System Revolutionizes Disease Tracking and Treatment Evaluation
In a groundbreaking development, researchers from the Centers for Disease Control and Prevention (CDC) and other prestigious institutions in the United States have devised a novel scoring system to assess the severity of MPOX, a highly contagious viral illness. This innovative approach aims to aid clinicians in effectively monitoring disease progression, evaluating treatment responses, identifying risk factors for severe illness, and assessing the efficacy of therapeutics. The scoring system, known as MPOX-SSS, was recently evaluated by the research team and their findings have been published in the Journal of Infectious Diseases.
The MPOX-SSS scoring system was conceptualized during the 2022 multicountry clade IIb MPOX outbreak. It incorporates seven key variables to determine disease severity: the number of active lesions, anatomic lesion involvement, presence of merged lesions, bacterial superinfection, mucosal involvement, level of care required, and the need for painkillers. By considering these factors, clinicians can now obtain a comprehensive understanding of a patient’s condition, enabling more targeted treatment strategies.
To validate the effectiveness of the scoring system, the researchers conducted a thorough analysis of 200 MPOX patients at a medical center in New York City between June and August 2023. The study participants had varying demographic profiles, with a median age of 34 years. Additionally, the majority were men (99%), men who have sex with men (96%), and a considerable proportion had comorbid HIV infections (49%). Notably, a significant number of patients (57%) were already receiving antiviral medication called tecovirimat (Tpoxx).
During the study, the research team investigated the association between the severity measure derived from the MPOX-SSS scoring system and other indicators expected to correlate with disease severity. These included Tpoxx prescription, CD4 count (an indicator of immune function in HIV patients), and treatment initiation after 3 days of illness. The scoring system successfully showcased its simplicity and ease of use, rendering it applicable in various clinical settings, both resource-limited and well-resourced environments.
Of the 200 patients reviewed, 172 (86%) had complete data allowing retrospective calculation of their MPOX-SSS scores. The variables that could not be scored due to missing data were the number of lesions (13%) and the presence of merged lesions (7%). Notably, patients who received Tpoxx, those who began treatment more than 3 days after symptom onset, and individuals with low CD4 counts exhibited higher severity scores according to the MPOX-SSS. Serial scores demonstrated a consistent association with clinical observations, while the system effectively identified changes in severity over time.
The researchers highlighted that the simplicity and adaptability of the MPOX-SSS scoring system render it suitable for a wide range of clinical environments. However, they emphasized the need for further research to validate the system in larger patient populations and explore its applicability to virus strains other than clade IIb.
The introduction of the MPOX-SSS scoring system marks a significant advancement in our ability to track and manage MPOX. By providing clinicians with a straightforward and comprehensive tool, this scoring system has the potential to revolutionize disease monitoring, treatment evaluation, and risk assessment. As further research and validation efforts are undertaken, the MPOX-SSS scoring system holds promise as a valuable asset in the global fight against this devastating illness.
