Long-term Mpox sequelae present a significant challenge for healthcare providers. Before the 2022 multinational clade II mpox virus outbreak, little was known about the virus’s persistent effects. This cohort study, conducted in New York City and Houston, provides critical data on the long-term physical and psychosocial impact experienced by patients 11 to 18 months after an acute mpox diagnosis. It also compares psychosocial and behavioral impacts between affected and at-risk groups. The findings underscore the need for continued monitoring and specialized care.
Understanding Long-Term Mpox Sequelae
The study enrolled 154 post-mpox and 201 no-mpox participants. Clinicians assessed post-mpox patients using a physical examination and clinical history. They classified persistent physical effects based on the tissue affected and the impact on appearance or function. Furthermore, all participants completed behavioral and psychosocial self-assessments. Interestingly, the proportion of participants reporting increased psychobehavioral symptoms was generally similar between the two groups. However, the physical toll of the illness was significant for those who contracted mpox.
Key Physical Sequelae Findings
A striking 58% of post-mpox participants reported at least one persistent sequela. Most of these, 56%, were related to appearance. This included scarring or skin changes. Importantly, over half (51%) of the appearance-related sequelae occurred at only two or fewer body sites. Therefore, the effects generally showed limited body distribution. Functional sequelae occurred in 13% of the post-mpox group. Of these patients, 50% experienced ongoing anorectal dysfunction. Additionally, 35% reported persistent urinary dysfunction. The study assessed associations between these physical effects and factors like acute illness severity and medical history.
Clinical Implications for Mpox Sequelae Management
The conclusion confirms that Mpox sequelae frequently lasted 11 to 18 months post-infection. While the physical effects often had limited body distribution and overall physical morbidity was low, the social and sexual consequences continue. Clinicians must recognize these persistent sequelae. Therefore, providers should implement comprehensive follow-up care that addresses not only physical changes but also the ongoing psychosocial needs of patients. The study acknowledged limitations, stating that the participants may not fully represent all mpox-affected and susceptible populations. Also, the findings might either overestimate or underestimate the frequency or severity of sequelae.
Frequently Asked Questions
Q1: How common are persistent sequelae after Mpox?
Fifty-eight percent (58%) of participants had at least one persistent sequela 11 to 18 months after their acute mpox diagnosis.
Q2: What types of persistent physical effects were most common?
The most common physical effects were appearance-related, making up 56% of all sequelae. Functional issues, such as anorectal and urinary dysfunction, were less common, affecting 13% of patients.
Q3: Did mpox cause persistent psychosocial symptoms?
The proportion of participants reporting increased psychobehavioral symptoms was generally similar between the post-mpox group and the group who were at risk but never contracted mpox (no-mpox).
References
- Cholli PA et al. Long-Term Mpox Sequelae 11 to 18 Months After Acute Illness : A Cohort Study in Two U.S. Cities. Ann Intern Med. 2026 Jan 20. doi: 10.7326/ANNALS-25-00036. PMID: 41554127.
- WHO. Clinical management and infection prevention and control for mpox: interim guidance. 2022.
- Patel AS, et al. Scarring and Pigmentary Changes Following Mpox Infection. Clin Infect Dis. 2024.