Coronavirus disease 2019 (COVID -19) is an acute infection of the respiratory tract that emerged in late 2019 1,2 . Initial outbreaks in China involved 13.8% of cases with severe courses, and 6.1% of cases with critical courses 3 . This severe presentation may result from the virus using a virus receptor that is expressed predominantly in the lung 2,4 ; the same receptor tropism is thought to have determined the pathogenicity-but also aided in the control-of severe acute respiratory syndrome (SARS) in 2003 5 . However, there are reports of cases of COVID-19 in which the patient shows mild upper respiratory tract symptoms, which suggests the potential for pre-or oligosymptomatic transmission 6-8 . There is an urgent need for information on virus replication, immunity and infectivity in specific sites of the body. Here we report a detailed virological analysis of nine cases of COVID-19 that provides proof of active virus replication in tissues of the

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Coronavirus disease 2019 (COVID-19) is an acute respiratory tract infection thatemerged in late 2019 1,2 . Initial outbreaks in China involved 13.8% cases with severe-, and 6.1% with critical courses 3 . This severe presentation corresponds to the usage of a virus receptor that is expressed predominantly in the lung 2,4 . By causing an early onset of severe symptoms, this same receptor tropism is thought to have determined pathogenicity but also aided the control of severe acute respiratory syndrome (SARS) in 2003 5 . However, there are reports of COVID-19 cases with mild upper respiratory tract symptoms, suggesting a potential for pre-or oligosymptomatic transmission 6-8 .There is an urgent need for information on body site -specific virus replication, immunity, and infectivity. Here we provide a detailed virological analysis of nine All rights reserved. No reuse allowed without permission. author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

Background Monkeypox is a zoonotic orthopoxvirus infection endemic in central and western Africa. In May 2022, human monkeypox infections including human-to-human transmission were reported in a multi-country outbreak in Europe and North America. Case presentations Here we present the first two cases of monkeypox infection in humans diagnosed in Germany. We present clinical and virological findings, including the detection of monkeypox virus DNA in blood and semen. The clinical presentation and medical history of our patients suggest close physical contact during sexual interactions as the route of infection. Conclusion Monkeypox requires rapid diagnosis and prompt public health response. The disease should be considered in the current situation especially the differential diagnosis of vesicular or pustular rash, particularly in patients with frequent sexual contacts. Most importantly, it is essential to raise awareness among all health professionals for the rapid and correct recognition and diagnosis of this disease, which is probably still underreported in Europe (Adler et al. in Lancet Infect Dis https://doi.org/10.1016/s1473-3099(22)00228-6, 2022).