Gastrointestinal Symptoms of Monkeypox Infection: A systematic review and meta-analysis.
Monkeypox
anorexia
gastrointestinal symptoms
meta-analysis
proctitis
Journal
Journal of medical virology
ISSN: 1096-9071
Titre abrégé: J Med Virol
Pays: United States
ID NLM: 7705876
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
revised:
02
03
2023
received:
11
01
2023
accepted:
24
03
2023
medline:
17
5
2023
pubmed:
29
3
2023
entrez:
28
3
2023
Statut:
ppublish
Résumé
Since early May 2022, outbreaks of Monkeypox (Mpox) cases have emerged and become a global concern. Studies exploring the gastrointestinal symptoms and/or liver injury of Mpox are still very limited. This systematic review and meta-analysis is the first to summarize the gastrointestinal symptoms reported by Mpox patients. We searched for Mpox studies published until October 21, 2022, in MEDLINE, EMBASE, SCOPUS, and organization websites. Mpox studies were observational studies that reported at least one of either gastrointestinal symptoms and/or liver injury in Mpox patients. Meta-analysis was done to obtain the pooled prevalence of gastrointestinal symptoms in Mpox patients. Subgroup analyses were done based on the study location, age groups, and Mpox Clades. The quality of included studies was assessed using the NIH Quality Assessment Tool. Overall, 31 studies that reported gastrointestinal symptoms and/or liver injury in Mpox patients were included. The reported gastrointestinal symptoms were abdominal pain, anorexia, diarrhea, nausea, and vomiting. There is a lack of reporting for liver injury. The most prevalent gastrointestinal symptoms in Mpox patients were anorexia (47%; 95% confidence interval [CI] 41%-53%), followed by vomiting (12%; 95% CI 11%-13%), nausea (10%; 95% CI 9%-11%), abdominal pain (9%; 95% CI 8%-10%), and diarrhea (5%; 95% CI 4%-6%). Additionally, the prevalence of proctitis, rectal/anal pain, and rectal bleeding were 11% (95% CI 11%-12%), 25% (95% CI 24%-27%), and 12% (95% CI 11%-13%), respectively. Anorexia was the most frequently reported gastrointestinal symptom in Mpox patients, followed by vomiting, nausea, abdominal pain, and diarrhea. Proctitis is a novel presentation of Mpox in the 2022 outbreak.
Types de publication
Meta-Analysis
Systematic Review
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e28709Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
WHO. WHO Recommends New Name for Monkeypox Disease. WHO; 2022. https://www.who.int/news/item/28-11-2022-who-recommends-new-name-for-monkeypox-disease
Oladoye MJ. Monkeypox: a neglected viral zoonotic disease. Eur J Med Educ Techno. 2021;14:em2108.
Petersen E, Kantele A, Koopmans M, et al. Human Monkeypox. Infect Dis Clin North Am. 2019;33(4):1027-1043.
Americo JL, Earl PL, Moss B. Virulence differences of mpox (monkeypox) virus clades I, IIa, and IIb.1 in a small animal model. Proc Natl Acad Sci. 2023;120(8):e2220415120.
Yakubovsky M, Shasha D, Reich S, et al. Monkeypox presenting as proctitis in men who have sex with men. Clin Infect Dis. 2023;76(3):528-530.
Angelo KM, Smith T, Camprubí-Ferrer D, et al. Epidemiological and clinical characteristics of patients with Monkeypox in the GeoSentinel Network: a cross-sectional study. Lancet Infect Dis. 2022;23:193-206.
Thornhill JP, Barkati S, Walmsley S, et al. Monkeypox virus infection in humans across 16 countries- April-June 2022. N Engl J Med. 2022;387(8):679-691.
Aguilera-Alonso D, Alonso-Cadenas JA, Roguera-Sopena M, Lorusso N, Miguel LGS, Calvo C. Monkeypox virus infections in children in Spain during the first months of the 2022 outbreak. Lancet Child Adolesc Health. 2022;6(11):e22-e23.
Catala A, Clavo-Escribano P, Riera-Monroig J, et al. Monkeypox outbreak in Spain: clinical and epidemiological findings in a prospective cross-sectional study of 185 cases. Br J Dermatol. 2022;187(5):765-772.
García-Piqueras P, Bergón-Sendín M, Córdoba-García-Rayo M, et al. Human monkeypox virus in a tertiary hospital in Madrid, Spain: an observational study of the clinical and epidemiological characteristics of 53 cases. Exp Dermatol. 2022;32(2):198-202.
Iñigo Martínez J, Gil Montalbán E, Jiménez Bueno S, et al. Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022. Euro Surveill. 2022;27(27):2200471.
Orviz E, Negredo A, Ayerdi O, et al. Monkeypox outbreak in Madrid (Spain): clinical and virological aspects. J Infect. 2022;85(4):412-417.
Peiró-Mestres A, Fuertes I, Camprubí-Ferrer D, et al. Frequent detection of monkeypox virus DNA in saliva, semen, and other clinical samples from 12 patients, Barcelona, Spain, May to June 2022. Euro Surveill. 2022;27(28):2200503.
Suárez Rodríguez B, Guzmán Herrador BR, Díaz Franco A, et al. Epidemiologic features and control measures during Monkeypox outbreak, Spain, June 2022. Emerging Infect Dis. 2022;28(9):1847-1851.
Tarín-Vicente EJ, Alemany A, Agud-Dios M, et al. Clinical presentation and virological assessment of confirmed human monkeypox virus cases in Spain: a prospective observational cohort study. Lancet. 2022;400(10353):661-669.
Veintimilla C, Catalán P, Alonso R, et al. The relevance of multiple clinical specimens in the diagnosis of monkeypox virus, Spain, June 2022. Euro Surveill. 2022;27(33):2200598.
Curran KG, Eberly K, Russell OO, et al. HIV and sexually transmitted infections among persons with monkeypox-eight U.S. jurisdictions, May 17-July 22, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(36):1141-1147.
Huhn GD, Bauer AM, Yorita K, et al. Clinical characteristics of human monkeypox, and risk factors for severe disease. Clin Infect Dis. 2005;41(12):1742-1751.
Meyerowitz EA, Gendlina I, Desai VJ, et al. Anorectal testing for Monkeypox virus infection in men who have sex with men with and without proctitis. Clin Infect Dis. 2022;76(5):934-937.
Philpott D, Hughes CM, Alroy KA, et al. Epidemiologic and clinical characteristics of Monkeypox cases- United States, May 17-July 22, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(32):1018-1022.
Reed KD, Melski JW, Graham MB, et al. The detection of monkeypox in humans in the Western hemisphere. N Engl J Med. 2004;350(4):342-350.
Reynolds MG, Yorita KL, Kuehnert MJ, et al. Clinical manifestations of human monkeypox influenced by route of infection. J Infect Dis. 2006;194(6):773-780.
Wilson P. Multistate outbreak of monkeypox-Illinois, Indiana, and Wisconsin, 2003. MMWR Morb Mortal Wkly Rep. 2003;52(23):537-540.
Jezek Z, Grab B, Szczeniowski M, Paluku KM, Mutombo M. Clinico-epidemiological features of monkeypox patients with an animal or human source of infection. Bull World Health Organ. 1988;66(4):459-464.
Jezek Z, Szczeniowski M, Paluku KM, Mutombo M. Human monkeypox: clinical features of 282 patients. J Infect Dis. 1987;156(2):293-298.
Pittman PR, Martin JW, Kingebeni PM, et al. Clinical characterization of human monkeypox infections in the Democratic Republic of the Congo. medRxiv. 2022;5(26):22273379.
Whitehouse ER, Bonwitt J, Hughes CM, et al. Clinical and epidemiological findings from enhanced Monkeypox surveillance in Tshuapa Province, Democratic Republic of the Congo during 2011-2015. J Infect Dis. 2021;223(11):1870-1878.
Cassir N, Cardona F, Tissot-Dupont H, et al. Observational cohort study of evolving epidemiologic, clinical, and virologic features of Monkeypox in Southern France. Emerging Infect Dis. 2022;28(12):2409-2415.
Mailhe M, Beaumont AL, Thy M, et al. Clinical characteristics of ambulatory and hospitalized patients with monkeypox virus infection: an observational cohort study. Clin Microbiol Infect. 2022;29(2):233-239.
Palich R, Burrel S, Monsel G, et al. Viral loads in clinical samples of men with monkeypox virus infection: a French case series. Lancet Infect Dis. 2023;23(1):74-80.
Ogoina D, Iroezindu M, James HI, et al. Clinical course and outcome of human monkeypox in Nigeria. Clin Infect Dis. 2020;71(8):e210-e214.
Ogoina D, Izibewule JH, Ogunleye A, et al. The 2017 human monkeypox outbreak in Nigeria-Report of outbreak experience and response in the Niger Delta University Teaching Hospital, Bayelsa State, Nigeria. PLoS One. 2019;14(4):e0214229.
Yinka-Ogunleye A, Aruna O, Dalhat M, et al. Outbreak of human monkeypox in Nigeria in 2017-18: a clinical and epidemiological report. Lancet Infect Dis. 2019;19(8):872-879.
Formenty P, Muntasir MO, Damon I, et al. Human monkeypox outbreak caused by novel virus belonging to Congo Basin clade, Sudan, 2005. Emerging Infect Dis. 2010;16(10):1539-1545.
Patel A, Bilinska J, Tam JCH, et al. Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak: descriptive case series. BMJ. 2022;378:e072410.
Gedela K, Da Silva Fontoura D, Salam A, et al. Infectious proctitis due to human monkeypox. Clin Infect Dis. 2023;76(3):e1424-e1427.
Sigle G, Kim R. Sexually transmitted proctitis. Clin Colon Rectal Surg. 2015;28(2):070-078.
Messina MD, Wolf EL, Kanmaniraja D, Alpert PL, Ricci ZJ. Imaging features of anorectal proctitis in monkeypox infection. Clin Imaging. 2022;92:109-111.
Gana T, Hunt LM. Young women and anal sex. BMJ. 2022;378:o1975.
Gigante CM, Korber B, Seabolt MH, et al. Multiple lineages of monkeypox virus detected in the United States, 2021-2022. Science. 2022;378(6619):560-565.
Kaler J, Hussain A, Flores G, Kheiri S, Desrosiers D. Monkeypox: a comprehensive review of transmission, pathogenesis, and manifestation. Cureus. 2022;14(7):e26531.
Lum FM, Torres-Ruesta A, Tay MZ, et al. Monkeypox: disease epidemiology, host immunity and clinical interventions. Nat Rev Immunol. 2022;22(10):597-613.
Riad A, Attia S. Monkeypox-related oral manifestations and implications: should dentists keep an eye out? J Med Virol. 2022;95(1):e28091.