Simadibrata Daniel Martin, Lesmana Elvira, Pratama Muhammad Iqbal Adi, Annisa Nagita Gianty, Thenedi Kevin, Simadibrata Marcellus
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Nuffield Department of Population Health, University of Oxford, Oxford, UK.
J Med Virol. 2023 Apr;95(4):e28709. doi: 10.1002/jmv.28709.
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.
自2022年5月初以来，猴痘病例爆发并成为全球关注的问题。探索猴痘胃肠道症状和/或肝损伤的研究仍然非常有限。本系统评价和荟萃分析首次总结了猴痘患者报告的胃肠道症状。我们在MEDLINE、EMBASE、SCOPUS和各组织网站上检索了截至2022年10月21日发表的猴痘研究。猴痘研究为观察性研究，报告了猴痘患者的胃肠道症状和/或肝损伤中的至少一项。进行荟萃分析以获得猴痘患者胃肠道症状的合并患病率。基于研究地点、年龄组和猴痘分支进行亚组分析。使用美国国立卫生研究院质量评估工具评估纳入研究的质量。总体而言，纳入了31项报告猴痘患者胃肠道症状和/或肝损伤的研究。报告的胃肠道症状有腹痛、厌食、腹泻、恶心和呕吐。关于肝损伤的报告较少。猴痘患者中最常见的胃肠道症状是厌食（47%；95%置信区间[CI]41%-53%），其次是呕吐（12%；95%CI 11%-13%）、恶心（10%；95%CI 9%-11%）、腹痛（9%；95%CI 8%-10%）和腹泻（5%；95%CI 4%-6%）。此外，直肠炎、直肠/肛门疼痛和直肠出血的患病率分别为11%（95%CI 11%-12%）、25%（95%CI 24%-27%）和12%（95%CI 11%-13%）。厌食是猴痘患者最常报告的胃肠道症状，其次是呕吐、恶心、腹痛和腹泻。直肠炎是2022年疫情中猴痘的一种新表现形式。
