Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha Medical College and Hospital, Saveetha University, Chennai, India.
Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil, 51001, Iraq.
BMC Infect Dis. 2024 Sep 17;24(1):992. doi: 10.1186/s12879-024-09884-y.
Mpox is a severe viral zoonosis that has emerged as a public health concern due to its potential for human-to-human transmission and severe illness. Understanding its clinical manifestations is crucial for effective management and control. Several systematic reviews have assessed various manifestations of Mpox. This umbrella review synthesizes evidence on Mpox's manifestations across different organ systems.
We conducted an umbrella review, adhering to Joanna Briggs Institute (JBI) methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focusing on systematic reviews of Mpox manifestations. We performed a literature search up to 25th September 2023, in databases like PubMed, Embase, and Web of Science. We included systematic reviews of observational studies, case reports, case series, or RCTs reporting any manifestations of Mpox in humans, focusing on a global scope. AMSTAR 2 was used to evaluate the quality of systematic reviews, and data has been synthesized in narrative and tabular manners.
A total of 25 systematic reviews were included, uncovering diverse manifestations of Mpox, such as cutaneous, cardiovascular, oral, ophthalmic, gastrointestinal, respiratory, and pregnancy-related. Cutaneous manifestations (up to 100%) were the most prevalent, featuring lesions and rashes. Constitutional symptoms of viral illness were reported in ~ 60% to > 85% of the cases. Significant respiratory symptoms were present in ~ 50% of cases overall. Headaches were the leading neurological symptom present in > 30%. Symptoms of gastrointestinal involvement ranged from 39% (oral lesions) with decreasing frequency to low diarrhea at ~ 5%, with proctitis percentages ranging from high teens to mid-twenties. Ophthalmic manifestations (6% but with wide variations among studies). Many primary studies included in the systematic reviews consisted of case reports and case series. A wide range of manifestations across different organ systems was observed. Negative outcomes for pregnancies were reported, but evidence is limited. Adverse cardiovascular and neurological outcomes were identified, though only a few studies provided insights into these findings.
Mpox exhibits diverse manifestations, impacting multiple organ systems, with substantial variations. The findings highlight the importance of ongoing, nuanced, and region-specific research and management strategies for Mpox. The reliance on case reports and series underscores the need for more high-quality, long-term studies to deepen our understanding and management of this significant public health concern.
猴痘是一种严重的病毒性人畜共患病，由于其具有人际传播和严重疾病的潜力，已成为公共卫生关注的焦点。了解其临床表现对于有效管理和控制至关重要。已经有几项系统评价评估了猴痘的各种表现。本伞式综述综合了不同器官系统中猴痘表现的证据。
我们按照乔安娜·布里格斯研究所（JBI）方法和系统评价和荟萃分析的首选报告项目（PRISMA）指南进行了伞式综述，重点关注猴痘表现的系统评价。我们在 2023 年 9 月 25 日之前在 PubMed、Embase 和 Web of Science 等数据库中进行了文献检索。我们纳入了系统评价观察性研究、病例报告、病例系列或随机对照试验，报告了人类猴痘的任何表现，重点是全球范围。使用 AMSTAR 2 评估系统评价的质量，并以叙述和表格的方式综合数据。
共纳入 25 项系统评价，揭示了猴痘的多种表现，如皮肤、心血管、口腔、眼科、胃肠道、呼吸和与妊娠相关的表现。皮肤表现（高达 100%）最为常见，表现为病变和皮疹。约 60%至>85%的病例报告了病毒性疾病的全身症状。整体上约 50%的病例有明显的呼吸道症状。头痛是最常见的神经系统症状，发生率>30%。胃肠道受累的症状范围从 39%（口腔病变），频率逐渐降低到约 5%的腹泻，而直肠炎的百分比从十几岁到二十几岁中期不等。眼科表现（6%，但各研究之间差异很大）。纳入系统评价的许多原始研究包括病例报告和病例系列。观察到不同器官系统的表现范围广泛。报告了妊娠不良结局，但证据有限。确定了不良心血管和神经系统结局，但只有少数研究提供了这些发现的见解。
猴痘表现出多种表现，影响多个器官系统，存在很大差异。研究结果强调了持续、细致和针对特定区域的研究和管理策略对于猴痘的重要性。对病例报告和系列的依赖突出表明需要更多高质量、长期的研究来加深我们对这一重大公共卫生问题的理解和管理。
