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Gastrointestinal Manifestations of Monkeypox Infection: A systematic review and meta-analysis
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  • Daniel Martin Simadibrata,
  • Elvira Lesmana,
  • Iqbal Pratama,
  • Nagita Gianty Annisa,
  • Kevin Thenedi,
  • Marcellus Simadibrata
Daniel Martin Simadibrata
Universitas Indonesia Fakultas Kedokteran
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Elvira Lesmana
Universitas Indonesia Fakultas Kedokteran
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Iqbal Pratama
Universitas Indonesia Fakultas Kedokteran
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Nagita Gianty Annisa
Universitas Indonesia Fakultas Kedokteran
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Kevin Thenedi
Universitas Gadjah Mada Departemen Pendidikan Kedokteran
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Marcellus Simadibrata
Universitas Indonesia Departemen Ilmu Penyakit Dalam

Corresponding Author:prof.marcellus.s@gmail.com

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Abstract

Background: Since early May 2022, outbreaks of Monkeypox (Mpox) cases have emerged and become a global concern. Studies exploring the gastrointestinal (GI) and/or liver manifestations of Mpox are still very limited. This systematic review and meta-analysis is the first to summarize the GI manifestations reported by Mpox patients. Methods: 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 GI and/or liver manifestations. Meta-analysis was done to obtain the pooled prevalence of GI manifestations in Mpox patients. The quality of included studies was assessed using the NIH Quality Assessment Tool. Results: Overall, 31 studies that reported GI and/or liver manifestations in Mpox patients were included. The five most commonly reported GI manifestations by studies were abdominal pain, anorexia, diarrhea, nausea and/or vomiting, and proctitis. There is a lack of reporting for liver manifestations. The most prevalent GI manifestations in Mpox patients were anorexia (47%; 95%CI 41-53%), followed by nausea and/or vomiting (12%; 95%CI 11-13%), proctitis (11%; 95%CI 11-12%), abdominal pain (9%; 95%CI 8-10%), and diarrhea (5%; 95%CI 4-6%). Conclusion: Anorexia was the most frequently reported GI manifestation in Mpox patients, followed by nausea and/or vomiting, proctitis, abdominal pain, and diarrhea. The presentation of proctitis during the ongoing Mpox outbreak highly suggests a potential for Mpox diagnosis.
11 Jan 2023Submitted to Journal of Medical Virology
12 Jan 2023Submission Checks Completed
12 Jan 2023Assigned to Editor
12 Jan 2023Review(s) Completed, Editorial Evaluation Pending
19 Jan 2023Reviewer(s) Assigned
08 Feb 2023Editorial Decision: Revise Major
02 Mar 20231st Revision Received
03 Mar 2023Submission Checks Completed
03 Mar 2023Assigned to Editor
03 Mar 2023Review(s) Completed, Editorial Evaluation Pending
05 Mar 2023Reviewer(s) Assigned
24 Mar 2023Editorial Decision: Accept