PDF(Pubmed)
Abstract：
BACKGROUND: A multicountry monkeypox disease (MPX) outbreak began in May 2022 in Europe, leading to the assessment as a potential Public Health Emergency of International Concern (PHEIC) on June 23, 2022. Some observational studies have partially characterised clinical features, hospitalisations, and deaths. However, no systematic reviews of this MPX outbreak have been published.
METHODS: We performed a systematic review with meta-analysis, using five databases to assess clinical features, hospitalisations, complications and deaths of MPX confirmed or probable cases. Observational studies, case reports and case series, were included. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95% CI). In addition, we carried out a subgroup analysis according to the continents and a sensitivity analysis excluding studies classified as having a high risk of bias.
RESULTS: A total of 19 articles were included, using only 12 articles in the quantitative synthesis (meta-analysis). For 1958 patients, rash (93%, 95% CI 80-100%), fever (72%, 95% CI 30-99%), pruritus (65%, 95% CI 47-81%), and lymphadenopathy (62%, 47-76%), were the most prevalent manifestations. Among the patients, 35% (95% CI 14-59%) were hospitalised. Some 4% (95% CI 1-9%) of hospitalised patients had fatal outcomes (case fatality rate, CFR).
CONCLUSIONS: MPX is spreading rapidly, with a third of hospitalised patients, but less than 5% with fatal outcomes. As this zoonotic virus spreads globally, countries must urgently prepare human resources, infrastructure and facilities to treat patients according to the emerging guidelines and the most reliable clinical information.
METHODS: We performed a systematic review with meta-analysis, using five databases to assess clinical features, hospitalisations, complications and deaths of MPX confirmed or probable cases. Observational studies, case reports and case series, were included. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95% CI). In addition, we carried out a subgroup analysis according to the continents and a sensitivity analysis excluding studies classified as having a high risk of bias.
RESULTS: A total of 19 articles were included, using only 12 articles in the quantitative synthesis (meta-analysis). For 1958 patients, rash (93%, 95% CI 80-100%), fever (72%, 95% CI 30-99%), pruritus (65%, 95% CI 47-81%), and lymphadenopathy (62%, 47-76%), were the most prevalent manifestations. Among the patients, 35% (95% CI 14-59%) were hospitalised. Some 4% (95% CI 1-9%) of hospitalised patients had fatal outcomes (case fatality rate, CFR).
CONCLUSIONS: MPX is spreading rapidly, with a third of hospitalised patients, but less than 5% with fatal outcomes. As this zoonotic virus spreads globally, countries must urgently prepare human resources, infrastructure and facilities to treat patients according to the emerging guidelines and the most reliable clinical information.
摘要：
背景：欧洲于2022年5月开始爆发多国猴痘病（MPX），导致2022年6月23日评估为潜在的国际关注的突发公共卫生事件（PHEIC）。一些观察性研究具有部分特征的临床特征，住院治疗,和死亡。然而,尚未发表有关此次MPX爆发的系统评价.
方法：我们用荟萃分析进行了系统评价，使用五个数据库来评估临床特征，住院治疗,MPX确诊或可能病例的并发症和死亡。观察性研究,病例报告和病例系列，包括在内。我们进行了随机效应模型荟萃分析，以计算合并的患病率和95％置信区间（95％CI）。此外,我们根据大陆进行了亚组分析,并进行了敏感性分析,排除了被分类为具有高偏倚风险的研究.
结果：共纳入19篇文章，在定量综合(荟萃分析)中只使用了12篇文章。1958年的病人皮疹（93%，95%CI80-100%)，发烧（72%，95%CI30-99%），瘙痒（65%，95%CI47-81%），和淋巴结病（62%，47-76%），是最普遍的表现。在患者中,35％（95％CI14-59％）住院。约4%(95%CI1-9%)的住院患者有致命结局(病死率，CFR)。
结论：MPX正在迅速传播，三分之一的住院患者，但不到5%有致命结局。随着这种人畜共患病病毒在全球传播，各国必须紧急准备人力资源，根据新兴指南和最可靠的临床信息治疗患者的基础设施和设施。
方法：我们用荟萃分析进行了系统评价，使用五个数据库来评估临床特征，住院治疗,MPX确诊或可能病例的并发症和死亡。观察性研究,病例报告和病例系列，包括在内。我们进行了随机效应模型荟萃分析，以计算合并的患病率和95％置信区间（95％CI）。此外,我们根据大陆进行了亚组分析,并进行了敏感性分析,排除了被分类为具有高偏倚风险的研究.
结果：共纳入19篇文章，在定量综合(荟萃分析)中只使用了12篇文章。1958年的病人皮疹（93%，95%CI80-100%)，发烧（72%，95%CI30-99%），瘙痒（65%，95%CI47-81%），和淋巴结病（62%，47-76%），是最普遍的表现。在患者中,35％（95％CI14-59％）住院。约4%(95%CI1-9%)的住院患者有致命结局(病死率，CFR)。
结论：MPX正在迅速传播，三分之一的住院患者，但不到5%有致命结局。随着这种人畜共患病病毒在全球传播，各国必须紧急准备人力资源，根据新兴指南和最可靠的临床信息治疗患者的基础设施和设施。
