对正在进行的猴痘(mpox)爆发知之甚少,世界各地患者的水痘临床特征尚未得到严格分析。因此,我们的目的是调查与水痘感染相关的临床特征,了解该病的病理生理和特点。对于这篇系统综述和荟萃分析,我们搜索了PubMed/MEDLINE,Embase,CINAHL,谷歌学者,以及截至2022年9月16日发表的文章的Cochrane系统评论数据库。我们使用随机效应模型来计算合并患病率和95%置信区间(CI)。我们使用I2统计量来评估异质性,Egger的测试来评估出版偏见,95%的预测间隔来确定不确定性水平,和纽卡斯尔-渥太华量表和乔安娜·布里格斯研究所的质量评估工具来评估偏见的风险。包括来自五大洲19个国家的26篇相关文章,并分析了5472例有18个独特特征的水痘患者的数据。临床特征的合并患病率为皮疹(85.7%,95%CI:68.3-94.3;k=21),发冷(77.8%,95%CI:70.5-83.7;k=3),和发烧(62.3%,95%CI:51.3-71.6;k=25),淋巴结病(58.6%,95%CI:47.2-69.2;k=21),嗜睡或疲惫(46.8%,95%CI:30.7-63.5;k=14),瘙痒(40.6%,95%CI:28.5-54.0;k=5),肌痛(36.0%,95%CI:24.3-49.7;k=16),头痛(34.6%,95%CI:23.4-47.8;k=17),皮肤溃疡(31.1%,95%CI:18.6-47.1;k=7),腹部症状(24.2%,95%CI:17.9-31.9;k=11),咽炎(23.0%,95%CI:12.7-37.9;k=14),呼吸道症状(19.5%,95%CI:6.8-44.6;k=6),恶心或呕吐(13.0%,95%CI:4.6-31.9;k=3),阴囊或阴茎水肿(10.7%,95%CI:6.3-17.7;k=4),结膜炎(7.1%,95%CI:2.4-18.9;k=6),和死亡(0.9%,95%CI:0.4-2.0;k=26)。这是第一个国际和全面的研究,以检查人类痘病毒感染的所有临床表现。我们的系统评价提出了对当前水痘爆发的全面了解,并可能作为未来研究水痘感染的病理机制和流行病学的关键数据。
Little is known about the ongoing monkeypox (mpox) outbreak, and the clinical features of mpox in patients worldwide have not been rigorously analysed. Thus, we aimed to investigate the clinical features associated with mpox infection and understand the pathophysiology and characteristics of the disease. For this systematic
review and meta-analysis, we searched PubMed/MEDLINE, Embase, CINAHL, Google Scholar, and the Cochrane Database of Systematic Reviews for articles published till 16 September 2022. We used a random effects model to calculate the pooled prevalence and 95% confidence interval (CI). We used the I2 statistic to assess heterogeneity, Egger\'s test to assess publication bias, 95% prediction interval to determine the level of uncertainty, and the Newcastle-Ottawa Scale and Joanna Briggs Institute quality assessment tool to assess the risk of bias. Twenty-six relevant articles from 19 countries across 5 continents were included, and data on 5472 mpox patients with 18 unique features were analysed. The pooled prevalence of clinical features of mpox were rash (85.7%, 95% CI: 68.3-94.3; k = 21), chills (77.8%, 95% CI: 70.5-83.7; k = 3), and fever (62.3%, 95% CI: 51.3-71.6; k = 25), lymphadenopathy (58.6%, 95% CI: 47.2-69.2; k = 21), lethargy or exhaustion (46.8%, 95% CI: 30.7-63.5; k = 14), pruritus (40.6%, 95% CI: 28.5-54.0; k = 5), myalgia (36.0%, 95% CI: 24.3-49.7; k = 16), headache (34.6%, 95% CI: 23.4-47.8; k = 17), skin ulcer (31.1%, 95% CI: 18.6-47.1; k = 7), abdomen symptom (24.2%, 95% CI: 17.9-31.9; k = 11), pharyngitis (23.0%, 95% CI: 12.7-37.9; k = 14), respiratory symptom (19.5%, 95% CI: 6.8-44.6; k = 6), nausea or vomiting (13.0%, 95% CI: 4.6-31.9; k = 3), scrotal or penile oedema (10.7%, 95% CI: 6.3-17.7; k = 4), conjunctivitis (7.1%, 95% CI: 2.4-18.9; k = 6), and death (0.9%, 95% CI: 0.4-2.0; k = 26). This is the first international and comprehensive study to examine all clinical presentations of human mpox infection. Our systematic
review proposes a comprehensive understanding of the current mpox outbreak and may serve as key data for future studies on the pathological mechanisms and epidemiology of mpox infections.