Gastrointestinal Manifestations of Monkeypox Infection: A systematic
review and meta-analysis
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.