Neurological and psychiatric presentations associated with human monkeypox virus infection: A systematic review and meta-analysis.
Neurological and psychiatric presentations associated with human monkeypox virus infection: A systematic review and meta-analysis.
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DOI：
10.1016/j.eclinm.2022.101644
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发表时间：
2022-10
影响因子：
15.1
通讯作者：
Rogers, Jonathan P.
中科院分区：
文献类型：
--
作者：
Badenoch, James B.;Conti, Isabella;Rengasamy, Emma R.;Watson, Cameron J.;Butler, Matthew;Hussain, Zain;Carter, Ben;Rooney, Alasdair G.;Zandi, Michael S.;Lewis, Glyn;David, Anthony S.;Houlihan, Catherine F.;Easton, Ava;Michael, Benedict D.;Kuppalli, Krutika;Nicholson, Timothy R.;Pollak, Thomas A.;Rogers, Jonathan P.
猴痘（MPX）感染的神经精神表现尚未得到很好的表征，尽管有证据表明神经系统受累与相关的天花感染有关。在这项预注册（PROSPERO ID 336649）系统性综述和荟萃分析中，我们检索了MEDLINE、EMBASE、PsycINFO、AMED和预印本服务器MedRxiv，检索时间截止至2022年5月31日。包括任何报告神经或精神表现的MPX感染者的研究设计。对于符合条件的症状，我们使用逆方差方法和相应的95%置信区间计算合并患病率。使用I2统计量评估研究间异质性可解释的变异程度。采用纽卡斯尔渥太华量表和Joanna Briggs研究所质量评估工具评估偏倚风险。从1705项独特的研究中，我们提取了19项合格研究的数据（1512名参与者，1031名使用CDC标准或PCR检测确认感染），其中大多数是队列研究和病例系列，没有对照组。研究质量一般中等。3个临床特征符合荟萃分析的条件：癫痫发作2.7%（95%CI 0.7- 10.2%，I2 0%），意识模糊2.4%（95%CI 1.1- 5.2%，I2 0%）和脑炎2.0%（95%CI 0.5- 8.2%，I2 55.8%）。其他经常报告的症状包括肌痛、头痛和疲劳，其中异质性太高，无法估计合并患病率，这可能是病毒分支和研究方法差异的结果。有初步证据表明一系列神经精神症状，包括严重的神经系统并发症（脑炎和癫痫发作）和非特异性神经系统特征（意识模糊、头痛和肌痛）。关于MPX的精神病学表现或后遗症的证据较少。这可能需要在目前的MPX疫情范围内进行监测，并进行前瞻性纵向研究，评估该病毒的中长期后遗症。需要稳健的方法来评价MPX与这些临床特征的潜在因果关系。需要更多的证据来解释患病率估计值的异质性。UKRI/MRC（MR/V03605 X/1）、MRC-CSF（MR/V007181/1）、MRC/AMED（MR/T028750/1）和Wellcome Trust（102186/B/13/Z）和（102186/B/13/Z）以及UCLH BRC。
Neuropsychiatric presentations of monkeypox (MPX) infection have not been well characterised, despite evidence of nervous system involvement associated with the related smallpox infection. In this pre-registered (PROSPERO ID 336649) systematic review and meta-analysis, we searched MEDLINE, EMBASE, PsycINFO, AMED and the preprint server MedRxiv up to 31/05/2022. Any study design of humans infected with MPX that reported a neurological or psychiatric presentation was included. For eligible symptoms, we calculated a pooled prevalence using an inverse variance approach and corresponding 95% confidence intervals. The degree of variability that could be explained by between-study heterogeneity was assessed using the I2 statistic. Risk of bias was assessed with the Newcastle Ottawa Scale and the Joanna Briggs Institute quality assessment tool. From 1705 unique studies, we extracted data on 19 eligible studies (1512 participants, 1031 with confirmed infection using CDC criteria or PCR testing) most of which were cohort studies and case series with no control groups. Study quality was generally moderate. Three clinical features were eligible for meta-analysis: seizure 2.7% (95% CI 0.7–10.2%, I2 0%), confusion 2.4% (95% CI 1.1–5.2%, I2 0%) and encephalitis 2.0% (95% 0.5–8.2%, I2 55.8%). Other frequently reported symptoms included myalgia, headache and fatigue, where heterogeneity was too high for estimation of pooled prevalences, possibly as a result of differences in viral clades and study methodology. There is preliminary evidence for a range of neuropsychiatric presentations including severe neurological complications (encephalitis and seizure) and nonspecific neurological features (confusion, headache and myalgia). There is less evidence regarding the psychiatric presentations or sequelae of MPX. This may warrant surveillance within the current MPX outbreak, with prospective longitudinal studies evaluating the mid- to long-term sequelae of the virus. Robust methods to evaluate the potential causality of MPX with these clinical features are required. More evidence is necessary to explain heterogeneity in prevalence estimates. UKRI/MRC (MR/V03605X/1), MRC-CSF (MR/V007181/1), MRC/AMED (MR/T028750/1) and the Wellcome Trust (102186/B/13/Z) and (102186/B/13/Z) and UCLH BRC.
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影响因子：
82.9
作者：
Isidro, Joana;Borges, Vitor;Pinto, Miguel;Sobral, Daniel;Santos, Joao Dourado;Nunes, Alexandra;Mixao, Veronica;Ferreira, Rita;Santos, Daniela;Duarte, Silvia;Vieira, Luis;Borrego, Maria Jose;Nuncio, Sofia;de Carvalho, Isabel Lopes;Pelerito, Ana;Cordeiro, Rita;Gomes, Joao Paulo
通讯作者：
Gomes, Joao Paulo
影响因子：
7.2
作者：
Hamza, Taye H.;van Houwelingen, Hans C.;Stijnen, Theo
通讯作者：
Stijnen, Theo
影响因子：
4.8
作者：
Badenoch JB;Rengasamy ER;Watson C;Jansen K;Chakraborty S;Sundaram RD;Hafeez D;Burchill E;Saini A;Thomas L;Cross B;Hunt CK;Conti I;Ralovska S;Hussain Z;Butler M;Pollak TA;Koychev I;Michael BD;Holling H;Nicholson TR;Rogers JP;Rooney AG
通讯作者：
Rooney AG
影响因子：
56.3
作者：
Adler, Hugh;Gould, Susan;Hine, Paul;Snell, Luke B.;Wong, Waison;Houlihan, Catherine F.;Osborne, Jane C.;Rampling, Tommy;Beadsworth, Mike Bj;Duncan, Christopher Ja;Dunning, Jake;Fletcher, Tom E.;Hunter, Ewan R.;Jacobs, Michael;Khoo, Saye H.;Newsholme, William;Porter, David;Porter, Robert J.;Ratcliffe, Libuse;Schmid, Matthias L.;Semple, Malcolm G.;Tunbridge, Anne J.;Wingfield, Tom;Price, Nicholas M.
通讯作者：
Price, Nicholas M.
影响因子：
10
作者：
Jennings, L. C.;Anderson, T. P.;Murdoch, D. R.
通讯作者：
Murdoch, D. R.