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A systematic review to identify novel clinical characteristics of monkeypox virus infection and therapeutic and preventive strategies to combat the virus

Archives of Virology volume 168, Article number: 195 (2023) Cite this article

Abstract

Since May 2022, there has been a global increase in the number of Mpox virus (MPXV) cases in countries that were previously considered non-endemic. In July 2022, the World Health Organization (WHO) declared this outbreak a public health emergency of international concern. The objective of this systematic review is to examine the novel clinical features of Mpox and to assess the available treatment options for managing the disease in patients who are afflicted with it. We conducted a systematic search in several databases, including PubMed, Google Scholar, Cochrane Library, and the grey literature, from May 2022 to February 2023. We identified 21 eligible studies, which included 18,275 Mpox cases, for final qualitative analysis. The majority of cases were reported in men who have sex with men (MSM) and immunocompromised individuals with HIV (36.1%). The median incubation period was 7 days (IQR: 3–21). The novel clinical manifestations include severe skin lesions on the palms, oral and anogenital regions, as well as proctitis, penile edema, tonsillitis, ocular disease, myalgia, lethargy, and sore throat, without any preceding prodromal symptoms or systemic illness. In addition, fully asymptomatic cases were documented, and various complications, including encephalomyelitis and angina, were noted. Clinicians must be familiar with these novel clinical characteristics, as they can aid in testing and tracing such patients, as well as asymptomatic high-risk populations such as heterosexuals and MSM. In addition to supportive care, currently, there are several effective prophylactic and treatment strategies available to combat Mpox, including the vaccines ACAM2000 and MVA-BN7, as well as the immunoglobulin VIGIV and the antivirals tecovirimat, brincidofovir, and cidofovir against severe Mpox infection.

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Data availability

Data are available from the corresponding author upon reasonable request.

Abbreviations

ACIP:

Advisory Committee on Immunization Practices

DNA:

Deoxyribonucleic acid

EUA:

Emergency use authorization

Ig:

Immunoglobulin

HIV:

Human immunodeficiency virus

STD:

Sexually transmitted diseases

MPXV:

Mpox virus

Mpox:

Monkeypox

MSM:

Men who have sex with men

RTPCR:

Real-time polymerase chain reaction

VIGIV:

Vaccinia Immune Globulin Intravenous

USCDC:

United States Centers for Disease Control

USFDA:

United States Food and Drug Administration

WHO:

World Health Organization

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Authors and Affiliations

  1. Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India

    Santenna Chenchula & Madhu Bhargavi Chandra

  2. Department of Pharmacology, MVJ Medical College and Research Hospital, Bangalore, Karnataka, India

    Mohan Krishna Ghanta

  3. Western Michigan University, Kalamazoo, Michigan, USA

    Krishna Chaitanya Amerneni

  4. SVSMCH, Mahbubnagar, Telangana, India

    Padmavathi Rajakarunakaran

  5. Department of Pharmacology, All India Institute of Medical Sciences, Mangalagiri, India

    Madhavrao Chavan

  6. Department of Internal Medicine, Government Medical College, Shahdol, Madhya Pradesh, India

    Rupesh Gupta

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All authors meet the ICMJE criteria for authorship. SC and MG conducted the literature search and data extraction and drafted the manuscript. KCA, PR, MBC, MRC, and RG revised the manuscript. All authors have reviewed and approved the final version of the manuscript.

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Chenchula, S., Ghanta, M.K., Amerneni, K. et al. A systematic review to identify novel clinical characteristics of monkeypox virus infection and therapeutic and preventive strategies to combat the virus. Arch Virol 168, 195 (2023). https://doi.org/10.1007/s00705-023-05808-4

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