Monkeypox can also cause brain lesions, finds a large meta-analysis

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Researchers from University College London conducted a meta-analysis of 19 studies involving more than 1.5 thousand people that had monkeypox.

The team lead by Jonathan Rogers found the virus can cause convulsions, confusion and encephalitis.

Monkeypox infection in humans was first reported in the 1970s.

Since then, localized outbreaks of the disease have been occurring regularly in Central and West Africa, primarily in the Democratic Republic of the Congo.

There have been isolated imported cases outside this region, until recently... usually associated with the trade in exotic animals that carry the virus.

In May 2022, cases of monkeypox were identified in the UK, after which the infection began to spread rapidly across Europe, North America and further around the world.

As of September 7, the World Health Organization (WHO) reports 54.7 thousand cases in 125 countries, vut only 18 officially confirmed deaths.

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AMAZING THOUSANDS OF CASES
Monkeypox typically presents with characteristic skin pustules, enlarged axillary lymph nodes, fatigue, fever, and headache.

However, as the virus spread, reports of atypical symptoms and complications of the disease, including neuropsychiatric ones, began to appear.

Given the high risks of the latter associated with disability and a significant decrease in the quality of life, Rogers’ team decided to estimate their prevalence through a systematic review and meta-analysis of available publications on the topic.

In order to do this, they searched the AMED, EMBASE, PsycINFO, MEDLINE databases and the medRxiv preprint service.

The generalized prevalence of the symptoms of interest was calculated by the inverse variance method.

Of the 1,705 publications found, 19 were eligible for inclusion, with a total of 1,512 contributions from the Republic of the Congo, Nigeria, the US, and the UK (45.1% female, mean age 24.2 years).

In 1031 of them, the diagnosis was confirmed by PCR or according to the criteria of the Centers for Disease Control and Prevention (CDC).

The meta-analysis of these studies identified 3 significant central nervous system lesions:

• Seizures are estimated to occur in 2.7% (95% CI 0.7–10.2%; I2 0%) of patients
• Confusion in 2.4% (95% CI 1.1–5 .2%; I2 0%)
• Encephalitis in 2% (95% CI 0.5–8.2%; I2 55.8%)

In addition, more than half of the patients experienced muscle and headache, fatigue, anxiety and depression.

However, the excessive heterogeneity of the work did not allow us to estimate their prevalence with sufficient accuracy.

As Rogers noted, severe neurological complications of monkeypox, such as seizures and encephalitis, occur in a small but sufficient number of cases to cause serious concern

The team also encourages further studies.

Source:

• EClinical Medicine: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(22)00374-1/fulltext
• Eureka Alert: https://www.eurekalert.org/news-releases/964057

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