한빛사논문
- 조회641
Hakyoung Kim 1, Rosie Kwon 2,3, Hojae Lee 2,3, Seung Won Lee 4, Masoud Rahmati 5, Ai Koyanagi 6,7, Lee Smith 8, Min Seo Kim 9, Guillermo F López Sánchez 10, Dragioti Elena 11,12, Seung Geun Yeo 13, Jae Il Shin 14, Wonyoung Cho 2, Dong Keon Yon 2,3,15
1Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
2Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
3Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
4Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea.
5Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran.
6Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain.
7Centre of Networked Biodemical Research on Mental Health (CIBERSAM), National Institute of Health Carlos III (ISCIII), Madrid, Spain.
8Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
9Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
10Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
11Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
12Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
13Department of Otolaryngology - Head & Neck Surgery, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
14Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea.
15Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
To whom correspondence should be addressed. Dong Keon Yon, MD, FACAAI, FAAAAI, Wonyoung Cho, PhD, Jae Il Shin, MD, PhD.
Abstract
Background: Viral load dynamics and shedding kinetics are critical factors for studying infectious diseases. However, evidence on the viral dynamics of mpox remains limited and inconclusive. Thus, we aimed to provide a comprehensive understanding of viral load and viability of the re-emerged mpox virus since 2022.
Methods: For this systematic review and meta-analysis, we searched PubMed/MEDLINE, Embase, and Google Scholar for published articles which are related to mpox viral dynamics up to April, 2023.
Results: From 19 studies, 880 samples and 1477 specimens were collected. The pooled median Ct values appeared in the following order: skin lesion (Ct value 21.7 [IQR 17.8-25.5]), anorectal (22.3 [16.9-27.6]), saliva (25.9 [22.5-31.1]), oral (29.0 [24.5-32.8]), semen (29.6 [25.9-33.4]), urine (30.5 [24.6-36.4]), pharyngeal (31.9 [26.5-37.3]), urethra (33.0 [28.0-35.0]), and blood (33.2 [30.4-36.1]). People living with HIV have lower Ct value in the skin (skin HIV+, 19.2 [18.3-20.0] versus skin HIV-, 25.4 [21.2-29.0]). From the Ct values and test day since symptom onset, we identified temporal trends of viral load for each specimen type. Changes in the trend were observed at 4 days in saliva, 5 days in blood, 6 days in skin, 7 days in anorectal, urine, semen, pharyngeal, and 8 days in urethra. We determined optimal Ct cutoff values for anorectal (34.0), saliva (27.7), and urethra (33.0) specimens, where a Ct value above each cutoff suggests minimal viral viability. Using these cutoff values, we derived the duration of viable viral isolation in each specific specimen type (anorectal 19 days; saliva 14 days; and urethra 14 days).
Conclusion: Skin lesion, anorectal, and saliva samples contained the highest viral load. The peak viral load manifests within 4-8 days after symptom onset, and viable virus detection was presumed to cease within 14-19 days from symptom onset in anorectal, saliva and urethra samples.
논문정보
- Research article
- 2023년 08월 (BRIC 등록일 2023-08-16)
- 국내(교신)+국외 연구진
- 의약학 > 응용의학
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