Hepatitis in the time of pandemics: A comparative bibliometric analysis of early publications on MIS-C, acute hepatitis of unknown aetiology and Mpox.

BACKGROUND

The emergence of acute hepatitis of unknown etiology in the spring of 2022 was strikingly reminiscent of how multisystem inflammatory syndrome in children (MIS-C) had appeared two years earlier.

OBJECTIVE

To carry out a bibliometric analysis of the early literature on acute hepatitis of unknown aetiology, and another coincident but non-pediatric disease, Mpox, in comparison with our previous findings on the early coverage of MIS-C.

METHODS AND SETTINGS: A review of the literature was conducted in the MEDLINE database, on preprint servers, and among Reuters news articles. Articles were included if they had been published in 2022 and were specifically about acute hepatitis of unknown aetiology or Mpox.

RESULTS

The first newspaper/non-academic journal article on acute hepatitis of unknown aetiology was published in week 14 and the weekly number rapidly peaked in week 16 before decreasing gradually down to zero in week 22. The first peer-reviewed article was published in week 15 and remained between 3 and 7 from weeks 17 to 23. Just under a quarter (23.5 %) of references in these articles were to health agency publications on acute hepatitis of unknown aetiology. Over 7-week periods beginning just before the corresponding health agency alerts, 25 articles were published on MIS-C (21 peer-reviewed and 4 preprints), 20 articles were published on acute hepatitis of unknown aetiology (18 peer-reviewed and 4 preprints), and 74 on Mpox (48 peer-reviewed and 26 preprints). The proportion of preprints was significantly associated with disease type (p = 0.03), as was the proportion of clinical studies, with values of 52 %, 10 %, and 18 %, respectively (p = 0.002). Many more non-academic articles were published on Mpox (N = 180) than on acute hepatitis of unknown aetiology (17) or MIS-C (24).

CONCLUSION

Although Mpox attracted more overall attention, the medical community responded similarly rapidly to acute hepatitis of unknown aetiology and to MIS-C. The fact that a major source of early information on these diseases was health agency reports suggests that these should be included in bibliographic databases for ease of access.