Atención de pacientes oftalmológicos durante la pandemia COVID-19: revisión panorámica rápida

Abstract

A new type of coronavirus (SARS-CoV-2) causes a respiratory distress syndrome that has been called COVID-19 and has generated an unprecedented pandemic. Serious complications include pneumonia, and mortality ranges from 2 to 5%. Until March 26, the World Health Organization reports 462 684 confirmed cases and 20 834 deaths worldwide. Dissemination occurs from aerosols or respiratory droplets. Different scientific societies have published clinical practice guidelines regarding ophthalmic care in the COVID-19 pandemic, but the information is presented inconsistently, which makes decision-making difficult. We conducted a sensitive bibliographic search in EMBASE and ophthalmic society webpages, of the clinical practice guidelines of ophthalmic care in pandemic COVID-19. We extracted the recommendations, organizing them into three categories: "Which patients to attend", "How should the clinic work", and "What interventions should be avoided". For each guideline, we assessed whether the search was systematic and whether the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was followed. Fourteen relevant articles were found. Fifty-one recommendations were extracted and are shown in a summary table. None are based on a systematic search for evidence, nor do any use GRADE to develop the recommendations. The clinical practice guidelines that we reviewed all recommend rescheduling all non-urgent consultations and surgeries, reinforcing contact precautions, the use of personal protection elements, and the disinfection of surfaces and instruments. The guidelines should be improved by incorporating systematic searches for evidence, using GRADE for recommendations, and Appraisal of Guidelines for Research and Evaluation (AGREE II) for reporting.