Ocular Manifestations of COVID-19: A Systematic Review and Meta-analysis.

Naser Nasiri,Hamid Sharifi,Azam Bazrafshan,Atefeh Noori,Ali Sharifi,Mohammad Karamouzian

doi:10.18502/jovr.v16i1.8256

Abstract

Several studies have reported the characteristics of Coronavirus disease 2019 (COVID-19), yet there is a gap in our understanding of the ocular manifestations of COVID-19. In this systematic review and meta-analysis, we investigated the prevalence of ocular manifestations in COVID-19 patients. We searched Pubmed, Embase, Scopus, Web of Science, and medRxiv from December 1, 2019 to August 11, 2020. Two independent reviewers screened the articles, abstracted the data, and assessed the quality of included studies in duplicate. Thirty-eight studies were eligible after screening of 895 unique articles, with a total of 8,219 COVID-19 patients (55.3% female; n = 3,486 out of 6,308 patients). Using data extracted from cross-sectional studies, we performed random-effects meta-analyses to estimate the pooled prevalence of ocular symptoms along with 95% confidence interval (CI). The prevalence of ocular manifestations was estimated to be 11.03% (95% CI: 5.71–17.72). In the studies that reported the details of observed ocular symptoms, the most common ocular manifestations were dry eye or foreign body sensation (n = 138, 16%), redness (n = 114, 13.3%), tearing (n = 111, 12.8%), itching (n = 109, 12.6%), eye pain (n = 83, 9.6%) and discharge (n = 76, 8.8%). Moreover, conjunctivitis had the highest rate among reported ocular diseases in COVID-19 patients (79 out of 89, 88.8%). The results suggest that approximately one out of ten COVID-19 patients show at least one ocular symptom. Attention to ocular manifestations, especially conjunctivitis, can increase the sensitivity of COVID-19 detection among patients.

Highlights

Ocular Manifestations of COVID-19; Nasiri et al 2019 in Wuhan, China,[1] and Coronavirus disease 2019 (COVID-19) swiftly spread across the globe, and was declared a pandemic on March 11, 2020.[2]. By August 14, 2020, 21,092,096 people were infected with SARS-CoV-2, 757,727 of whom passed away due to COVID-19 or its adverse health consequences.[3]
The pooled prevalence of all ocular manifestations among COVID -19 patients was 11.03% (Figure 2), The most prevalent ocular manifestations were dry eye or foreign body sensation (n = 138, 16.0%), redness (n = 114, 13.3%), tearing (n = 111, 12.8%), itching (n = 109, 12.6%), eye pain (n = 83, 9.6%), and discharge (n = 76, 8.8%)
Based on the existing evidence, we found the pooled prevalence of all ocular symptoms to be 11.03% among COVID19 patients

Summary

Introduction

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was initially detected in late. Ocular Manifestations of COVID-19; Nasiri et al2019 in Wuhan, China,[1] and Coronavirus disease 2019 (COVID-19) swiftly spread across the globe, and was declared a pandemic on March 11, 2020.[2] By August 14, 2020, 21,092,096 people were infected with SARS-CoV-2, 757,727 of whom passed away due to COVID-19 or its adverse health consequences.[3]. While some patients show a wider range of gastrointestinal symptoms such as diarrhea, abdominal pain, low appetite, and vomit,[5] others have shown renal and ocular symptoms.[6]

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