Manifestations and Virus Detection in the Ocular Surface of Adult COVID-19 Patients: A Meta-Analysis

Yu-Yen Chen; Yung-Feng Yen; Li-Ying Huang; Pesus Chou

doi:10.1155/2021/9997631

Manifestations and Virus Detection in the Ocular Surface of Adult COVID-19 Patients: A Meta-Analysis

J Ophthalmol. 2021 Jun 19:2021:9997631. doi: 10.1155/2021/9997631. eCollection 2021.

Authors

Yu-Yen Chen^{1

2

3

4}, Yung-Feng Yen^{5

6

7}, Li-Ying Huang^{8

9}, Pesus Chou^{2

3}

Affiliations

¹ Department of Ophthalmology, Taichung Veterans General Hospital, Taichung 407, Taiwan.
² School of Medicine, National Yang-Ming University, Taipei 112, Taiwan.
³ Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei 112, Taiwan.
⁴ School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan.
⁵ Section of Infectious Diseases, Taipei City Hospital, Taipei 103, Taiwan.
⁶ Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei 112, Taiwan.
⁷ Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan.
⁸ School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei 242, Taiwan.
⁹ Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei 243, Taiwan.

Abstract

Purpose: This study aims to examine the prevalence rate of ocular manifestations and the positive rate for the real-time reverse transcriptase-polymerase chain reaction (RT-PCR) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in conjunctival/tear swabs among adult patients with coronavirus disease 2019 (COVID-19).

Methods: PubMed and EMBASE were reviewed between December 1, 2019, and January 31, 2021, and only peer-reviewed clinical studies in our pooled analyses were included. Details regarding the patient numbers, demographics, ocular manifestations, positivity of ocular surface RT-PCR, and severity of pneumonia were recorded from each study. Primary outcomes were the occurrence of ocular manifestations and virus detection on the ocular surface. Meanwhile, secondary outcomes included frequencies of various ocular symptoms/signs (s/s), the proportion of patients with ocular manifestation as the initial symptom, and the relationship between the severity of pneumonia and the presentation of ocular manifestations.

Results: In total, 35 studies with 4,432 adult COVID-19 patients were included in this analysis. The overall prevalence rate of ocular manifestations was found to be 11.3%, and the positive rate of SARS-CoV-2 in the ocular surface was 7.4%. The four most common ocular s/s were follicular conjunctivitis, redness, watering, and discharge. A proportion of 3.3% presented with ocular s/s preceding other findings. Besides, patients with higher severity of pneumonia were more likely to have ocular manifestations (odds ratio = 2.25; 95% confidence interval (CI): 1.45-3.50).

Conclusion: As per our findings, it was determined that ocular transmission of SARS-CoV-2 might be possible, highlighting the importance of eye protective equipment among healthcare personnel.

Publication types

Review