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Meta-Analysis
. 2021 Nov-Dec:44:102191.
doi: 10.1016/j.tmaid.2021.102191. Epub 2021 Nov 8.

Ocular manifestations in COVID-19 patients: A systematic review and meta-analysis

Yueyang Zhong  1 , Kai Wang  1 , Yanan Zhu  1 , Danni Lyu  1 , Yinhui Yu  1 , Su Li  1 , Ke Yao  2
Affiliations
Meta-Analysis

Ocular manifestations in COVID-19 patients: A systematic review and meta-analysis

Yueyang Zhong et al. Travel Med Infect Dis. 2021 Nov-Dec.

Abstract

Introduction: With the accumulating evidence of ocular manifestations of the 2019 novel coronavirus disease (COVID-19), the study aimed to systematically summarize the ocular manifestations in COVID-19 patients.

Methods: The PubMed, EMBASE, Web of Science databases were searched through June 2021. Studies that provided clinical characteristics and outcomes and reported on the ocular manifestations or conjunctival swab RT-PCR tests among COVID-19 patients were included.

Results: A total of 30 studies involving 5,717 patients were identified. Ocular manifestations including conjunctival hyperemia (7.6%, 95% confidence interval [CI] 1.8-8.9%), conjunctival discharge (4.8%, 95% CI 1.8-8.9%), epiphora (6.9%, 95% CI 2.8-12.8%), and foreign body sensation (6.9%, 95% CI 2.4-13.0%) were observed. The positive rate of conjunctival swab tests was 3.9% (95% CI 0.2-6.4%). Severe cases of COVID-19 were associated with an increased risk of developing ocular complications (odds ratio [OR] = 2.77, 95% CI 1.75-4.40).

Conclusions: Despite their relatively low incidence rate in COVID-19 patients, ocular manifestations may be non-specific and present as the initial symptoms of infection. The presence of SARS-CoV-2 in the conjunctival swabs implicates the eye as a potential source of infection. Early diagnosis and proper eye protection would help prevent viral transmission.

Keywords: COVID-19; Coronavirus; Meta-analysis; Ocular manifestation; SARS-CoV-2.

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Conflict of interest statement

The authors declare that there is no conflict of interest associated with this manuscript.

Figures

Fig. 1
Fig. 1
PRISMA flowchart depicting selection of studies.
Fig. 2
Fig. 2
Proportion of ocular manifestations of conjunctival hyperemia in COVID-19 patients.
Fig. 3
Fig. 3
Positive rate of conjunctival swab RT-PCR test in COVID-19 patients.
Fig. 4
Fig. 4
Risk of ocular manifestations in severe COVID-19 patients.
See this image and copyright information in PMC

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