Ocular surface manifestations of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis

• Published in: PloS one 2020-11, Vol.15 (11), p.e0241661-e0241661
• Main Authors: Aggarwal, Kanika, Agarwal, Aniruddha, Jaiswal, Nishant, Dahiya, Neha, Ahuja, Alka, Mahajan, Sarakshi, Tong, Louis, Duggal, Mona, Singh, Meenu, Agrawal, Rupesh, Gupta, Vishali
• Format: Article
• Language: English
• Subjects: Betacoronavirus; Bias; Conjunctiva - virology; Conjunctivitis; Conjunctivitis - virology; Coronaviridae; Coronavirus Infections - complications; Coronaviruses; COVID-19; Cross-sectional studies; Data collection; Diagnosis; Disease transmission; Eye Diseases - virology; Eye manifestations; Eye Pain - virology; Health risks; Heterogeneity; Hospitals; Humans; Medical education; Medical personnel; Medical prognosis; Medicine and Health Sciences; Meta-analysis; Pain; Pandemics; Pediatrics; Physical Sciences; Physiological aspects; Pneumonia, Viral - complications; Research and Analysis Methods; Respiratory diseases; Ribonucleic acid; RNA; SARS-CoV-2; Search engines; Search methods; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Systematic review; Systemic diseases; Tears - virology; Viral diseases
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0241661

This study was performed to determine the occurrence of ocular surface manifestations in patients diagnosed with coronavirus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A systematic search of electronic databases i.e. PubMed, Web of Science, CINAHL, OVID and Google scholar was performed using a comprehensive search strategy. The searches were current through 31st May 2020. Pooled data from cross-sectional studies was used for meta-analysis and a narrative synthesis was conducted for studies where a meta-analysis was not feasible. A total of 16 studies reporting 2347 confirmed COVID-19 cases were included. Pooled data showed that 11.64% of COVID-19 patients had ocular surface manifestations. Ocular pain (31.2%), discharge (19.2%), redness (10.8%), and follicular conjunctivitis (7.7%) were the main features. 6.9% patients with ocular manifestations had severe pneumonia. Viral RNA was detected from the ocular specimens in 3.5% patients. The most common reported ocular presentations of COVID-19 included ocular pain, redness, discharge, and follicular conjunctivitis. A small proportion of patients had viral RNA in their conjunctival/tear samples. The available studies show significant publication bias and heterogeneity. Prospective studies with methodical collection and data reporting are needed for evaluation of ocular involvement in COVID-19.