Pooled Prevalence Estimate of Ocular Manifestations in Covid-19 Patients: A Systematic Review and Meta-Analysis Publisher Pubmed



Soltani S^{1, 2} ; Zandi M^{3, 4} ; Ahmadi SE³ ; Zarandi B³ ; Hosseini Z⁴ ; Rezayat SA⁵ ; Abyadeh M⁶ ; Pakzad I^{7, 8} ; Malekifar P⁹ ; Pakzad R^{10, 11} ; Mozhgani S^{12, 13}
Source: Iranian Journal of Medical Sciences Published:2022

Abstract

Background: There are reports of ocular tropism due to respiratory viruses such as severe acute respiratory syndromecoronavirus-2 (SARS-CoV-2). Various studies have shown ocular manifestation in coronavirus disease-2019 (COVID-19) patients. We aimed to identify ophthalmic manifestations in COVID-19 patients and establish an association between ocular symptoms and SARS-CoV-2 infection. Methods:Asystematic search of Medline, Scopus, Web of Science, Embase, and Cochrane Library was conducted for publications from December 2019 to April 2021. The search included MeSH terms such as SARS-CoV-2 and ocular manifestations. The pooled prevalence estimate (PPE) with 95% confidence interval (CI) was calculated using binomial distribution and random effects. The meta-regression method was used to examine factors affecting heterogeneity between studies. Results: Of the 412 retrieved articles, 23 studies with a total of 3,650 COVID-19 patients were analyzed. The PPE for any ocular manifestations was 23.77% (95% CI: 15.73-31.81). The most prevalent symptom was dry eyes with a PPE of 13.66% (95% CI: 5.01-25.51). The PPE with 95% CI for conjunctival hyperemia, conjunctival congestion/conjunctivitis, and ocular pain was 13.41% (4.65-25.51), 9.14% (6.13-12.15), and 10.34% (4.90-15.78), respectively. Only two studies reported ocular discomfort and diplopia. The results of meta-regression analysis showed that age and sample size had no significant effect on the prevalence of any ocular manifestations. There was no significant publication bias in our meta-analysis. Conclusion: There is a high prevalence of ocular manifestations in COVID-19 patients. The most common symptoms are dry eyes, conjunctival hyperemia, conjunctival congestion/ conjunctivitis, ocular pain, irritation/itching/burning sensation, and foreign body sensation. © 2022, Shriaz University of Medical Sciences. All rights reserved.