The Prevalence of ocular manifestations and ocular samples polymerase chain reaction positivity in patients with COVID 19 - a systematic review and meta-analysis

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Abstract

Objective

To estimate the prevalence of ocular manifestations and ocular samples polymerase chain reaction (PCR) positivity among COVID-19 patients.

Methods

A systematic literature review was performed using search engines (PubMed, Google Scholar, Medrixv and BioRixv) with keywords “SARS-CoV-2”, “novel coronavirus”, “COVID-19”, “ocular manifestations”, “conjunctival congestion”, “Ocular detection”, “Polymerase chain reaction”, and “conjunctivitis”. The measure of heterogeneity was evaluated with the I 2 statistic. The pooled proportion of patients presenting with symptoms and ocular samples PCR positivity was estimated.

Results

A total of 20 studies (14 studies and 6 case-reports) were included in the systematic review and 14 studies were included in the meta-analysis. The pooled prevalence of conjunctivitis was 5.17% (95% CI: 2.90-8.04). Conjunctivitis was reported as an initial symptom of the disease in 0.858 % (95% CI: 0.31-1.67). Common associated features include itching, chemosis, epiphora. Seven patients (29 %) with conjunctivitis showed positive results in ocular samples, whereas 13 patients (54%) showed positive only in their nasopharyngeal samples (NPs) or sputum samples and 4 patients (16 %) were negative for both NPs and Sputum as well as ocular samples. The pooled prevalence of ocular PCR positivity was 2.90 % (95% CI: 1.77 – 4.46) vs. NPs 89.8% (95% CI: 78.80-79.0).

Conclusion

The prevalence of conjunctivitis and ocular samples PCR positivity among COVID-19 patients was low indicating that the eye is a less affected organ. However, conjunctivitis may present as the first symptom of the disease making the patient seek medical care at the earliest.

Synopsis

Viral conjunctivitis was the only symptom reported. The prevalence of conjunctivitis and ocular samples polymerase chain reaction positivity among COVID-19 patients was low indicating the eye is a less effected organ.

Article activity feed

  1. SciScore for 10.1101/2020.06.29.20142414: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Literature search strategy, screening and data extraction: A comprehensive literature search was performed using four search engines PubMed
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    , Google scholar, BioRixv and Medrixv till 10th June 2020.
    Google scholar
    suggested: (Google Scholar, RRID:SCR_008878)
    The keywords used for the literature search were “SARS-CoV-2”, “novel coronavirus”, “COVID-19”, “ocular manifestations”, “conjunctival congestion”, “Ocular detection”, “Polymerase …