Manifestations of Ocular Surface Diseases in Patients with Laboratory-Confirmed COVID-19: A Systematic Review and Meta-Analysis

The epidemiology of ocular manifestations and associated complications in patients with Corona Virus Disease 2019 (COVID-19) have been investigated worldwide. Herein, we aimed to summarize the frequency of ocular symptoms of COVID-19 in the current systematic review and meta-analysis using available literature.

A search of PubMed, Scopus, Web of Science, EBSCO, and Embase electronic databases to review the systematic literature until August 2021. The Hoy et al., 2012 tool was used to evaluate the quality of studies. For Data extraction, two reviewers blind and independently extracted data from the abstract and full text of the studies included. 95% confidence interval for effect size with random effect model and restricted maximum likelihood (REML) method were calculated. Meta-analysis was performed using Stata/MP v.16 software (The fastest version of Stata).

Initially, 210 studies were retrieved, of which we reviewed the full text of 24 records, and eight were selected for final meta-analysis. The prevalence of redness in patients with COVID-19 was 12.37% (ES, 95% CI -1.11%, 25.85%), and heterogeneity was found (I2 = 99.37%; p <0.001) (High heterogeneity). The prevalence of Ocular manifestations as the first symptom of COVID-19 in patients was 2.63% (ES, 95% CI 1.23%, 4.03%).

This systematic review and meta-analysis found the prevalence of redness, dryness, ocular pain, foreign body sensation, discharge, itching, follicular conjunctivitis, and watering as 12.37%, 26.70%, 30.64%, 14.47%, 19.93%, 8.77%, 12.77%, and 10.23%, respectively.