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

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Introduction

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

          Methods

          The PubMed, EMBASE, Web of Science databases were searched from through June 2021. Studies that provided clinical characteristics and outcomes and reported on 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 to 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 conjunctival swabs implicates it as a potential source of infection. Early diagnosis and proper eye protection would help prevent viral transmission.

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)
          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor

            Markus Hoffmann, Hannah Kleine-Weber, Simon Schroeder … (2020)
            Summary The recent emergence of the novel, pathogenic SARS-coronavirus 2 (SARS-CoV-2) in China and its rapid national and international spread pose a global health emergency. Cell entry of coronaviruses depends on binding of the viral spike (S) proteins to cellular receptors and on S protein priming by host cell proteases. Unravelling which cellular factors are used by SARS-CoV-2 for entry might provide insights into viral transmission and reveal therapeutic targets. Here, we demonstrate that SARS-CoV-2 uses the SARS-CoV receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming. A TMPRSS2 inhibitor approved for clinical use blocked entry and might constitute a treatment option. Finally, we show that the sera from convalescent SARS patients cross-neutralized SARS-2-S-driven entry. Our results reveal important commonalities between SARS-CoV-2 and SARS-CoV infection and identify a potential target for antiviral intervention.
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              Bias in meta-analysis detected by a simple, graphical test

              Jos I. M. Egger, G D Smith, M. Schneider … (1997)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Travel Med Infect Dis
                Journal ID (iso-abbrev): Travel Med Infect Dis
                Title: Travel Medicine and Infectious Disease
                Publisher: Published by Elsevier Ltd.
                ISSN (Print): 1477-8939
                ISSN (Electronic): 1873-0442
                Publication date PMC-release: 8 November 2021
                Publication date (Electronic): 8 November 2021
                Electronic Location Identifier: 102191
                Affiliations
                [1]Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
                Author notes
                [∗ ]Corresponding author. Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou 310009, China.
                [1]

                Yueyang Zhong and Kai Wang contributed equally to this work.

                Article
                Publisher Item ID: S1477-8939(21)00232-5 Publisher ID: 102191
                DOI: 10.1016/j.tmaid.2021.102191
                PMC ID: 8574127
                PubMed ID: 34763068
                SO-VID: dc7c5e75-4959-4980-b55b-7ccae37782d7
                Copyright © © 2021 Published by Elsevier Ltd.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 2 September 2020
                Date revision received : 9 July 2021
                Date accepted : 26 October 2021
                Categories
                Subject: Article

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: covid-19,sars-cov-2,coronavirus,ocular manifestation,meta-analysis,ace2, angiotensin-converting enzyme 2,ahrq, agency for healthcare research and quality,covid-19, the 2019 novel coronavirus disease,or, odds ratio,rt-pcr, reverse transcription polymerase chain reaction,sars-cov-2, severe acute respiratory syndrome coronavirus 2,tmprss2, transmembrane protease serine 2
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: covid-19, sars-cov-2, coronavirus, ocular manifestation, meta-analysis, ace2, angiotensin-converting enzyme 2, ahrq, agency for healthcare research and quality, covid-19, the 2019 novel coronavirus disease, or, odds ratio, rt-pcr, reverse transcription polymerase chain reaction, sars-cov-2, severe acute respiratory syndrome coronavirus 2, tmprss2, transmembrane protease serine 2

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