Ocular involvement in coronavirus disease 2019 (COVID-19): a clinical and molecular analysis

Shemer, Asaf; Einan‐Lifshitz, Adi; Itah, Amir; Dubinsky‐Pertzov, Biana; Pras, Eran; Hecht, Idan

doi:10.1007/s10792-020-01592-1

Cited by 28 publications

(33 citation statements)

References 20 publications

(27 reference statements)

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“…Most of the studies were official recommendations of ophthalmological societies for precaution and prevention of SARS-CoV-2 infection or studies on the impact of COVID-19 outbreak on eye care. Currently, the presence and prevalence of ocular manifestations in SARS-CoV-2 infection, consistent with conjunctivitis and including conjunctival hyperemia, chemosis, epiphora, or increased secretions, are still controversial (92)(93)(94)(95). Despite it was reported that only a small percentage (from about 1 to 6%) of SARS-CoV-2 positive patients developed signs of conjunctivitis, other studies showed that up to 31% of SARS-CoV-2 hospitalized patients presented conjunctivitis (96)(97)(98)(99).…”

Section: Eyesmentioning

confidence: 99%

Body Localization of ACE-2: On the Trail of the Keyhole of SARS-CoV-2

et al. 2020

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The explosion of the new coronavirus (SARS-CoV-2) pandemic has brought the role of the angiotensin converting enzyme 2 (ACE2) back into the scientific limelight. Since SARS-CoV-2 must bind the ACE2 for entering the host cells in humans, its expression and body localization are critical to track the potential target organ of this infection and to outline disease progression and clinical outcomes. Here, we mapped the physiological body distribution, expression, and activities of ACE2 and discussed its potential correlations and mutal interactions with the disparate symptoms present in SARS-CoV-2 patients at the level of different organs. We highlighted that despite during SARS-CoV-2 infection ACE2-expressing organs may become direct targets, leading to severe pathological manifestations, and subsequent multiple organ failures, the exact mechanism and the potential interactions through which ACE2 acts in these organs is still heavily debated. Further scientific efforts, also considering a personalized approach aimed to consider specific patient differences in the mutual interactions ACE2-SARS-CoV-2 and the long-term health effects associated with COVID-19 are currently mandatory.

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Section: Eyesmentioning

confidence: 99%

Body Localization of ACE-2: On the Trail of the Keyhole of SARS-CoV-2

et al. 2020

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“…Another issue worth exploring is the inconsistent results of the ocular surface RT-PCR among different studies. Four studies conducted by Seah, Meduri, Pirraglia, and Shemer revealed zero positive rates [ 8 , 31 , 34 , 38 ]. However, 21 (55.3%) out of 38 COVID-19 patients in Hanege's study had positive RT-PCT results in conjunctival swabs [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Manifestations and Virus Detection in the Ocular Surface of Adult COVID-19 Patients: A Meta-Analysis

Chen

Yen

Huang

et al. 2021

Journal of Ophthalmology

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Purpose. This study aims to examine the prevalence rate of ocular manifestations and the positive rate for the real-time reverse transcriptase-polymerase chain reaction (RT-PCR) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in conjunctival/tear swabs among adult patients with coronavirus disease 2019 (COVID-19). Methods. PubMed and EMBASE were reviewed between December 1, 2019, and January 31, 2021, and only peer-reviewed clinical studies in our pooled analyses were included. Details regarding the patient numbers, demographics, ocular manifestations, positivity of ocular surface RT-PCR, and severity of pneumonia were recorded from each study. Primary outcomes were the occurrence of ocular manifestations and virus detection on the ocular surface. Meanwhile, secondary outcomes included frequencies of various ocular symptoms/signs (s/s), the proportion of patients with ocular manifestation as the initial symptom, and the relationship between the severity of pneumonia and the presentation of ocular manifestations. Results. In total, 35 studies with 4,432 adult COVID-19 patients were included in this analysis. The overall prevalence rate of ocular manifestations was found to be 11.3%, and the positive rate of SARS-CoV-2 in the ocular surface was 7.4%. The four most common ocular s/s were follicular conjunctivitis, redness, watering, and discharge. A proportion of 3.3% presented with ocular s/s preceding other findings. Besides, patients with higher severity of pneumonia were more likely to have ocular manifestations (odds ratio = 2.25; 95% confidence interval (CI): 1.45–3.50). Conclusion. As per our findings, it was determined that ocular transmission of SARS-CoV-2 might be possible, highlighting the importance of eye protective equipment among healthcare personnel.

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“…It should be noted that there is scant information on patients with severe form of the disease. Due to lack of possibility to perform ophthalmic examination on patients in serious condition staying in ICUs, they were excluded from most studies [ 35 ].…”

Section: Conjunctivitismentioning

confidence: 99%

SARS-CoV-2 and the Eyes: A Review of the Literature on Transmission, Detection, and Ocular Manifestations

Szczęśniak

Brydak-Godowska

2021

Med Sci Monit

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During the coronavirus disease 2019 (COVID-19) pandemic, numerous reports of ocular anomalies occurring in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have emerged. The most frequently reported pathology is conjunctivitis, which may be the first or only clinical manifestation of the disease. Involvement of SARS-CoV-2 in development of alterations in other ocular structures was suggested, including the cornea, the retina, and blood vessels. Possible mechanisms include direct activity of the viral agent, as well as systemic inflammatory response with accompanying thromboembolic complications. Genetic material of SARS-CoV-2 was detected in ocular secretions of infected individuals, including asymptomatic patients. Moreover, angiotensin-converting enzyme 2 (ACE2), a receptor protein used by the virus to enter the cell, has been found on the surface of various structures of the eye, which indicates a risk of transmission through ocular tissues. Therefore, it is crucial to use eye protection by medical professionals having contact with potentially infected patients. This paper is a review of the literature regarding ocular manifestations of SARS-CoV-2 infection and a summary of the current state of knowledge about possibility of transmission from an ophthalmology point of view. For data collection, a thorough PubMed search was performed, using the key words: “COVID ocular”, “COVID eye”, “SARS-CoV-2 ocular”, and “SARS-CoV-2 eye”. Conclusions: SARS-CoV-2 infection may manifest itself in various ocular conditions. Eye protection should not be neglected, as recent studies suggest the eye as a potential route of transmission. Further search for adequate safety measures in ophthalmology practice is required.

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Ocular involvement in coronavirus disease 2019 (COVID-19): a clinical and molecular analysis

Cited by 28 publications

References 20 publications

Body Localization of ACE-2: On the Trail of the Keyhole of SARS-CoV-2

Body Localization of ACE-2: On the Trail of the Keyhole of SARS-CoV-2

Manifestations and Virus Detection in the Ocular Surface of Adult COVID-19 Patients: A Meta-Analysis

SARS-CoV-2 and the Eyes: A Review of the Literature on Transmission, Detection, and Ocular Manifestations

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