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Faubert A, Bohsina R, You E, Hébert M, Griffith M, Aubin MJ. Diagnostic Accuracy of Conjunctival Rt-Pcr in Sars-Cov-2: A Systematic Review and Diagnostic Accuracy Meta-Analysis. Ocul Immunol Inflamm 2024:1-12. [PMID: 38687292 DOI: 10.1080/09273948.2023.2272200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/13/2023] [Indexed: 05/02/2024]
Abstract
PURPOSE To study the positivity rate of conjunctival realtime polymerase chain reaction (RT-PCR) testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). DESIGN Systematic review and diagnostic accuracy meta-analysis. METHODS MEDLINE and EMBASE were queried using medical subject headings terms. Diagnostic accuracy meta-analyses and forest plots were obtained using the RevMan software. RESULTS After deduplication, appraisal of abstract titles and full-text analysis of 1441 articles, 42 articles with 3351 COVID-19 patients were included in this review. Of these, 412 conjunctival swabs/Schirmer paper strips tested positive for SARS-CoV-2 by RT-PCR. The pooled sensitivity of the RT-PCR tests across the 24 studies with laboratory-confirmed COVID-19 patients was 10.3%. CONCLUSIONS Only 1 in 10 RT-PCR tests performed on conjunctival swabs were positive for SARS-CoV-2. Although this suggests that SARS-CoV-2 is likely present and detectable in the conjunctiva, this detection method has low diagnostic potential.
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Affiliation(s)
- A Faubert
- University Ophthalmology Center, Maisonneuve-Rosemont Hospital (HMR), Canada
| | - R Bohsina
- University Ophthalmology Center, Maisonneuve-Rosemont Hospital (HMR), Canada
| | - E You
- University Ophthalmology Center, Maisonneuve-Rosemont Hospital (HMR), Canada
| | - M Hébert
- University Ophthalmology Center, Maisonneuve-Rosemont Hospital (HMR), Canada
| | - M Griffith
- University Ophthalmology Center, Maisonneuve-Rosemont Hospital (HMR), Canada
| | - M J Aubin
- University Ophthalmology Center, Maisonneuve-Rosemont Hospital (HMR), Canada
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Marzoog BA. Manifestations of coronavirus infection disease-19 in anterior eye segment: An up-to-date review. Oman J Ophthalmol 2024; 17:4-10. [PMID: 38524336 PMCID: PMC10957037 DOI: 10.4103/ojo.ojo_237_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/25/2023] [Indexed: 03/26/2024] Open
Abstract
Coronavirus infection disease-19 (COVID-19) is a worldwide catastrophic emergency that first appeared in late 2019, in Wuhan, China. COVID-19 is a multitropism disease that first affects lung tissue. However, extrapulmonary manifestations have been suspected from the first COVID-19 cases. The ocular signs and symptoms were from the early changes that occur during the course of the disease. Changes in the anterior eye segment have a relatively higher incidence than the posterior eye segment. Of which, conjunctivitis, COVID-19 pharyngioceratoconjuctivitis, iridocyclitis, corneal punctate epitheliopathy, and pathomorphological changes in the physio-anatomy of the anterior eye segment. The potential pathogenesis includes direct penetration of the virus into the eye (conjunctiva, lumbus, and cornea) or due to a systemic pathway through viremia, as well as due to autoimmune antibodies against the ocular structure (immune privilege). The presence of ocular manifestations of the external anterior fibrous layer suggests a mild course of the disease.
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Affiliation(s)
- Basheer Abdullah Marzoog
- World-Class Research Center, Digital Biodesign and Personalized Healthcare, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Tran E, Phu V, Xu R, Teoderascu A, Aly M, Shah N, Malvankar-Mehta MS. Ocular manifestations of COVID-19: systematic review and meta-analysis. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023:S0008-4182(23)00248-X. [PMID: 37683691 DOI: 10.1016/j.jcjo.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/30/2023] [Accepted: 08/11/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE Our study aims to build on our understanding of COVID-19 by detailing a comprehensive look at the prevalence of different ocular manifestations related to COVID-19 infection. DESIGN Systematic review and meta-analysis. METHODS Eligible studies published between June 20, 2021, and May 11, 2023, were retrieved from the MEDLINE, EMBASE, and CINAHL databases as well as grey literature. Covidence was used to conduct the systematic review. Duplicate records were removed, and 2 independent reviewers screened records for relevance. After screening, a risk-of-bias assessment was carried out. Data were extracted, and a meta-analysis was performed using STATA 14.0. Fixed-effects and random-effects models were computed based on heterogeneity. RESULTS Our meta-analysis included 43 articles with a total of 10,572 subjects. The results showed that COVID-19 patients had a significantly higher prevalence of conjunctivitis (effect size [ES] = 0.11; 95% CI, 0.07-0.15), ptosis (ES = 0.22; 95% CI, 0.15-0.30), and ophthalmoplegia (ES = 0.40; 95% CI, 0.06-0.74). Our results also indicate that COVID-19 patients have higher prevalence of cotton wool spots (ES = 0.06; 95% CI, 0.03-0.09), retinal hemorrhages (ES = 0.12; 95% CI, 0.06-0.18), and retinal vein tortuosity (ES = 0.19; 95% CI, 0.09-0.35). CONCLUSION COVID-19 can exhibit extrapulmonary manifestations, affecting both the anterior and posterior segments of the eye. Common anterior-segment findings include conjunctivitis, whereas posterior-segment findings may include cotton wool spots, retinal hemorrhages, and retinal vein tortuosity. Improving our understanding of the ocular manifestations of COVID-19 has the potential to facilitate quicker diagnosis and subsequent treatment.
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Affiliation(s)
- Edward Tran
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Vivian Phu
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Riley Xu
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Angela Teoderascu
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Mohamed Aly
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Nirmit Shah
- Melbourne Medical School, University of Melbourne, Parkville, Australia
| | - Monali S Malvankar-Mehta
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON.
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Susiyanti M, Daniel H, Faridah D, Devona DA, Pramitha P, Bela B, Haryanto B, Barliana JD, Estu D, Victor AA, Putri ND, Candra J, Sutandi N, Sitorus RS. Incidence and clinical characteristic of ocular surface manifestation: an evaluation of conjunctival swab results in Corona Virus 2019 (COVID-19) patients in Jakarta, Indonesia. J Ophthalmic Inflamm Infect 2023; 13:20. [PMID: 37097586 PMCID: PMC10127182 DOI: 10.1186/s12348-023-00343-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/07/2023] [Indexed: 04/26/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the spectrum of ocular characteristics and viral presence in the conjunctival swab of patients with COVID-19. METHODS In this cross-sectional study, fifty-three patients were recruited from two COVID-19 referral hospitals in Jakarta (Cipto Mangunkusumo Hospital and Persahabatan Hospital) from July 2020 to March 2021. The inclusion criteria were patients who were suspected of or confirmed cases of COVID-19 with or without ocular symptoms. Demographic data, history of COVID-19 exposure, underlying medical condition, systemic symptoms, ocular symptoms, supporting laboratory results, reverse-transcriptase polymerase chain reaction (RT-PCR) of naso-oropharyngeal (NOP) swab and conjunctival swab were collected. RESULTS Fifty-three patients who were suspected, probable or confirmed cases of Covid-19 were included. Forty-six out of 53 patients (86.79%) tested positive for either Covid-19 antibody rapid test or naso-oropharyngeal (NOP) swab. Forty-two patients tested positive for NOP swab. Fourteen out of 42 patients (33.33%) experienced symptoms of ocular infection including red eye, epiphora, itchy eyes, and eye discharge. None of these patients were tested positive for conjunctival swab. Two out of 42 patients (4.76%), who were tested positive for conjunctival swab, did not experience any ocular symptoms. CONCLUSIONS Establishing the relationship between Covid-19 infection, ocular symptoms, and presence of SARS-CoV-2 virus on the ocular surface proves to be challenging. In Covid-19 patients, ocular symptoms did not warrant a positive conjunctival swab result. On the contrary, a patient without ocular symptoms can also have detectable presence of SARS-CoV-2 virus on the ocular surface.
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Affiliation(s)
- Made Susiyanti
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Hisar Daniel
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Diah Faridah
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Dinda Arken Devona
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Pradnya Pramitha
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Budiman Bela
- Department of Clinical Microbiology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Budi Haryanto
- Department of Clinical Microbiology, Faculty of Medicine Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Julie Dewi Barliana
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Dian Estu
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Andi Arus Victor
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Nina Dwi Putri
- Department of Child Health, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Julius Candra
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Nathania Sutandi
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia
| | - Rita S Sitorus
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jalan Kimia No. 8-10, Jakarta, 10320, Indonesia.
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R. Nayak R, Bhat S, R Kamath A, Chandak A, Khare K. Detection of SARS-CoV-2 in conjunctival secretion and tears in patients with COVID-19 in a tertiary care centre, South India. . F1000Res 2023; 11:1059. [PMID: 37012994 PMCID: PMC10066052 DOI: 10.12688/f1000research.123556.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 01/07/2023] Open
Abstract
Aims and objectives: Purpose of this study is to detect the presence of SAR-CoV-2 viral RNA in conjunctival secretions of COVID-19 patients and to compare the RT-PCR positivity rate for SARS-CoV-2 in conjunctival and nasopharyngeal swab. Materials and method: Eighty hospitalised COVID-19 patients whose nasopharyngeal swab tested positive for SARS-CoV-2 by RT-PCR were included in the study. Conjunctival swab was collected from eyes of these patients and sent for detection of SARS-CoV-2 by RT-PCR method. Results: Among the eighty patients, 51 (63.7%) were males and 29 (36.3%) were females. The mean age of the patients was 55.93 ± 16.59. Six patients had ocular manifestations. Eleven (13.75%) patients tested positive on conjunctival swab for SARS-CoV-2 viral RNA and only one of them had ocular manifestations out of the eleven. Conclusion: In our study the presence of SARS-CoV-2 in conjunctival secretions of COVID-19 patients was detected and this was not dependent on presence of ocular manifestations or duration of disease. Though the conjunctival positivity is lower compared to the nasopharyngeal swab sampling, ocular surface and secretions can be a potential route of viral transmission.
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Affiliation(s)
- Rajesh R. Nayak
- Department of Opthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Sevitha Bhat
- Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Ajay R Kamath
- Department of Opthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Anshul Chandak
- Department of Opthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Kanishk Khare
- Department of Opthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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R. Nayak R, Bhat S, R Kamath A, Chandak A, Khare K. Detection of SARS-CoV-2 in conjunctival secretion and tears in patients with COVID-19 in a tertiary care centre, South India. . F1000Res 2022; 11:1059. [PMID: 37012994 PMCID: PMC10066052 DOI: 10.12688/f1000research.123556.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 01/08/2023] Open
Abstract
Aims and objectives: Purpose of this study is to detect the presence of SAR-CoV-2 viral RNA in conjunctival secretions of COVID-19 patients and to compare the RT-PCR positivity rate for SARS-CoV-2 in conjunctival and nasopharyngeal swab. Materials and method: Eighty hospitalised COVID-19 patients whose nasopharyngeal swab tested positive for SARS-CoV-2 by RT-PCR were included in the study. Conjunctival swab was collected from eyes of these patients and sent for detection of SARS-CoV-2 by RT-PCR method. Results: Among the eighty patients, 51 (63.7%) were males and 29 (36.3%) were females. The mean age of the patients was 55.93 ± 16.59. Six patients had ocular manifestations. Eleven (13.75%) patients tested positive on conjunctival swab for SARS-CoV-2 viral RNA and only one of them had ocular manifestations out of the eleven. Conclusion: In our study the presence of SARS-CoV-2 in conjunctival secretions of COVID-19 patients was detected and this was not dependent on presence of ocular manifestations or duration of disease. Though the conjunctival positivity is lower compared to the nasopharyngeal swab sampling, ocular surface and secretions can be a potential route of viral transmission.
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Affiliation(s)
- Rajesh R. Nayak
- Department of Opthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Sevitha Bhat
- Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Ajay R Kamath
- Department of Opthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Anshul Chandak
- Department of Opthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Kanishk Khare
- Department of Opthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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