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Coronavirus disease 2019 (SARS-CoV-2) and colonization of ocular tissues and secretions: a systematic review.
Eye (Lond). 2020 Jul; 34(7):1206-1211.E

Abstract

Coronavirus disease 19 (COVID-19) has been described to potentially be complicated by ocular involvement. However, scant information is available regarding severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and ocular structures tropism. We conducted a systematic review of articles referenced in PubMed, Cochrane Library, Web of Science and Chinese Clinical Trial Register (ChiCTR) from December 20, 2019 to April 6, 2020, providing information on the presence of SARS-CoV-2 in cornea, conjunctiva, lacrimal sac, and tears. We excluded ongoing clinical studies as for unobtainable conclusive results. Of 2422 articles, 11 met the inclusion criteria for analysis and were included in the study. None of the studies were multinational. Among the 11 selected papers there were three original articles, one review, four letters, two editorials, and one correspondence letter. Globally, 252 SARS-CoV-2 infected patients were included in our review. The prevalence of ocular conjunctivitis complicating the course of COVID-19 was demonstrated to be as high as 32% in one study only. Globally, three patients had conjunctivitis with a positive tear-PCR, 8 patients had positive tear-PCR in the absence of conjunctivitis, and 14 had conjunctivitis with negative tear-PCR. The majority of the available data regarding SARS-CoV-2 colonization of ocular and periocular tissues and secretions have to be considered controversial. However, it cannot be excluded that SARS-CoV-2 could both infect the eye and the surrounding structures. SARS-CoV-2 may use ocular structure as an additional transmission route, as demonstrated by the COVID-19 patients' conjunctival secretion and tears positivity to reverse transcriptase-PCR SARS-CoV-2-RNA assay.

Authors+Show Affiliations

Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy. francescoaiello@hotmail.com.Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.Moorfields Eye Hospital NHS Foundation Trust, London, UK.Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

32424327

Citation

Aiello, Francesco, et al. "Coronavirus Disease 2019 (SARS-CoV-2) and Colonization of Ocular Tissues and Secretions: a Systematic Review." Eye (London, England), vol. 34, no. 7, 2020, pp. 1206-1211.
Aiello F, Gallo Afflitto G, Mancino R, et al. Coronavirus disease 2019 (SARS-CoV-2) and colonization of ocular tissues and secretions: a systematic review. Eye (Lond). 2020;34(7):1206-1211.
Aiello, F., Gallo Afflitto, G., Mancino, R., Li, J. O., Cesareo, M., Giannini, C., & Nucci, C. (2020). Coronavirus disease 2019 (SARS-CoV-2) and colonization of ocular tissues and secretions: a systematic review. Eye (London, England), 34(7), 1206-1211. https://doi.org/10.1038/s41433-020-0926-9
Aiello F, et al. Coronavirus Disease 2019 (SARS-CoV-2) and Colonization of Ocular Tissues and Secretions: a Systematic Review. Eye (Lond). 2020;34(7):1206-1211. PubMed PMID: 32424327.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coronavirus disease 2019 (SARS-CoV-2) and colonization of ocular tissues and secretions: a systematic review. AU - Aiello,Francesco, AU - Gallo Afflitto,Gabriele, AU - Mancino,Raffaele, AU - Li,Ji-Peng Olivia, AU - Cesareo,Massimo, AU - Giannini,Clarissa, AU - Nucci,Carlo, Y1 - 2020/05/18/ PY - 2020/04/06/received PY - 2020/04/22/accepted PY - 2020/04/16/revised PY - 2020/5/20/pubmed PY - 2020/7/4/medline PY - 2020/5/20/entrez SP - 1206 EP - 1211 JF - Eye (London, England) JO - Eye (Lond) VL - 34 IS - 7 N2 - Coronavirus disease 19 (COVID-19) has been described to potentially be complicated by ocular involvement. However, scant information is available regarding severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and ocular structures tropism. We conducted a systematic review of articles referenced in PubMed, Cochrane Library, Web of Science and Chinese Clinical Trial Register (ChiCTR) from December 20, 2019 to April 6, 2020, providing information on the presence of SARS-CoV-2 in cornea, conjunctiva, lacrimal sac, and tears. We excluded ongoing clinical studies as for unobtainable conclusive results. Of 2422 articles, 11 met the inclusion criteria for analysis and were included in the study. None of the studies were multinational. Among the 11 selected papers there were three original articles, one review, four letters, two editorials, and one correspondence letter. Globally, 252 SARS-CoV-2 infected patients were included in our review. The prevalence of ocular conjunctivitis complicating the course of COVID-19 was demonstrated to be as high as 32% in one study only. Globally, three patients had conjunctivitis with a positive tear-PCR, 8 patients had positive tear-PCR in the absence of conjunctivitis, and 14 had conjunctivitis with negative tear-PCR. The majority of the available data regarding SARS-CoV-2 colonization of ocular and periocular tissues and secretions have to be considered controversial. However, it cannot be excluded that SARS-CoV-2 could both infect the eye and the surrounding structures. SARS-CoV-2 may use ocular structure as an additional transmission route, as demonstrated by the COVID-19 patients' conjunctival secretion and tears positivity to reverse transcriptase-PCR SARS-CoV-2-RNA assay. SN - 1476-5454 UR - https://www.unboundmedicine.com/medline/citation/32424327/Coronavirus_disease_2019__SARS_CoV_2__and_colonization_of_ocular_tissues_and_secretions:_a_systematic_review_ L2 - http://dx.doi.org/10.1038/s41433-020-0926-9 DB - PRIME DP - Unbound Medicine ER -