Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.
Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Eye (Lond). 2020 Jul;34(7):1206-1211. doi: 10.1038/s41433-020-0926-9. Epub 2020 May 18.
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.
新型冠状病毒病（COVID-19）已被描述为可能伴有眼部受累。然而，关于严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）和眼结构嗜性的信息很少。我们对 2019 年 12 月 20 日至 2020 年 4 月 6 日在 PubMed、Cochrane 图书馆、Web of Science 和中国临床试验注册中心（ChiCTR）中引用的文章进行了系统评价，提供了有关 SARS-CoV-2 在角膜、结膜、泪囊和眼泪中存在的信息。我们排除了正在进行的临床研究，因为它们没有得出明确的结论。在 2422 篇文章中，有 11 篇符合分析纳入标准，并被纳入研究。没有一项研究是跨国研究。在所选择的 11 篇论文中，有 3 篇原始文章、1 篇综述、4 篇信件、2 篇社论和 1 篇通信信。在全球范围内，共有 252 例 SARS-CoV-2 感染患者纳入我们的综述。只有一项研究表明，COVID-19 病程中并发眼部结膜炎的患病率高达 32%。在全球范围内，有 3 例结膜炎患者的泪液 PCR 呈阳性，8 例无结膜炎患者的泪液 PCR 呈阳性，14 例结膜炎患者的泪液 PCR 呈阴性。关于 SARS-CoV-2 对眼部和眼周组织和分泌物的定植的大多数现有数据仍存在争议。然而，不能排除 SARS-CoV-2 可能同时感染眼睛和周围结构。SARS-CoV-2 可能将眼部结构作为额外的传播途径，因为 COVID-19 患者的结膜分泌物和眼泪对逆转录酶聚合酶链反应 SARS-CoV-2-RNA 检测呈阳性。
