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Acute and sub-acute ocular manifestations in pediatric patients with COVID-19: A systematic review

Sedigheh Madani1

  • 1Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Medical Hypothesis, Discovery & Innovation Ophthalmology Journal
|August 29, 2023
PubMed

Insights

Ocular manifestations are uncommon in acute COVID-19 but frequent in MIS-C. Conjunctivitis, often non-purulent, is the primary sign in pediatric MIS-C, requiring vigilant detection by healthcare providers.

Area of Science:

  • Ophthalmology
  • Pediatrics
  • Infectious Diseases

Background:

  • The COVID-19 pandemic presents significant health challenges.
  • Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of COVID-19.
  • Ocular manifestations can be an early indicator of MIS-C, necessitating prompt diagnosis and treatment.

Purpose of the Study:

  • To systematically review and summarize acute and sub-acute ocular manifestations in pediatric patients with laboratory-confirmed COVID-19.
  • To identify the prevalence and types of ocular symptoms associated with COVID-19 and MIS-C in children.

Main Methods:

  • Systematic review of online primary studies published between January 1, 2019, and November 18, 2020.
  • Searched PubMed/MEDLINE using comprehensive ophthalmologic and COVID-19-related terms.
  • Included studies with no language restriction; eligibility and quality assessed by two independent reviewers.

Main Results:

  • Of 463 pediatric patients with acute COVID-19, 15.5% exhibited acute ocular manifestations, including rare cases of retinal vein occlusion and photophobia with meningoencephalitis.
  • Among 895 pediatric patients with MIS-C, 52.4% had ocular manifestations, predominantly non-purulent conjunctivitis.

Conclusions:

  • Ocular symptoms are present in less than one-fifth of pediatric COVID-19 cases.
  • Non-purulent conjunctivitis is the sole ocular finding in half of MIS-C patients and may be easily overlooked.
  • Healthcare providers must maintain vigilance for early detection of MIS-C in pediatric patients during the COVID-19 pandemic.
Abstract

Keywords:
COVID-19SARS-CoV-2childrenconjunctivitiscoronavirus disease 2019multisystem inflammatory syndromepandemicpediatriciansevere acute respiratory syndrome coronavirus 2

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