Background The effect of eye protection to prevent SARS-CoV-2 infection in the real-world remains uncertain. We aimed to synthesize all available research on the potential impact of eye protection on transmission of SARS-CoV-2. Methods We searched PROSPERO, PubMed, Embase, The Cochrane Library for clinical trials and comparative observational studies in CENTRAL, and Europe PMC for pre-prints. We included studies that reported sufficient data to estimate the effect of any form of eye protection including face shields and variants, goggles, and glasses, on subsequent confirmed infection with SARS-CoV-2. Results We screened 898 articles and included 6 reports of 5 observational studies from 4 countries (USA, India, Columbia, and United Kingdom) that tested face shields, goggles, and wraparound eyewear on 7567 healthcare workers. The three before-and-after and one retrospective cohort studies showed statistically significant and substantial reductions in SARS-CoV-2 infections favouring eye protection with odds ratios ranging from 0.04 to 0.6, corresponding to relative risk reductions of 96% to 40%. These reductions were not explained by changes in the community rates. However, the one case–control study reported odds ratio favouring no eye protection (OR 1.7, 95% CI 0.99, 3.0). The high heterogeneity between studies precluded any meaningful meta-analysis. None of the studies adjusted for potential confounders such as other protective behaviours, thus increasing the risk of bias, and decreasing the certainty of evidence to very low. Conclusions Current studies suggest that eye protection may play a role in prevention of SARS-CoV-2 infection in healthcare workers. However, robust comparative trials are needed to clearly determine effectiveness of eye protections and wearability issues in both healthcare and general populations. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-021-01025-3.
【저자키워드】 COVID-19, SARS-CoV-2, Eye protection, Face shield, Infection prevention, 【초록키워드】 Meta-analysis, Europe, clinical trial, Healthcare workers, Trial, SARS-COV-2 infection, India, clinical trials, Relative risk, variants, heterogeneity, observational studies, observational study, healthcare, Risk of bias, Research, Effectiveness, Community, USA, United Kingdom, SARS-CoV-2 infections, Odds ratio, Protective behaviours, reduction, retrospective cohort study, Goggles, supplementary material, 95% CI, Odds ratios, certainty, Cochrane Library, substantial reductions, CENTRAL, article, risk reduction, transmission of SARS-CoV-2, glasses, populations, country, Prevent, confounder, current, robust, Result, tested, reported, subsequent, screened, adjusted, searched, determine, changes in, explained, statistically significant, certainty of evidence, comparative observational study, infection with SARS-CoV-2, PMC, precluded, remains uncertain, substantial reduction, 【제목키워드】 systematic review,