OBJECTIVES: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has had far-reaching health consequences, triggering off a chain of events involving multiple organs. The second wave of COVID-19 was worst in India and severely affected the people. We aimed to analyse the complications of COVID-19 on cardiovascular, neurological, and ocular system in Indian patients.

METHODS: The search was conducted in Embase platform using well-defined search strategy to identify studies reporting the complications of COVID-19 in Indian patients from inception of the database to 07 June 2022. Narrative/systematic reviews were excluded.

RESULTS: A total of 1400 citations were retrieved; 38 studies met the inclusion criteria and included in analysis. Included studies were mostly case reports (n=28), retrospective observational (n=5), and prospective observational (n=5) studies. Patients were adults in most studies (97%). Eighteen studies reported ocular complications, with blurred vision, conjunctivitis, endophthalmitis reported by 16.6% of patients each, followed by loss of vision (11.1%). Case reports mentioned retinal vein occlusion, retinal artery occlusion, hyperemia, bilateral panuveitis, ophthalmoplegia, acute bilateral retrobulbar optic neuritis. Thirteen studies reported neurological complications, with headache (38%) being the most common complication, followed by fatigue, seizure and encephalitis (23% each). Case reports described complications such as confusion, depression, anxiety, psychosis, encephalopathy, polyradiculoneuropathy, facial palsy, global aphasia, acute cerebellitis, stroke, cerebral ataxia. Ten studies reported cardiovascular complications, and tachycardia (50%) was the most commonly reported complication, followed by acute coronary syndrome, cardiac injury, and bradycardia (20% each). Case reports mentioned hypertension, ischemic heart disease, pericardial effusion, cardiac tamponade, and congenital heart block as the cardiovascular complications.

CONCLUSIONS:

This review identified COVID-19 has caused significant complications on the ocular system, followed by neurological and cardiovascular organ system. Identification and reporting of these manifestations of SARS-CoV-2 will help in formulating the guidelines and protocol for early diagnosis and management.