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Senthil R, Abirami, Sivanand N, Karthikeyan P. COVID-19 Infection During Pregnancy and Hearing Loss in Infants: A Clinical Study. Indian J Otolaryngol Head Neck Surg 2024; 76:2351-2354. [PMID: 38883448 PMCID: PMC11169122 DOI: 10.1007/s12070-024-04483-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/31/2023] [Indexed: 06/18/2024] Open
Abstract
Aims To find the prevalence of hearing loss in children born to mothers who had COVID-19 infection during pregnancy. Materials and Methods This was a prospective observational study conducted on 1960 babies born to mothers who were COVID positive during their pregnancy .All children born to RTPCR positive COVID-19 pregnant women were included in the study and babies who had any other risk factor for neonatal SNHL were excluded from the study. All the babies were subjected to OAE, and if it came pass, the test was repeated 2 weeks later. Those patients with repeat OAE also as refer were subjected to Brainstem Evoked Response Audiometry and findings correlated. Results The study included 1960 neonates who were subjected to neonatal hearing screening by OAE. There were 1020 males (52.04%) and 940(47.96%) females and 80 cases of consanguinity. Fifty babies were excluded due to comorbidities. In the initial OAE test 380 neonates failed (19.9%) following which BERA was done and ten patients was found to Sensorineural hearing loss. Conclusion The prevalence of hearing loss in our study on babies born to mothers with COVID-19 infection during pregnancy is 0.005. Although these primary results from our study does not indicate any immediate effect of SARS-COV-2 maternal infection on neonatal hearing. More children need to be tested and followed up over an extended period of time to detect any possible delayed auditory effects. Those patients who were identified to have hearing loss in our study will have to be on long term follow-up as we see long terms effects on cognition, memory, heart health, etc. in COVID survivors. Level of evidence Level 1.
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Affiliation(s)
- Rethesh Senthil
- Department of ENT, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pillaiyarkuppam, Pondicherry India
| | - Abirami
- Department of ENT, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pillaiyarkuppam, Pondicherry India
| | - Nikhil Sivanand
- Department of ENT, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pillaiyarkuppam, Pondicherry India
| | - Padmanabhan Karthikeyan
- Department of ENT, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pillaiyarkuppam, Pondicherry India
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Wang Q, Gu H, Ren J, Zhao Y, Meng Z. Analysis of characteristics of and risk factors for otological symptoms after COVID-19 infection. PLoS One 2024; 19:e0297100. [PMID: 38300969 PMCID: PMC10833509 DOI: 10.1371/journal.pone.0297100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/21/2023] [Indexed: 02/03/2024] Open
Abstract
The purpose of this study was to explore the characteristics of and risk factors for otological symptoms after contracting COVID-19. We invited 468 participants who had been infected with COVID-19 to participate in a survey. 310 (66.2%) were women and 158 (33.8%) were men. The mean age is 38.73 (12.21) years. The questionnaire included their basic information, symptoms and symptom duration after SARS-CoV-2 infection, number of vaccine doses received, and details regarding otological symptoms. In total, 106/468 (22.6%) participants experienced tinnitus, 66/468 (14.1%) hearing loss, 103/468 (22.0%) aural fullness, and 71/468 (15.2%) dizziness. Women were more prone to experience tinnitus (P = 0.022) and dizziness (P = 0.001) than men. The group with hearing loss were older (P = 0.025), and their initial COVID-19 symptoms lasted longer (P = 0.028) than those of patients without. Patients with aural fullness were more likely to experience fatigue than patients without (P = 0.002). Patients experiencing dizziness were more likely to experience pharyngalgia (P = 0.040) and fatigue (P = 0.005) than those without. The number of vaccine doses was positively associated with the resolution of otological symptoms (P = 0.035). Multiple logistic regression analysis revealed that sex was an independent risk factor for tinnitus (odds ratio [OR], 1.802; 95% confidence interval [CI], 1.099-2.953; P = 0.020), the duration of initial COVID-19 symptoms for hearing loss (OR, 1.055; 95% CI, 1.008-1.105; P = 0.023), and sex for dizziness (OR, 2.870; 95% CI, 1.489-5.535; P = 0.002). Sex, age, COVID-19-related fatigue, and the duration of initial COVID-19 symptoms may affect the occurrence of otological symptoms, and vaccines may aid their resolution.
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Affiliation(s)
- Qiang Wang
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Hailing Gu
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Jianjun Ren
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Zhao
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaoli Meng
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China
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Shibafar S, Jafarlou F. A review on the impacts of COVID-19 on the auditory system: Implications for public health promotion research. Health Promot Perspect 2023; 13:280-289. [PMID: 38235010 PMCID: PMC10790126 DOI: 10.34172/hpp.2023.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/26/2023] [Indexed: 01/19/2024] Open
Abstract
Background Currently, there are few studies on the relationship between COVID-19 and the auditory system. In the current study, a review of the studies conducted in the fields of etiopathology, clinical manifestations, research, and treatment of hearing loss caused byCOVID-19 was conducted, which can be used as a baseline for future studies. Methods We utilized the research approach suggested by Arksey and O'Malley to carry out this scoping review. Search was conducted in Farsi and English with a focus on the onset of hearing loss in patients with COVID-19 through Medline and PubMed, and Google Scholar search engine. Studies included were those involving adult patients diagnosed with COVID-19 who experienced hearing loss, ear pain, ear discharge, and otitis media. Studies were eligible for inclusion if there was a description of the otologic dysfunction, specifically onset, duration, or clinical outcomes. Results Among 90 studies identified, 35 studies were included in the review process. Our findings suggest several possible mechanisms for sudden sensorineural hearing loss (SSNHL) in COVID-19 patients, and COVID-19 infection could have deleterious effects on the inner ear, specifically on the hair cells of the cochlea despite patients being asymptomatic and early identification of SSNHL in COVID-19patients can save the hearing and also patient. Conclusion Hearing loss in COVID-19 infection has not received much attention by health care professionals. Sensorineural hearing loss (SNHL), tinnitus, and/or vertigo have been shown to occur during and following COVID-19 infection. Due to lack of research studies, and the inconsistency and even contradictory of the findings, it remains questionable whether COVID-19 contributes to the high incidence of hearing loss. The proper understanding of the mechanisms behind hearing loss in COVID-19 infections needs further research. However, it seems likely that SNHL could be included among the manifestations of those-called "long COVID" syndrome.
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Affiliation(s)
- Samin Shibafar
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Audiology, School of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Jafarlou
- Department of Audiology, School of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Arsović N, Jovanović M, Babac S, Čvorović L, Radivojević N, Arsović K. Cochlear Implantation in Patients with Bilateral Sudden Sensorineural Hearing Loss after COVID-19 Infection. J Pers Med 2023; 13:1708. [PMID: 38138935 PMCID: PMC10745051 DOI: 10.3390/jpm13121708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
COVID-19 infection is associated with a variety of neurological manifestations. Since the inner ear is vulnerable to viruses, sensorineural hearing loss (SNHL) has been reported to occur following SARS-CoV-2 infection. We present here two cases of profound SNHL following SARS-CoV-2 infection. Pure-tone audiograms confirmed profound SNHL. The tympanogram and Auditory Brainstem Responses showed no abnormal symptoms. MRIs and CTs identified some changes but no significant anatomical nor physiological manifestations explaining the obvious cause for hearing loss. High doses of oral corticosteroids with additional conservative therapy were given with no therapeutic response, and therefore, cochlear implant surgery was performed. One case was bilaterally treated, and the other one received an implantation on one side. Both surgeries were carried out without intra- nor postoperative complications. Interestingly, in both cases, advanced fibrotic tissue was found during surgery. Both cases reported successful rehabilitation and are satisfied with their new sound perception following cochlear implantation.
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Affiliation(s)
- Nenad Arsović
- Faculty of Medicine, University of Belgrade, 11000 Beograd, Serbia; (L.Č.); (N.R.); (M.J.)
- Institute for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, 11000 Beograd, Serbia
| | - Marija Jovanović
- Faculty of Medicine, University of Belgrade, 11000 Beograd, Serbia; (L.Č.); (N.R.); (M.J.)
- Centre for Radiology and MRI, MRI Depratment Neuroradiology, Clinical Centre of Serbia, 11000 Beograd, Serbia
| | - Snežana Babac
- Faculty of Special Education and Rehabilitation, University of Belgrade, 11000 Beograd, Serbia;
- ENT Clinic, Clinical and Hospital Centre ‘Zvezdara’, 11120 Beograd, Serbia
| | - Ljiljana Čvorović
- Faculty of Medicine, University of Belgrade, 11000 Beograd, Serbia; (L.Č.); (N.R.); (M.J.)
- Institute for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, 11000 Beograd, Serbia
| | - Nemanja Radivojević
- Faculty of Medicine, University of Belgrade, 11000 Beograd, Serbia; (L.Č.); (N.R.); (M.J.)
- Institute for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, 11000 Beograd, Serbia
| | - Konstantin Arsović
- Institute for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, 11000 Beograd, Serbia
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Damkier P, Cleary B, Hallas J, Schmidt JH, Ladebo L, Jensen PB, Lund LC. Sudden Sensorineural Hearing Loss Following Immunization With BNT162b2 or mRNA-1273: A Danish Population-Based Cohort Study. Otolaryngol Head Neck Surg 2023; 169:1472-1480. [PMID: 37288514 DOI: 10.1002/ohn.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/24/2023] [Accepted: 05/13/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To compare the occurrence of sudden sensorineural hearing loss following immunization with BNT162b2 (Comirnaty®; Pfizer BioNTech) or mRNA-1273 (Spikevax®; Moderna) to the occurrence among unvaccinated individuals. STUDY DESIGN Cohort study. SETTING Nationwide Danish health care registers comprised all Danish residents living in Denmark on October 1, 2020, who were 18 years or older or turned 18 in 2021. METHODS We compared the occurrence of sudden sensorineural hearing loss following immunization with BNT162b2 (Comirnaty®; Pfizer BioNTech) or mRNA-1273 (Spikevax®; Moderna) (first, second, or third dose) against unvaccinated person time. Secondary outcomes were a first-ever hospital diagnosis of vestibular neuritis and a hearing examination, by an ear-nose-throat (ENT) specialist, followed by a prescription of moderate to high-dose prednisolone. RESULTS BNT162b2 or mRNA-1273 vaccine was not associated with an increased risk of receiving a discharge diagnosis of sudden sensorineural hearing loss (adjusted hazard ratio [HR]: 0.99, confidence interval [CI]: 0.59-1.64) or vestibular neuritis (adjusted HR: 0.94, CI: 0.69-1.24). We found a slightly increased risk (adjusted HR: 1.40, CI, 1.08-1.81) of initiating moderate to high-dose oral prednisolone following a visit to an ENT specialist within 21 days from receiving a messenger RNA (mRNA)-based Covid-19 vaccine. CONCLUSION Our findings do not suggest an increased risk of sudden sensorineural hearing loss or vestibular neuritis following mRNA-based COVID-19 vaccination. mRNA-Covid-19 vaccination may be associated with a small excess risk of a visit to an ENT specialist visit followed by a prescription of moderate to high doses of prednisolone.
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Affiliation(s)
- Per Damkier
- Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Brian Cleary
- Pharmacy Department, Rotunda Hospital, Dublin, Ireland
- School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Jesper Hallas
- Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jesper H Schmidt
- Research Unit for ORL-Head and Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Louise Ladebo
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Peter B Jensen
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lars Christian Lund
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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Bhatt IS, Washnik NJ, Kingsbury S, Deshpande AK, Kingsbury H, Bhagavan SG, Michel K, Dias R, Torkamani A. Identifying Health-Related Conditions Associated with Tinnitus in Young Adults. Audiol Res 2023; 13:546-562. [PMID: 37489384 PMCID: PMC10366783 DOI: 10.3390/audiolres13040048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/10/2023] [Accepted: 07/06/2023] [Indexed: 07/26/2023] Open
Abstract
OBJECTIVE The present study investigated the epidemic of tinnitus in college-aged young adults. Our first objective was to identify health conditions associated with tinnitus in young adults. The second objective was to evaluate the predictive utility of some known risk factors. STUDY DESIGN A cross-sectional design was used to investigate the prevalence and risk factors for tinnitus. SETTING A questionnaire was distributed, reaching out to a large college-aged population. A total of 2258 young adults aged 18-30 years were recruited from April 2021 to February 2022. INTERVENTIONS A questionnaire was administered to investigate the epidemiology of tinnitus in a population of college-aged young adults. RESULTS About 17.7% of young adults reported bothersome tinnitus perception lasting for ≥5 min in the last 12 months. The prevalence of chronic tinnitus (bothersome tinnitus for ≥1 year) and acute tinnitus (bothersome tinnitus for <1 year) was 10.6% and 7.1%, respectively. About 19% of the study sample reported at least one health condition. Individuals reporting head injury, hypertension, heart disease, scarlet fever, and malaria showed significantly higher odds of reporting chronic tinnitus. Meningitis and self-reported hearing loss showed significant associations with bothersome tinnitus. The prevalence of chronic tinnitus was significantly higher in males reporting high noise exposure, a positive history of reoccurring ear infections, European ethnic background, and a positive health history. Risk modeling showed that noise exposure was the most important risk factor for chronic tinnitus, followed by sex, reoccurring ear infections, and a history of any health condition. A positive history of COVID-19 and self-reported severity showed no association with tinnitus. Individuals reporting reoccurring ear infections showed a significantly higher prevalence of COVID-19. CONCLUSIONS While young adults with health conditions are at a higher risk of reporting tinnitus, the predictive utility of a positive health history remains relatively low, possibly due to weak associations between health conditions and tinnitus. Noise, male sex, reoccurring ear infections, European ethnicity, and a positive health history revealed higher odds of reporting chronic tinnitus than their counterparts. These risk factors collectively explained about 16% variability in chronic tinnitus, which highlights the need for identifying other risk factors for chronic tinnitus in young adults.
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Affiliation(s)
- Ishan Sunilkumar Bhatt
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Nilesh J Washnik
- Department of Hearing Speech and Language Sciences, Ohio University, Athens, OH 45701, USA
| | - Sarah Kingsbury
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Aniruddha K Deshpande
- Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY 11549, USA
| | - Hailey Kingsbury
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Srividya Grama Bhagavan
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Klayre Michel
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Raquel Dias
- Department of Microbiology and Cell Science, University of Florida, Gainesville, FL 32603, USA
| | - Ali Torkamani
- Department of Integrative Structural and Computational Biology, Scripps Science Institute, La Jolla, CA 92037, USA
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Amoodi H, Abualross O, Meer N, Alharbi NA. Prevalence and Types of Otological Symptoms Presenting in COVID-19 Patients in Jeddah, Saudi Arabia: A Questionnaire-Based Study. Cureus 2023; 15:e42042. [PMID: 37593281 PMCID: PMC10431966 DOI: 10.7759/cureus.42042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
Background The clinical manifestations of coronavirus disease 2019 (COVID-19) can cause sensory dysfunction of taste, smell, and hearing. Otological symptoms may exceed hearing loss to ear pressure, tinnitus, and hyperacusis. Objective The objective of this study was to identify the prevalence and types of otological symptoms among patients diagnosed with COVID-19 in Jeddah, Saudi Arabia. Methods This is a cross-sectional study that was conducted among COVID-19 patients who have been diagnosed at Dr. Soliman Fakeeh Hospital (DSFH), Jeddah KSA, aged 18 years or older. The data collection was done through phone-call interviews utilizing an online form of a pre-structured questionnaire. The form included six otological symptoms; each symptom was further detailed with regard to duration, intensity, clinical course (continuous vs intermittent), and recovery. Results A total of 406 responses from patients diagnosed with COVID-19 were analyzed. Females represented 53.7% of the sample. The highest proportion of patients (30%) was in the age group of 31-40, followed by 22.9% in the age group of 25-30. The otological symptoms' prevalence rates were as follows: dizziness, vertigo, or imbalance 34.5%, ear pain 13.1%, tinnitus 12.1%, ear pressure 10%, hearing loss 6.4%, and hyperacusis 5.4%. Males had a higher prevalence of tinnitus, while females had higher reported symptoms of ear pain, hearing loss, and hyperacusis. Conclusion The most common otological symptoms were dizziness, vertigo, and imbalance among one-third of COVID-19 patients. Females reported higher rates of symptoms with ear pressure having significantly higher odds among females. Age groups were also significantly associated with ear pain, tinnitus, and ear pressure.
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Affiliation(s)
- Hosam Amoodi
- Department of Otolaryngology, Head and Neck Surgery, University of Jeddah, Jeddah, SAU
- Department of Otolaryngology, Head and Neck Surgery, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
| | | | - Nuha Meer
- Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
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Gibson K, Ling JCC, Peters M. Experience of sudden sensorineural hearing loss following a mild COVID-19 infection. BMJ Case Rep 2023; 16:16/4/e252899. [PMID: 37055075 PMCID: PMC10105996 DOI: 10.1136/bcr-2022-252899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023] Open
Abstract
A woman in her 30s was referred to an otolaryngologist with an acute onset of aural fullness, noise sensitivity, unilateral sudden onset hearing loss, vertigo and tinnitus. She had a confirmed COVID-19 infection 5 weeks prior. A pure tone audiogram confirmed sensorineural hearing loss. MRI identified an empty sella of the pituitary gland and without an obvious cause for hearing loss. Oral prednisolone and betahistine were prescribed, and her audiovestibular symptoms slowly improved over the subsequent months. The patient continues to experience intermittent tinnitus.
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Affiliation(s)
- Kim Gibson
- Rosemary Bryant AO Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Hawthorn, South Australia, Australia
| | - John C C Ling
- Specialists on Goodwood, Adelaide, South Australia, Australia
| | - Micah Peters
- Rosemary Bryant AO Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Is intrauterine exposure to COVID-19 infection a risk factor for infant hearing loss? Am J Otolaryngol 2023; 44:103859. [PMID: 36989751 PMCID: PMC10032117 DOI: 10.1016/j.amjoto.2023.103859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/19/2023] [Indexed: 03/24/2023]
Abstract
Purpose To determine whether exposure to intrauterine COVID-19 infection causes congenital or late-onset hearing loss in infants. Material and method The hearing screening results of infants born in a tertiary hospital between March 2020 and April 2022 with and without a history of intrauterine exposure to COVID-19 infection (36 infants each) were retrospectively analyzed within one month after birth in all infants and additionally at six months after intrauterine COVID-19 infection exposure in the study group. The automated auditory brainstem response (AABR) test was used for the hearing evaluation. Results The polymerase chain reaction test was negative in study group exposed to intrauterine COVID-19 infection. The number of infants admitted to the intensive care unit (ICU), and the length of ICU stay were significantly higher in this group (p < 0.01). Six infants (16.6 %) in the study group failed the first AABR test bilaterally, but five of these infants passed the second AABR test. A bilateral severe sensorineural hearing loss was detected in one infant (2.77 %). All the infants in the study group underwent the AABR test again at six months, and all infants, except this infant, passed the test. In the control group, five infants (13.88 %) failed the first AABR test bilaterally, but they all passed the second test. Conclusions Exposure to COVID-19 infection in the intrauterine period does not cause congenital or late-onset hearing loss (within six months) in infants; therefore, gestational COVID-19 infection is not a risk factor for infant hearing loss.
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Lan WL, Chen CH, Chu YC, Cheng YF, Huang CY. Is There an Association between Concurrent Epstein-Barr Virus Infection and Sudden Hearing Loss?-A Case-Control Study in an East Asian Population. J Clin Med 2023; 12:jcm12051946. [PMID: 36902736 PMCID: PMC10004397 DOI: 10.3390/jcm12051946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/12/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Viral infection serves as the crucial etiology for the development of sudden sensorineural hearing loss (SSNHL). We aimed to investigate whether there is an association between concurrent Epstein-Barr virus (EBV) infection and SSNHL in an East Asian population. Patients who were older than 18 years of age and met the criteria of sudden hearing loss without an identifiable etiology were enrolled from July 2021 until June 2022, followed by the serological testing of IgA antibody responses against EBV-specific early antigen (EA) and viral capsid antigen (VCA) with an indirect hemagglutination assay (IHA) and real-time quantitative polymerase chain reaction (qPCR) of EBV DNA in serum before the treatment was initiated. After the treatment for SSNHL, post-treatment audiometry was performed to record the treatment response and degree of recovery. Among the 29 patients included during enrollment, 3 (10.3%) had a positive qPCR result for EBV. In addition, a trend of poor recovery of hearing thresholds was noted for those patients with a higher viral PCR titer. This is the first study to use real-time PCR to detect possible concurrent EBV infection in SSNHL. Our study demonstrated that approximately one-tenth of the enrolled SSNHL patients had evidence of concurrent EBV infection, as reflected by the positive qPCR test results, and a negative trend between hearing gain and the viral DNA PCR level was found within the affected cohort after steroid therapy. These findings indicate a possible role for EBV infection in East Asian patients with SSNHL. Further larger-scale research is needed to better understand the potential role and underlying mechanism of viral infection in the etiology of SSNHL.
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Affiliation(s)
- Wei-Lun Lan
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Chih-Hao Chen
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Yuan-Chia Chu
- Information Management Office, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Medical AI Development Center, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Department of Information Management, National Taipei University of Nursing and Health, Taipei 112, Taiwan
| | - Yen-Fu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Chii-Yuan Huang
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Information Management Office, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Correspondence:
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11
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The Role of IL-6 in Inner Ear Impairment: Evidence from 146 Recovered Patients with Omicron Infected in Tianjin, China. J Clin Med 2023; 12:jcm12031114. [PMID: 36769761 PMCID: PMC9917594 DOI: 10.3390/jcm12031114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To explore the effect of inflammatory factors on inner ear impairment in a sample of Omicron-infected patients with a high rate of vaccination in China. METHODS One hundred and forty-six recovered Omicron-infected patients performed the distortion product otoacoustic emission (DPOAE) test and serum test for inflammatory factors; demographic data and vaccination statuses were collected from the questionnaire. RESULTS Out of 146 patients, the DPOAE pass rate was 81.5% (119/146). Inner ear impairment was significantly correlated with IL-6 titer. The odds ratio (aOR) was 1.24 (95% CI: 1.04-1.49) after adjusting for age, sex, and vaccine characteristics. Notably, this relationship only existed in the 18-60 years group. There were no significant protective effects of vaccination on inner ear function. CONCLUSIONS Inner ear impairment still exists in Omicron-infected patients, which was significantly correlated with IL-6 titer. This relationship was mainly observed in young and middle-aged people, possibly due to a stronger immune response in this age group. The protective effect of vaccination on the inner ear could not be proved.
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12
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Sinus, middle-ear and mastoid radiological findings of severe acute respiratory syndrome coronavirus-2. J Laryngol Otol 2023; 137:76-80. [PMID: 36263731 DOI: 10.1017/s0022215122002304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the incidence of radiological inflammation within the paranasal sinuses, middle ear and mastoid in patients with confirmed severe acute respiratory syndrome coronavirus-2. METHODS A retrospective cohort study was conducted to examine consecutive adults (aged over 18 years) with coronavirus disease 2019 (confirmed on polymerase chain reaction within 7 days of imaging) who underwent computed tomography of the head between 1 March 2020 and 24 June 2020. Lund-Mackay and mastoid and middle-ear opacification scores were used to categorise the extent of sinus and mastoid opacification on axial and coronal computed tomography images. RESULTS Of 147 patients originally identified, only 83 met the inclusion criteria. Sinus opacification was present in 51.8 per cent of patients (n = 43), and middle-ear or mastoid opacification was observed in 24.1 per cent (n = 20). There was no statistically significant difference in sinus or middle-ear and mastoid opacification between patients after stratification based on 30-day all-cause mortality. CONCLUSION Radiological computed tomography findings suggest mild mucosal disease within the sinuses, middle ear and mastoid. There was no statistical correlation between such opacification and 30-day mortality.
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13
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Cinar BC, Demirtas B, Can M, Yesil IE, Bajin MD. Cochlear Function in Adults Exposed to Severe Acute Respiratory Syndrome Coronavirus 2. Audiol Neurootol 2022:1-6. [PMID: 36516739 PMCID: PMC9843727 DOI: 10.1159/000527811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 10/10/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a viral infection with a wide variety of symptoms, including fever, coughing, sneezing, fatigue, and a loss of taste and smell. Moreover, there are some recent studies that investigate the effects of SARS-CoV-2 on hearing and auditory performance. With this current study, we investigate the early effects of the coronavirus disease on hair cells in the cochlea. METHODS In the current study, there were 25 subjects (17 females, 8 males) who tested positive for polymerase chain reaction on nasopharyngeal swabs. They had reported normal auditory functions and no history of otology before SARS-CoV-2. To determine auditory functions, pure-tone audiometry, otoacoustic emissions (OAE) tests, and threshold equalizing noise (TEN) tests were used. RESULTS Although the hearing thresholds increased at higher frequencies, they were within normal limits according to four-frequency pure-tone averages. All participants had normal OAE, and there were no detected dead regions for any of the subjects. Even so, there were significant increases in hearing thresholds in TEN. CONCLUSION There is no cochlear dysfunction discovered by OAE and TEN in SARS-CoV-2-affected individuals. Nonetheless, the increase in hearing thresholds at higher frequencies, other than the pure-tone average frequencies detected by TEN, and the decrease in the presence of detected OAE could be related to deterioration in the basal part of the cochlea.
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Affiliation(s)
- Betul Cicek Cinar
- Department of Audiology, Faculty of Health Science, Hacettepe University, Ankara, Turkey,*Betul Cicek Cinar,
| | - Beyza Demirtas
- Department of Audiology, Faculty of Health Science, Hacettepe University, Ankara, Turkey
| | - Mehmet Can
- Department of Audiology, Faculty of Health Science, Karamanoğlu Mehmet Bey University, Karaman, Turkey
| | - Ibrahim Emir Yesil
- Department of ENT, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Munir Demir Bajin
- Department of ENT, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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14
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Muacevic A, Adler JR, Alsini AY, Al-zuraiqi BR, Badr K, Alghamdi SAM, Thabet Ali-Eldin EM, Alghamdi F. Sudden Sensorineural Hearing Loss as a Rare Sequela After Complete Recovery From COVID-19 Infection: Case Series and Literature Review. Cureus 2022; 14:e31856. [PMID: 36579210 PMCID: PMC9791610 DOI: 10.7759/cureus.31856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 11/25/2022] Open
Abstract
Respiratory disease caused by a mutant coronavirus variant has spread rapidly worldwide. According to reports, the COVID-19 version propagated at the end of 2019 and originated in Wuhan, China. On January 30, 2022, the World Health Organization declared the outbreak a Public Health Emergency of International Concern, and on March 11, 2020, the outbreak has declared a pandemic. The COVID-19 infection might appear with no symptoms, very few symptoms, or extremely severe symptoms We are the first to identify sudden sensorineural hearing loss (SSNHL) as a side effect in COVID-19 patients who have fully recovered from the illness. Additionally, all reported cases of this presentation have an unexplained unilateral left ear involvement. This article reviews the literature and four cases of COVID-19 patients with SSNHL. We present four cases of COVID-19 positivity that were verified by PCR analysis of nasopharyngeal swabs. After fully recovering from the infection, all patients developed acute sensorineural hearing loss on the left side. A deterioration in the hearing ability among COVID-19 survivors makes it possible that the problem persists long after their recovery from infection. To support such a claim, additional in-depth research is required. The current study, in our opinion, will contribute to an increase in understanding about COVID-19, promote awareness, and alert healthcare professionals to take into account and discuss any symptoms.
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15
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Khoza-Shangase K. Cochleovestibular findings linked to COVID-19: A scoping review for clinical care planning in South Africa. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2022; 69:e1-e12. [PMID: 36073075 PMCID: PMC9452924 DOI: 10.4102/sajcd.v69i2.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 12/15/2022] Open
Abstract
Background On 30 January 2020, the World Health Organization (WHO) officially declared an outbreak of the coronavirus disease 2019 (COVID-19) to be a global health emergency. Research has focused on the impact and response to life-threatening symptoms of COVID-19 across the lifespan; however, there is a need to investigate the effects of COVID-19 on the cochleovestibular system, as viral infections are known to impact this system. This is particularly important for contexts where resources are limited and prioritisation of resources requires strong risk versus benefit evaluations. Objective Therefore, the purpose of this scoping review was to investigate published evidence on the impact of COVID-19 on the cochleovestibular system across the lifespan in order to allow for strategic clinical care planning in South Africa, where capacity versus demand challenges exist. Methods Electronic bibliographic databases such as CINAHL, EBSCOHost, MEDLINE, ProQuest, PubMed, Scopus and ScienceDirect were searched for peer-reviewed publications between January 2020 and January 2022. These had to be published in English and related to the impact of COVID-19 on the cochleovestibular system, where the question was: ‘what evidence has been published on the impact of COVID-19 on the cochleovestibular system?’ Review selection and characterisation was performed by the researcher with an independent review by a colleague using pretested forms. Results Of a total of 24 studies that met the inclusion criteria, the current scoping review revealed limited conclusive published evidence linking COVID-19 to permanent hearing function symptoms. Current evidence supports the possibility of COVID-19, similar to other viral infections in adults, impacting the cochleovestibular system and causing tinnitus, vertigo and sudden sensorineural hearing loss (SSNHL), with the symptoms being generally temporary and resolving either partially or completely following therapy with steroids, with very inconclusive findings in the paediatric population. Conclusion These findings raise global implications for properly designed studies, which include longitudinal follow-up of cases across the lifespan, examining this link with some focus on establishing the pathophysiologic mechanisms at play as well. In the meanwhile, current findings raise the value of polymerase chain reaction (PCR) testing for all patients presenting with unexplained cochleovestibular symptoms during the pandemic, as these may be the only presenting symptoms indicating COVID-19, thus requiring careful treatment and management.
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Affiliation(s)
- Katijah Khoza-Shangase
- Department of Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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16
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Lee SW, De Chua KW, Yuen HW. Relationship between SARS-CoV-2 and hearing loss: A mini-review. PROCEEDINGS OF SINGAPORE HEALTHCARE 2022. [DOI: 10.1177/20101058221139957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The most reported symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were initially fever, dry cough, and sore throat. However, as we continue to review the literature, the loss of taste and smell were also added as clinical symptoms of the novel SARS-CoV-2. At present, the effects of SARS-CoV-2 on the auditory system is still not well-understood. This study is mini-review and aims to find out more about the relationship between SARS-CoV-2 and hearing loss through review of the literature. From our findings, hearing loss is the primary otological symptom of SARS-CoV-2, followed by tinnitus and dizziness. In conclusion, SARS-CoV-2 may have an effect on our auditory system, but due to the small sample sizes in the existing literature, further prospective studies are warranted to determine the relationship between the virus and hearing loss.
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Affiliation(s)
- Sin Wai Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore
| | - Kenneth Wei De Chua
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore
| | - Heng-Wai Yuen
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore
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17
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Sensorineural Hearing Loss Post-COVID-19 Infection: An Update. Audiol Res 2022; 12:307-315. [PMID: 35735365 PMCID: PMC9219889 DOI: 10.3390/audiolres12030032] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 11/17/2022] Open
Abstract
The course of COVID-19 infection may be complicated by a variety of neurological manifestations. Since the inner ear is vulnerable to viruses, sensorineural hearing loss (SNHL) has been reported to occur following the SARS-CoV-2 infection, often resulting in long-term morbidity and worsening the quality of life. The interest in how the virus affects the inner ear has gradually increased since the pandemic’s spread, but little is still known about the SNHL potentially caused by SARS-CoV-2. The aim of this paper is to evaluate the possible association between SNHL and COVID-19 infection, through a systematic literature review. Currently available data suggest that SARS-CoV-2 may hamper cochlear function; however, available reports are still limited. Large cohort and prospective studies are necessary to evaluate the long-term effects of this viral infection in the inner ear.
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18
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Neuro-otological Symptoms: An Atypical Aspect of COVID-19 Disease. Indian J Otolaryngol Head Neck Surg 2022; 74:3273-3282. [PMID: 35465132 PMCID: PMC9012049 DOI: 10.1007/s12070-022-03088-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/12/2022] [Indexed: 01/08/2023] Open
Abstract
This study aimed to evaluate the various neuro-otological symptoms experienced by patients with COVID-19 disease. This is a retrospective study conducted from September 2020 to August 2021. Patients with positive RTPCR tests for COVID-19, aged between 18 and 60 years were included in the study. The patients were assessed for neuro-otological symptoms, the type, frequency, and character of these symptoms, their relation with age, gender and COVID-19 disease. Of the 286 patients, 64 (22.3%) had neuro-otological symptoms. The mean age of the patients was 36.3 ± 8.1 years. The frequency of neuro-otological symptoms was higher in females than males and was more frequent in the age group of 18–30 years as compared with other age groups. Of these 64 patients, 29 had vertigo (10.1%), 21 (7.3%) tinnitus, 16 (5.5%) experienced hearing loss. Like many viral diseases, apart from its typical prodromal symptoms, COVID-19 can also cause symptoms like tinnitus, hearing loss, and vertigo.
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19
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Ong KMC, Cruz TLG. Otologic and vestibular symptoms in COVID-19: A scoping review. World J Otorhinolaryngol Head Neck Surg 2022; 8:WJO257. [PMID: 35599837 PMCID: PMC9111077 DOI: 10.1002/wjo2.57] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 01/17/2022] [Indexed: 12/23/2022] Open
Abstract
Background Otologic and vestibular symptoms have been seen in patients confirmed to have COVID-19 disease. Further discussion of these symptoms may provide insight into short- and long-term management for these patients. Objective The aim of this review was to describe the otologic and vestibular symptoms that present in patients with COVID-19. The primary outcomes of this review were onset, duration and clinical outcomes of these symptoms. Sources of Evidence Pub Med, APAMed Central, Herdin, CINAHL, Scopus, Springer Link, ProQuest Coronavirus Research Database, and Google Scholar were searched for the articles to be included. Eligibility Criteria Studies included were those involving adult patients diagnosed with COVID-19 who experienced hearing loss, ear pain, ear discharge, otitis media, vertigo, or tinnitus. Studies were eligible for inclusion if there was a description of the otologic dysfunction, specifically onset, duration, or clinical outcomes. Results The majority of patients who experienced hearing loss (68%), tinnitus (88%), vertigo/dizziness (30%), ear pain (8%), and discharge (100%) did so within a month of experiencing the typical symptoms of COVID-19. A majority also experienced complete resolution of their symptoms within 2 weeks. Standard treatment for COVID-19 was usually provided but when specific diagnoses are made for these symptoms (e.g., sudden sensorineural hearing loss, otitis media, vestibular neuritis), they are treated in the same manner as one would for non-COVID-19 cases, in addition to the management for COVID-19. In certain cases, there may be a need for additional work-up to rule out other causes. Conclusions Otologic and vestibular symptoms were present in COVID-19 patients, majority as part of the systemic nature of the disease. The onset, duration, and course were consistent with the natural history of a systemic viral infection. COVID-19 should be considered in any patient with a new-onset hearing loss, tinnitus, or vertigo/dizziness, even in the absence of infectious or respiratory symptoms.
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Affiliation(s)
- Kimberly Mae C. Ong
- Philippine National Ear Institute, National Institutes of HealthUniversity of the Philippines ManilaManilaPhilippines
- College of MedicineUniversity of the Philippines ManilaManilaPhilippines
| | - Teresa Luisa G. Cruz
- Philippine National Ear Institute, National Institutes of HealthUniversity of the Philippines ManilaManilaPhilippines
- College of MedicineUniversity of the Philippines ManilaManilaPhilippines
- Department of OtorhinolaryngologyUniversity of the Philippines‐Philippine General HospitalManilaPhilippines
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20
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Kaliyappan K, Chen YC, Krishnan Muthaiah VP. Vestibular Cochlear Manifestations in COVID-19 Cases. Front Neurol 2022; 13:850337. [PMID: 35370886 PMCID: PMC8971520 DOI: 10.3389/fneur.2022.850337] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/15/2022] [Indexed: 01/08/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a high transmissible infectious disease that primarily impacts the respiratory system and leads to death as it worsens. Ever since the World Health Organization declared the disease as a global pandemic, the pathophysiology, clinical manifestations, and disease prognosis has been discussed in various literature. In addition to impaired respiratory health, the symptoms also indicated the involvement of the cardiovascular and neurological system after SARS-CoV-2 infection. Despite the pulmonary, cardiovascular, and neurological complications, many reports also revealed the prevalence of vestibulocochlear symptoms like dizziness, vertigo, vestibular neuritis, sudden sensorineural hearing loss, and tinnitus. Though many clinical reports and scientific reviews reported the vestibular and cochlear impairments associated with coronavirus disease 2019 (COVID-19) infection, the underlying pathological mechanisms are still unclear and unexplored. In this review, we discussed the published clinical reports, research articles, and literature reviews related to vestibulocochlear manifestations following SARS-CoV-2 infections. We also summarized the current knowledge about the prevalence, epidemiological and clinical features, and potential pathological mechanisms related to vestibular and cochlear manifestations resulting from COVID-19 infections.
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Affiliation(s)
- Kathiravan Kaliyappan
- Department of Rehabilitation Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, United States
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- *Correspondence: Yu-Chen Chen
| | - Vijaya Prakash Krishnan Muthaiah
- Department of Rehabilitation Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, United States
- Vijaya Prakash Krishnan Muthaiah
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21
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Jafari Z, Kolb BE, Mohajerani MH. Hearing Loss, Tinnitus, and Dizziness in COVID-19: A Systematic Review and Meta-Analysis. Can J Neurol Sci 2022; 49:184-195. [PMID: 33843530 PMCID: PMC8267343 DOI: 10.1017/cjn.2021.63] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Extensive studies indicate that severe acute respiratory syndrome coronavirus (SARS-CoV-2) involves human sensory systems. A lack of discussion, however, exists given the auditory-vestibular system involvement in CoV disease 2019 (COVID-19). The present systematic review and meta-analysis were performed to determine the event rate (ER) of hearing loss, tinnitus, and dizziness caused by SARS-CoV-2. METHODS Databases (PubMed, ScienceDirect, Wiley) and World Health Organization updates were searched using combined keywords: 'COVID-19,' 'SARS-CoV-2,' 'pandemic,' 'auditory dysfunction,' 'hearing loss,' 'tinnitus,' 'vestibular dysfunction,' 'dizziness,' 'vertigo,' and 'otologic symptoms.' RESULTS Twelve papers met the eligibility criteria and were included in the study. These papers were single group prospective, cross-sectional, or retrospective studies on otolaryngologic, neurologic, or general clinical symptoms of COVID-19 and had used subjective assessments for data collection (case histories/medical records). The results of the meta-analysis demonstrate that the ER of hearing loss (3.1%, CIs: 0.01-0.09), tinnitus (4.5%, CIs: 0.012-0.153), and dizziness (12.2%, CIs: 0.070-0.204) is statistically significant in patients with COVID-19 (Z ≤ -4.469, p ≤ 0.001). CONCLUSIONS COVID-19 can cause hearing loss, tinnitus, and dizziness. These findings, however, should be interpreted with caution given insufficient evidence and heterogeneity among studies. Well-designed studies and follow-up assessments on otologic symptoms of SARS-CoV-2 using standard objective tests are recommended.
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Affiliation(s)
- Zahra Jafari
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, Canada
| | - Bryan E. Kolb
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, Canada
| | - Majid H. Mohajerani
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, Canada
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22
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Taga A, Lauria G. COVID-19 and the Peripheral Nervous System. A 2-year review from the pandemic to the vaccine era. J Peripher Nerv Syst 2022; 27:4-30. [PMID: 35137496 PMCID: PMC9115278 DOI: 10.1111/jns.12482] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 01/31/2022] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Abstract
Increasing literature has linked COVID‐19 to peripheral nervous system (PNS) diseases. In addition, as we move from the pandemic to the vaccination era, literature interest is shifting towards the potential association between COVID‐19 vaccines and PNS manifestations. We reviewed published literature on COVID‐19, COVID‐19 vaccines and PNS manifestations between 1 January 2020 and 1 December 2021. For Guillain‐Barré syndrome (GBS), isolated cranial neuropathy (ICN) and myositis associated with COVID‐19, the demographic, clinical, laboratory, electrophysiological and imaging features were included in a narrative synthesis. We identified 169 studies on COVID‐19‐associated complications, including 63 papers (92 patients) on GBS, 29 papers (37 patients) on ICN and 11 papers (18 patients) on myositis. Additional clinical phenotypes included chronic inflammatory demyelinating polyneuropathy, vasculitic neuropathies, neuralgic amyotrophy, critical care‐related complications, and myasthenia gravis. PNS complications secondary to COVID‐19 vaccines have been reported during randomized clinical trials, in real‐world case reports, and during large‐scale surveillance programs. These mainly include cases of GBS, Bell's palsy, and cases of neuralgic amyotrophy. Based on our extensive review of the literature, any conclusion about a pathophysiological correlation between COVID‐19 and PNS disorders remains premature, and solely supported by their temporal association, while epidemiological and pathological data are insufficient. The occurrence of PNS complications after COVID‐19 vaccines seems limited to a possible higher risk of facial nerve palsy and GBS, to a degree that widespread access to the ongoing vaccination campaign should not be discouraged, while awaiting for more definitive data from large‐scale surveillance studies.
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Affiliation(s)
- Arens Taga
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Giuseppe Lauria
- Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan.,Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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23
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Di Mauro P, La Mantia I, Cocuzza S, Sciancalepore PI, Rasà D, Maniaci A, Ferlito S, Tundo I, Anzivino R. Acute Vertigo After COVID-19 Vaccination: Case Series and Literature Review. Front Med (Lausanne) 2022; 8:790931. [PMID: 35071270 PMCID: PMC8770332 DOI: 10.3389/fmed.2021.790931] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/06/2021] [Indexed: 12/13/2022] Open
Abstract
Objective: The aim of this study was to present some cases of acute vertigo potentially related to the coronavirus disease 2019 (COVID-19) vaccine and review the available literature about cochleovestibular dysfunction after the COVID-19 vaccination. Methods: In the period from May to July 2021, we evaluated 33 patients (mean age 54.3 ± 14.1) with “acute vertigo” post COVID-19 vaccination. A detailed medical history was taken on comorbidities, types of vaccines received, and symptoms associated. All patients underwent otoneurological evaluation, such as head impulse test, nystagmus evaluation, test of skew (HINTS) examination. Head shaking test-induced nystagmus, hyperventilation-induced nystagmus, and parossistic positional nystagmus were studied to search for vestibular impairment. Results: Symptoms included 16 patients (48.5%) with objective vertigo, 14 patients (42.4%) with subjective vertigo, and 3 patients (9.1%) with dizziness. Of the associated ear, nose, and throat (ENT) symptoms, the most expressed was tinnitus (18.2%). Bedside examination showed absent nystagmus in 7 patients (21.2%), 9 patients (27.3%) had horizontal or rotatory nystagmus, 17 patients (51.5%) had a vertical or oblique nystagmus, negative HST, or “central HINTS.” Discussion and Conclusions: The 9 patients had an evoked nystagmus pathognomonic for benign paroxysmal positional vertigo; in the remaining 17 cases, peripheral vestibular dysfunction could be excluded and central disorder may be suggested. Due to the prevalence of nystagmus of non-peripheral origin, a central nervous system involvement could not be excluded. However, due to the small sample size, a definite cause–effect relationship between vaccination and vertigo cannot be inferred. In light of expected third dose, large-scale and well-designed studies are needed to better define possible adverse reactions of the COVID-19 vaccine.
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Affiliation(s)
- Paola Di Mauro
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", ENT Section, A.O.U. Policlinico "G.Rodolico-San Marco", University of Catania, Catania, Italy
| | - Ignazio La Mantia
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", ENT Section, A.O.U. Policlinico "G.Rodolico-San Marco", University of Catania, Catania, Italy
| | - Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", ENT Section, A.O.U. Policlinico "G.Rodolico-San Marco", University of Catania, Catania, Italy
| | - Pasqua Irene Sciancalepore
- Centre of Phoniatry and Rehabilitation of Communication Disorders - Azienda Sanitaria Locale Lecce, Lecce, Italy
| | - Deborak Rasà
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", ENT Section, A.O.U. Policlinico "G.Rodolico-San Marco", University of Catania, Catania, Italy
| | - Antonino Maniaci
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", ENT Section, A.O.U. Policlinico "G.Rodolico-San Marco", University of Catania, Catania, Italy
| | - Salvatore Ferlito
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", ENT Section, A.O.U. Policlinico "G.Rodolico-San Marco", University of Catania, Catania, Italy
| | - Isabella Tundo
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", ENT Section, A.O.U. Policlinico "G.Rodolico-San Marco", University of Catania, Catania, Italy
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24
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Jung WW, Hoegerl C. Sudden Sensorineural Hearing Loss and Why It’s an Emergency. Cureus 2022; 14:e21418. [PMID: 35198323 PMCID: PMC8855894 DOI: 10.7759/cureus.21418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 01/19/2022] [Indexed: 11/21/2022] Open
Abstract
This review shows the importance of sudden sensorineural hearing loss (SSNHL) as a significant cause of hearing loss that often goes under-recognized, especially by primary care physicians. Contrasted with conductive hearing loss, SSNHL involves inner ear damage. This work reviewed the diagnostic methods and treatments of SSNHL in the U.S. and Canada, including treatment options. It is imperative that primary care physicians and providers be able to recognize this condition early so that treatment may be initiated without delay as hearing loss can become permanent if not managed immediately.
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25
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Essawy WM. Effectiveness of oral corticosteroids (prednisolone) in sensorineural hearing loss post COVID-19. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2022; 38:162. [PMCID: PMC9748904 DOI: 10.1186/s43163-022-00347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Numerous infections can result in neurological symptoms, including anosmia, facial paralysis, and abrupt sensorineural hearing loss (SSNHL). During the earlier SARS pandemic, coronaviruses were linked to a loss of smell and taste due to brain damage. Purpose To clinically detect corticosteroid treatment effectiveness in SSNHL post-COVID-19 infection and to detect the factors that affect the prognosis for these patients for better diagnosis and earlier management. Subjects and method Subjects included 20 subjects diagnosed by PCR as COVID-19 virus positive, complaining of sudden onset hearing loss post viral infection in different durations. All subjects had basic audiological evaluation done pre-treatment and repeated after 1 week, 2 weeks, and 1 month after treatment with methylprednisolone 21-acetate tablets. Results Onset of hearing loss post-COVID infection ranged from 1 to 3 months. As regards the improvement recognized with treatment course, thirteen patients (65%) of all twenty patients showed complete improvement at 1 month after starting treatment, and seven patients (35%) showed no improvement even after 1 month. Conclusion SSNHL has been widely recognized in the context of COVID-19 to date. Early corticosteroid therapy could help in the recovery of hearing, especially if the beginning of therapy was early in the first 2 weeks.
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Affiliation(s)
- Wessam Mostafa Essawy
- grid.412258.80000 0000 9477 7793Audio-vestibular Unit, Department of Otorhinolaryngology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Burd S, Lebedeva A, Avakyan G, Rubleva Y, Pantina N, Yurchenko A, Kovaleva I. COVID-19-associated damage of the peripheral nervous system. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:15-21. [DOI: 10.17116/jnevro202212209115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abstract
BACKGROUND Various case reports have described sudden sensorineural hearing loss (SSNHL) in patients with the 2019 novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our aim was to determine the incidence of COVID-19 in patients with SSNHL. METHODS All consecutive patients with audiometric confirmed SSNHL between November 2020 and March 2021 in a Dutch large inner city teaching hospital were included. All patients were tested for COVID-19 by polymerase-chain-reaction (PCR) and awaited the results in quarantine. RESULTS Out of 25 patients, zero (0%) tested positive for COVID-19. Two patients had previously tested positive for COVID-19: at three and eight months prior to the onset of hearing loss. CONCLUSIONS This is the largest series to date investigating COVID-19 in SSNHL patients. In this series there is no apparent relationship between SSNHL and COVID-19.
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No lasting impact of Covid-19 on the auditory system: a prospective cohort study. The Journal of Laryngology & Otology 2021. [PMCID: PMC8576134 DOI: 10.1017/s002221512100267x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Objective Otological complications are considered early symptoms of severe acute respiratory syndrome coronavirus-2; however, it is unknown how long these symptoms last and whether the virus leaves any hearing disorders post-recovery. Methods This prospective cohort study comprised 31 mild or moderate confirmed coronavirus disease 2019 patients and 26 age-matched control peers (21–50 years old). Patients were questioned about their otological symptoms, and their hearing status was assessed during one month post-diagnosis. Results Patients showed a significantly higher rate of otological symptoms (hearing loss, ear fullness, ear pain, dizziness or vertigo, communication difficulties, and hyperacusis) versus the control group (p ≤ 0.022). The symptoms resolved early, between 2 and 8 days after their appearance. No significant differences were observed between the two groups in pure tone and extended high-frequency audiometry, transient evoked otoacoustic emissions, distortion product otoacoustic emissions, or auditory brainstem response following recovery. Conclusion The findings indicate that, in mild to moderate coronavirus disease 2019 cases, otological symptoms resolve within a week, and the virus has no lasting impact on the auditory system.
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Dharmarajan S, Bharathi MB, Sivapuram K, Prakash BG, Madhan S, Madhu A, Devi GN, Aliya SA, Ramya SB. Hearing Loss-a Camouflaged Manifestation of COVID 19 Infection. Indian J Otolaryngol Head Neck Surg 2021; 73:494-498. [PMID: 33996529 PMCID: PMC8109216 DOI: 10.1007/s12070-021-02581-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/17/2021] [Indexed: 11/28/2022] Open
Abstract
The symptomatology of novel Severe Acute Respiratory Syndrome Corona virus type 2 infection runs the entire gamut of mild to moderate and serious illness among the affected individuals. As listed in recent literature, respiratory, cardiovascular, gastrointestinal, olfactory and gustatory systems are commonly involved. With the growing knowledge about the disease, varied manifestations have been identified and lately, otorhinolaryngology dysfunctions in COVID 19 have been described. Hearing loss in COVID era is one of the emerging areas of concern and calls for further research in the field for the better understanding and treatment of this entity. This study was designed to assess the audiological profile among 100 mild to moderately affected COVID-19 individuals, so as to make a contribution to the emerging literature on otologic manifestations in COVID 19. In our case series, high frequency hearing loss and referred OAE was noted among significant number of COVID 19 positive patients. This was even observed in patients without any otologic symptoms. Hence, early identification and intervention if required helps to give a better quality of life to the patient.
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Affiliation(s)
- Sandhya Dharmarajan
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - M. B. Bharathi
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Kavya Sivapuram
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - B. G. Prakash
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Sriram Madhan
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Ashima Madhu
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - G. Nivetha Devi
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Shaik Ayesha Aliya
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - S. B. Ramya
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
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Pokharel S, Tamang S, Pokharel S, Mahaseth RK. Sudden sensorineural hearing loss in a post-COVID-19 patient. Clin Case Rep 2021; 9:e04956. [PMID: 34703602 PMCID: PMC8520694 DOI: 10.1002/ccr3.4956] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/02/2021] [Accepted: 09/25/2021] [Indexed: 12/23/2022] Open
Abstract
A detailed history and diagnostic evaluation for recent or past COVID-19 infection is vital in patients presenting with Sudden Sensorineural Hearing Loss (SSNHL) since SSNHL could be a sequelae of COVID-19 and timely diagnosis and intervention could significantly improve hearing and quality of life.
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Affiliation(s)
- Santoshi Pokharel
- College of MedicineNepalese Army Institute of Health SciencesKathmanduNepal
| | - Sumita Tamang
- College of MedicineNepalese Army Institute of Health SciencesKathmanduNepal
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De Luca P, Scarpa A, Ralli M, Tassone D, Simone M, De Campora L, Cassandro C, Di Stadio A. Auditory Disturbances and SARS-CoV-2 Infection: Brain Inflammation or Cochlear Affection? Systematic Review and Discussion of Potential Pathogenesis. Front Neurol 2021; 12:707207. [PMID: 34421805 PMCID: PMC8373381 DOI: 10.3389/fneur.2021.707207] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/28/2021] [Indexed: 12/23/2022] Open
Abstract
Patients affected by COVID-19 present a series of different symptoms; despite some of these are common, other less likely appear. Auditory symptoms seem to be less frequent, maybe because rarer or, alternatively, because they are underestimated during the clinical investigation. The hearing impairment might be related to the central or peripheral involvement of the auditory pathways; in particular, the likelihood of thrombosis might be one of the causes. To date, the prevalence of auditory symptoms such as sudden or progressive sensorineural hearing loss and tinnitus is unclear in COVID-19 patients. However, their presence might be an early sign of thrombosis or spread of the infection into the brain. In this systematic review of the literature we investigated the presence of auditory symptoms in COVID-19 patients and discussed their potential origin and causal relationship with SARS-CoV-2. Results showed that, despite rarely, auditory impairment can appear in patients with COVID-19 and should always be investigated for an early treatment and potential indicator of involvement of the central nervous system.
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Affiliation(s)
- Pietro De Luca
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Alfonso Scarpa
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Domenico Tassone
- Otolaryngology Unit, San Giovanni Addolorata Hospital, Rome, Italy
| | - Matteo Simone
- Otolaryngology Unit, San Giovanni Addolorata Hospital, Rome, Italy
| | - Luca De Campora
- Otolaryngology Unit, San Giovanni Addolorata Hospital, Rome, Italy
| | | | - Arianna Di Stadio
- Department of Surgery and Biomedical Sciences, Section of Otorhinolaryngology, "Santa Maria della Misericordia" University Hospital, Perugia, Italy
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The effect of coronavirus disease 2019 on the hearing system. The Journal of Laryngology & Otology 2021; 135:810-814. [PMID: 34344488 DOI: 10.1017/s0022215121001961] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to evaluate different auditory regions with audiological tests, based on the presumption that there may be damage to the structures in the hearing system after coronavirus disease 2019. METHODS Twenty individuals with no history of coronavirus disease 2019 and 27 individuals diagnosed with coronavirus disease 2019 were compared. Pure tone, speech and extended high-frequency audiometry, acoustic immitansmetry, transient evoked and distortion product otoacoustic emissions testing, and auditory brainstem response testing were conducted. RESULTS The pure tone audiometry and extended high-frequency mean threshold values were higher in the coronavirus disease 2019 group. The transient evoked otoacoustic emissions signal-to-noise ratios were bilaterally lower at 4 kHz in individuals with a coronavirus disease 2019 history. In the auditory brainstem response test, only the interpeak latencies of waves III-V were significantly different between groups. CONCLUSION Coronavirus disease 2019 may cause damage to the hearing system. Patients should be followed up in the long term with advanced audiological evaluation methods in order to determine the extent and level of damage.
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Narozny W, Tretiakow D, Skorek A. INTRALABYRINTHINE HEMORRHAGE IN A PATIENT WITH COVID-19 - A CHALLENGE FOR AN OTOLOGIST. Otol Neurotol 2021; 42:e967. [PMID: 34260515 DOI: 10.1097/mao.0000000000003232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Waldemar Narozny
- Department of Otolaryngology Medical University of Gdansk, Poland
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35
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Bhatta S, Sharma S, Sharma D, Maharjan L, Bhattachan S, Sah MK, Singhal A, Ghanpur AD, Ganesuni D. Study of Hearing Status in COVID-19 Patients: A Multicentered Review. Indian J Otolaryngol Head Neck Surg 2021; 74:3036-3042. [PMID: 34277385 PMCID: PMC8274964 DOI: 10.1007/s12070-021-02710-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/20/2021] [Indexed: 12/25/2022] Open
Abstract
To evaluate the hearing status of COVID-19 patients and compare with control group. Prospective study carried out in 9 institutes. The pure tone audiogram and impedance audiometry of COVID-19 patients performed initially and at 3 months follow up. The control group consisted COVID-19 negative individuals with no history of ear related diseases. The average of air and bone conduction threshold (AC and BC) were compared between the COVID-19 patients and control group using independent t-test with a p value of less than 0.05 considered significant. Total of 331 patients, age 32 ± 4.3 years, 66.7% males and 33.3% females were included in the study. There were 80 individuals in the control group. Aural symptoms were, tinnitus in 1.8%, aural fullness in 1.4%, hearing loss in 3. 9%, and ear ache in 1.8% were present initially, resolved at 3 months follow up. The impedance audiometry demonstrated type B and type C curve in 5.1% and 1.15% ears, and out of these 64.7% and 40% improved at 3 months follow up respectively. No significant difference observed between the average AC and BC of the COVID-19 patients and control group. The COVID-19 infection may present with aural symptoms; however, it was concluded that there was no significant difference in the hearing status of the COVID-19 positive patients in comparison to the control group. The presence of some changes in the normal functioning of the eustachian tube and middle ear in the COVID-19 infection was also highlighted.
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Affiliation(s)
| | | | - Dibya Sharma
- Indira Gandhi Memorial Hospital, Male', Maldives
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Dusan M, Milan S, Nikola D. COVID-19 caused hearing loss. Eur Arch Otorhinolaryngol 2021; 279:2363-2372. [PMID: 34235578 PMCID: PMC8263317 DOI: 10.1007/s00405-021-06951-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/17/2021] [Indexed: 12/23/2022]
Abstract
Purpose The objective of this cross-sectional study was to determine if there is a potential link between COVID-19 infection and hearing loss. Methods The prospective study was conducted in the COVID Hospital Clinical Centre Niš, Serbia. We performed tonal audiometry and used a custom questionnaire and medical histories to determine the incidence of hearing loss in COVID-19 positive patients. Results There were 74 patients with COVID-19 that met the inclusion criteria of this study and they composed our experimental group. Fifty-four (73%) were men and 20 (27%) women. There were 30 (40.5%) patients with hearing loss. Seventeen patients had unilateral and 13 had bilateral hearing loss. Significant differences between hearing loss groups and control group were found across all age groups, but not at all frequencies. No important differences were found when unilateral hearing loss and bilateral hearing loss groups were compared. There were no significant differences in distributions of comorbidities between the patients with hearing loss and normal hearing patients. Conclusions We found that 30 (40.5%) of the COVID-19 positive patients had sensorineural type of hearing loss. Across all age groups, there were statistically significant differences in frequencies between the COVID-19 positive patients and the control group. There were no significant differences in distributions of comorbidities between the patients with hearing loss and normal hearing patients. Distribution of unilateral and bilateral hearing loss and audiogram types was also not significantly different between the age groups.
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Affiliation(s)
- Milisavljevic Dusan
- Department of Otolaryngology, University Clinic Centre Nis, Bul. Zorana Đinđića 48, Nis, Serbia.
| | - Stankovic Milan
- Department of Otolaryngology, University Clinic Centre Nis, Bul. Zorana Đinđića 48, Nis, Serbia
| | - Dordevic Nikola
- Department of Otolaryngology, University Clinic Centre Nis, Bul. Zorana Đinđića 48, Nis, Serbia
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Narozny W, Tretiakow D, Skorek A. In Reference to The Challenges of Pharmacotherapy of SARS-CoV-2 Infection in Patients With Sudden Sensorineural Hearing Loss Due to COVID-19. Laryngoscope 2021; 131:E2335. [PMID: 33729578 PMCID: PMC8251197 DOI: 10.1002/lary.29514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 12/23/2022]
Affiliation(s)
- Waldemar Narozny
- Department of OtolaryngologyGdansk Medical UniversityGdanskPoland
| | - Dmitry Tretiakow
- Department of OtolaryngologyGdansk Medical UniversityGdanskPoland
| | - Andrzej Skorek
- Department of OtolaryngologyGdansk Medical UniversityGdanskPoland
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Beukes E, Ulep AJ, Eubank T, Manchaiah V. The Impact of COVID-19 and the Pandemic on Tinnitus: A Systematic Review. J Clin Med 2021; 10:2763. [PMID: 34201831 PMCID: PMC8268057 DOI: 10.3390/jcm10132763] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 01/08/2023] Open
Abstract
This review aimed to systematically review what has been published regarding tinnitus during the coronavirus disease 2019 (COVID-19) pandemic up to March 2021 by performing both narrative and quantitative meta-analyses. Of the 181 records identified, 33 met the inclusion criteria, which generally had a fair risk of overall bias. In the included, 28 studies focused on the impact of the COVID-19 virus on tinnitus and 5 studies focused on the impact of the pandemic on tinnitus. From the studies identifying the impact of COVID-19 on tinnitus, there were 17 cross-sectional studies (n = 8913) and 11 case series or case report studies (n = 35). There were 2 cross-sectional studies (n = 3232) and 3 pre-post-test design studies (n = 326) focusing on the impact of the pandemic on tinnitus. No consistent patterns were found regarding the presentation of the tinnitus or additional factors that could have tinnitus developing in the disease impact studies. For the pandemic impact studies, the associated stress and anxiety of the pandemic were consistently suggested to contribute to tinnitus experiences. The pooled estimated prevalence of tinnitus post COVID-19 was 8% (CI: 5 to 13%). Medical professionals should be aware that tinnitus might be more problematic following the pandemic or after having COVID-19.
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Affiliation(s)
- Eldre Beukes
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX 77710, USA; (A.J.U.); (T.E.); (V.M.)
- Vision and Hearing Sciences Research Centre, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge CB1 1TP, UK
| | - Alyssa Jade Ulep
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX 77710, USA; (A.J.U.); (T.E.); (V.M.)
| | - Taylor Eubank
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX 77710, USA; (A.J.U.); (T.E.); (V.M.)
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX 77710, USA; (A.J.U.); (T.E.); (V.M.)
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Karnataka 576104, India
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Asfour L, Kay-Rivest E, Roland JT. Cochlear implantation for single-sided deafness after COVID-19 hospitalization. Cochlear Implants Int 2021; 22:353-357. [PMID: 34151741 DOI: 10.1080/14670100.2021.1936364] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Understanding the clinical manifestations of the coronavirus disease (COVID-19) has become an urgent objective in the research community. Amongst the emerging neurologic complications is sensorineural hearing loss. While several cases of hearing loss amongst COVID-19 patients have been reported, the management of these patients has yet to be discussed and determined. Herein we present cochlear implant outcomes for a patient who suffered from unilateral sensorineural hearing loss after a prolonged hospital course for COVID-19. METHODS A patient who was hospitalized for COVID-19 for one month and subsequently developed unilateral profound sensorineural hearing loss underwent cochlear implantation for single-sided deafness. His COVID-19 hospital course was reviewed in detail. Speech perception and audiometric assessments were used to evaluate cochlear implant outcomes. RESULTS After cochlear implantation, the patient demonstrated improved speech perception on the implanted side and decreased tinnitus within 1 month of activation. CONCLUSIONS Cochlear implantation may be an appropriate intervention for patients who suffer from severe sensorineural hearing loss following infection with COVID-19.
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Affiliation(s)
- Leena Asfour
- Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, NY, USA
| | - Emily Kay-Rivest
- Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, NY, USA
| | - J Thomas Roland
- Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, NY, USA
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Sudden hearing loss and coronavirus disease 2019: the role of corticosteroid intra-tympanic injection in hearing improvement. The Journal of Laryngology & Otology 2021; 135:464-466. [PMID: 33913413 DOI: 10.1017/s0022215121001080] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Coronavirus disease 2019 was first seen in December 2019. Due to the insidious and complex nature of the disease, the list of symptoms is rapidly expanding. So far, few studies have reported sudden sensorineural hearing loss as a possible symptom of coronavirus disease 2019. CASE REPORT A 60-year-old woman with a complaint of sudden sensorineural hearing loss and subjective severe tinnitus presented to the ENT clinic. Coronavirus disease 2019 was subsequently confirmed with a polymerase chain reaction test. At the time of presentation, she was treated with intra-tympanic dexamethasone. Improvements in hearing threshold and speech perception, and a subjective reduction in tinnitus, were observed after treatment. CONCLUSION This case report supports evidence from other case reports of a possible association between coronavirus disease 2019 and sudden sensorineural hearing loss. Sudden sensorineural hearing loss may be a symptom of this disease that behaves as an underlying aggravating factor. Intra-tympanic injection of corticosteroids is recommended for managing these patients during the pandemic.
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Almufarrij I, Munro KJ. One year on: an updated systematic review of SARS-CoV-2, COVID-19 and audio-vestibular symptoms. Int J Audiol 2021; 60:935-945. [PMID: 33750252 DOI: 10.1080/14992027.2021.1896793] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The aim was to systematically review the literature to December 2020, in order to provide a timely summary of evidence on SARS-CoV-2, COVID-19 and audio-vestibular symptoms. DESIGN The protocol was registered in the International Prospective Register of Systematic Reviews. The methods were developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Risk of bias was assessed using the National Institutes of Heath quality assessment tools. STUDY SAMPLE After rejecting 850 records, 28 case reports/series and 28 cross-sectional studies met the inclusion criteria. RESULTS There are multiple reports of hearing loss (e.g. sudden sensorineural), tinnitus and rotatory vertigo in adults having a wide range of COVID-19 symptom severity. The pooled estimate of prevalence based primarily on retrospective recall of symptoms, was 7.6% (CI: 2.5-15.1), 14.8% (CI: 6.3-26.1) and 7.2% (CI: 0.01-26.4), for hearing loss, tinnitus and rotatory vertigo, respectively. However, these could be an over-estimate because it was not always clear that studies report a change in symptom. CONCLUSION There are multiple reports of audio-vestibular symptoms associated with COVID-19. However, there is a dearth of high-quality studies comparing COVID-19 cases and controls. REVIEW REGISTRATION Prospective Register of Systematic Reviews (PROSPERO); registration number CRD42020227038).
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Affiliation(s)
- Ibrahim Almufarrij
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK.,Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Kevin J Munro
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK.,Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Abstract
Purpose of Review The present review discusses the peripheral nervous system (PNS) manifestations associated with coronavirus disease 2019 (COVID-19). Recent Findings Nerve pain and skeletal muscle injury, Guillain-Barré syndrome, cranial polyneuritis, neuromuscular junction disorders, neuro-ophthalmological disorders, neurosensory hearing loss, and dysautonomia have been reported as PNS manifestations in patients with COVID-19. Summary Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19. COVID-19 has shown syndromic complexity. Not only does SARS-CoV-2 affect the central nervous system but also it involves the PNS. The PNS involvement may be due to dysregulation of the immune system attributable to COVID-19. Here we review the broad spectrum of PNS involvement of COVID-19.
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Karimi-Boroujeni M, Zahedi-Amiri A, Coombs KM. Embryonic Origins of Virus-Induced Hearing Loss: Overview of Molecular Etiology. Viruses 2021; 13:71. [PMID: 33419104 PMCID: PMC7825458 DOI: 10.3390/v13010071] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 12/19/2022] Open
Abstract
Hearing loss, one of the most prevalent chronic health conditions, affects around half a billion people worldwide, including 34 million children. The World Health Organization estimates that the prevalence of disabling hearing loss will increase to over 900 million people by 2050. Many cases of congenital hearing loss are triggered by viral infections during different stages of pregnancy. However, the molecular mechanisms by which viruses induce hearing loss are not sufficiently explored, especially cases that are of embryonic origins. The present review first describes the cellular and molecular characteristics of the auditory system development at early stages of embryogenesis. These developmental hallmarks, which initiate upon axial specification of the otic placode as the primary root of the inner ear morphogenesis, involve the stage-specific regulation of several molecules and pathways, such as retinoic acid signaling, Sonic hedgehog, and Wnt. Different RNA and DNA viruses contributing to congenital and acquired hearing loss are then discussed in terms of their potential effects on the expression of molecules that control the formation of the auditory and vestibular compartments following otic vesicle differentiation. Among these viruses, cytomegalovirus and herpes simplex virus appear to have the most effect upon initial molecular determinants of inner ear development. Moreover, of the molecules governing the inner ear development at initial stages, SOX2, FGFR3, and CDKN1B are more affected by viruses causing either congenital or acquired hearing loss. Abnormalities in the function or expression of these molecules influence processes like cochlear development and production of inner ear hair and supporting cells. Nevertheless, because most of such virus-host interactions were studied in unrelated tissues, further validations are needed to confirm whether these viruses can mediate the same effects in physiologically relevant models simulating otic vesicle specification and growth.
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Affiliation(s)
- Maryam Karimi-Boroujeni
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
| | - Ali Zahedi-Amiri
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada;
- Manitoba Centre for Proteomics and Systems Biology, Winnipeg, MB R3E 3P4, Canada
| | - Kevin M. Coombs
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada;
- Manitoba Centre for Proteomics and Systems Biology, Winnipeg, MB R3E 3P4, Canada
- Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
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Fancello V, Hatzopoulos S, Corazzi V, Bianchini C, Skarżyńska MB, Pelucchi S, Skarżyński PH, Ciorba A. SARS-CoV-2 (COVID-19) and audio-vestibular disorders. Int J Immunopathol Pharmacol 2021; 35:20587384211027373. [PMID: 34142589 PMCID: PMC8216371 DOI: 10.1177/20587384211027373] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/03/2021] [Indexed: 12/23/2022] Open
Abstract
To describe the audio-vestibular disorders related to the newly SARS-CoV-2 infection, including the possible ototoxicity side-effects related to the use of drugs included in the SARS-CoV-2 treatment protocols. A systematic review was performed according to the PRISMA protocol. The Medline and Embase databases were searched from March 1, 2020 to April 9, 2021. Initially the search yielded 400 manuscripts, which were reduced to 15, upon the application of inclusion criteria. Sensorineural hearing loss (SNHL) is the most frequent audio-vestibular symptom described, occurring alone or in association with tinnitus and vertigo. The etiopathogenesis of the inner ear disorders related to COVID-19 infection is still poorly understood. The number of reports of COVID-19 infections associated to audio-vestibular disorders is increasing; even if the quality of the studies available is often insufficient, audio-vestibular disorders should be considered as possible manifestations to be included among the symptoms of this infection.
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Affiliation(s)
- Virginia Fancello
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - Stavros Hatzopoulos
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - Virginia Corazzi
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - Chiara Bianchini
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - Magdalena B Skarżyńska
- Institute of Sensory Organs, Kajetany, Poland
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Stefano Pelucchi
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - Piotr Henryk Skarżyński
- Institute of Sensory Organs, Kajetany, Poland
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
- Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Warsaw, Poland
| | - Andrea Ciorba
- ENT and Audiology Unit, Department of Neuroscience and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
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Moradi F, Enjezab B, Ghadiri-Anari A. The role of androgens in COVID-19. Diabetes Metab Syndr 2020; 14:2003-2006. [PMID: 33091758 PMCID: PMC7557269 DOI: 10.1016/j.dsx.2020.10.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/11/2020] [Accepted: 10/13/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIM The coronavirus disease 2019 (COVID-19) pandemic is a global health emergency. According to the findings, male patients with COVID-19 infection are at an increased risk for severe complications than females. The causes of this issue are unknown and are most probably multifactorial. Sexual hormones affect the immune system, so estrogen strengthens the immune system, and testosterone suppresses it. Due to the reports of the high prevalence of androgenic alopecia in hospitalized patients with COVID-19 and a higher risk of respiratory disease and increased use of allergy/asthma medications among patients with polycystic ovary syndrome (PCOS) as a hyperandrogenism condition compared with non-PCOS women, this review aimed to evaluate androgens role in COVID-19. METHODS 42 related articles from 2008 to 2020 were reviewed with the keywords of androgens, hormonal factors, and hair loss in combination with COVID-19 in medical research databases. RESULTS The evidence of transmembrane protease, serine 2 (TMPRSS2) expression in lung tissue, which is an androgen-regulated gene and expressed mainly in the adult prostate may interpret the increased susceptibility of the male gender to severe COVID-19 complications. Moreover, angiotensin-converting enzyme 2 (ACE-2) acts as a functional receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and male hormones are effective in the ACE-2 passageway and simplify SARS-CoV-2 entry into host cells. CONCLUSION Further studies on the severity of symptoms in patients with COVID-19 in other hyperandrogenism conditions compared to the control group are recommended.
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Affiliation(s)
| | - Behnaz Enjezab
- Research Center for Nursing and Midwifery Care, Department of Midwifery, Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Akram Ghadiri-Anari
- Department of Internal Medicine, Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Abstract
Sudden onset sensorineural hearing loss (SSNHL) is frequently seen by otolaryngologists. The exact pathophysiology of the disease is still unknown, with the most likely causative factor being following a viral infection. Immediate steroids are the best treatment to improve prognosis. Despite a plethora of papers in the literature describing SSNHL, there are only a few reported cases of hearing loss following COVID-19, none of which have been reported in the UK. This paper presents the first UK case of SSNHL following COVID-19. Physical examination and imaging excluded any other cause of hearing loss. A literature review showed that four other cases have been previously described. Hearing loss can be a significant cause of morbidity and can easily be missed in the intensive care setting. Being aware and screening for SSNHL following COVID-19 enables an early course of steroids, which offers the best chance of recovering hearing.
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Affiliation(s)
- Foteini Stefania Koumpa
- University College London, London, UK
- Royal National Throat Nose and Ear Hospital, London, UK
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Lang B, Hintze J, Conlon B. Coronavirus disease 2019 and sudden sensorineural hearing loss. J Laryngol Otol 2020; 134:1-3. [PMID: 33000716 PMCID: PMC7684203 DOI: 10.1017/s0022215120002145] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 emerged in December 2019 in Wuhan, China, and was declared a global health emergency of international concern by the World Health Organization on 30th January 2020. It has resulted in almost 600 000 deaths to date worldwide. Sudden sensorineural hearing loss is a known complication of a number of viral infections, but there is little in the literature to date on its association with coronavirus disease 2019. CASE REPORT This paper presents the case of a 30-year-old female staff nurse who contracted coronavirus disease 2019 and presented to our department with a significant unilateral sensorineural hearing loss confirmed on audiogram. She was treated with a course of oral steroids, but unfortunately there was no improvement in her hearing. CONCLUSION This case report is important as it highlights the importance of having a low index of suspicion when patients present with a variety of symptoms not previously associated with coronavirus disease 2019. The paper also discusses the controversy surrounding the use of steroids in the management of this disease.
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Affiliation(s)
- B Lang
- Department of Otorhinolaryngology and Head and Neck Surgery, St James University Hospital, Dublin, Ireland
| | - J Hintze
- Department of Otorhinolaryngology and Head and Neck Surgery, St James University Hospital, Dublin, Ireland
| | - B Conlon
- Department of Otorhinolaryngology and Head and Neck Surgery, St James University Hospital, Dublin, Ireland
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