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Cao X, Yi H. Sudden Sensorineural Hearing Loss Before COVID-19, During COVID-19, and After Inactivated Vaccination: Experience From a Tertiary Referral Center in China. Otol Neurotol 2024:00129492-990000000-00566. [PMID: 38918072 DOI: 10.1097/mao.0000000000004233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
OBJECTIVE The purpose of this study was to investigate the incidence rate and audiological characteristics of sudden sensorineural hearing loss (SSHL) before the COVID-19 pandemic, during the COVID-19 pandemic, and after inactivated vaccination, and to analyze whether the novel coronavirus or inactivated vaccination have an impact on hearing loss. MATERIALS AND METHODS The clinical data of all patients who visited the hospital in July 2019 (before pandemic), July 2020 (during pandemic) and July 2021 (after the inactivated vaccination at least the first basic dose of COVID-19 vaccination) were retrospective analyzed. All patients diagnosed with sudden sensorineural hearing loss in these three periods were screened, and their incidence rate, hearing characteristics, and prognosis were compared. RESULTS Overall, the incidence rates of sudden hearing loss in July 2019, July 2020, and July 2021 were 0.59, 0.60, and 0.52% (25 of 4225, 20 of 3322, 28 of 5432), respectively, without significant difference (χ2 = 0.372, p = 0.830). A significant difference was noted in the incidence of hypertension (p = 0.02), whereas no significant difference was noted in age (p = 0.591, p = 0.66), sex (p = 0.19, p = 0.08), main symptoms (p = 0.18, p = 0.15), side (p = 0.483, p = 0.89), audiogram shape (p = 0.56, p = 0.989), average hearing threshold of affected frequency (p = 0.81, p = 0.89), average hearing threshold of normal ear affected frequency (p = 0.65, p = 0.68), average hearing threshold of affected frequency after treatment (p = 0.49, p = 0.38), days between symptoms onset and hospital visit (p = 0.62, p = 0.85), treatment plan (p = 0.551, p = 0.474), and effectiveness (p = 0.104, p = 0.050). CONCLUSION Our study failed to find a correlation between the novel coronavirus pandemic and inactivated vaccination and SSHL, and there was no direct evidence supporting that COVID-19 or inactivated vaccination had an impact on the incidence rate and prognosis of SSHL patients.
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Affiliation(s)
- Xin Cao
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
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2
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Kondo K, Honda K, Goshima K, Inoue N, Shinjo D, Tsutsumi T, Fushimi K. Otologic disease trends in Japan post-COVID-19 outbreak: A retrospective time-series analysis. Auris Nasus Larynx 2024; 51:525-530. [PMID: 38522357 DOI: 10.1016/j.anl.2024.01.004] [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: 11/17/2023] [Revised: 12/17/2023] [Accepted: 01/12/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE To evaluate the potential impact of coronavirus disease 2019 (COVID-19) and vaccinations on otologic diseases, including facial nerve paralysis (including Ramsay Hunt syndrome), vestibular neuritis, sudden sensorineural hearing loss, and Meniere's disease. METHODS In this retrospective study, we conducted a time-series analysis employing a causal impact algorithm on a large-scale inpatient database in Japan. We compared the actual number of hospitalized patients with otologic diseases to two predictions: one without any covariates and another with a covariate accounting for the reduction in the number of hospitalized patients due to lockdown measures. Additionally, we performed Granger causality tests to ensure the robustness of our findings. RESULTS No significant increase was noted in the number of hospitalized patients with otologic diseases following the onset of the COVID-19 pandemic in the causal impact analysis. Similarly, no notable surge was observed in hospitalizations for these diseases following the introduction of the COVID-19 vaccine. The Granger causality tests results aligned with the causal impact analysis findings. CONCLUSION Our findings indicate that COVID-19 and vaccinations had minimal discernible effects on hospitalization of patients with otologic diseases, suggesting that otologic diseases may not be significantly impacted by COVID-19 and vaccinations, which could have implications for public health policies and the allocation of healthcare resources during a pandemic. Further research and monitoring of long-term effects are warranted to validate these findings and guide healthcare decision-making.
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Affiliation(s)
- Keisuke Kondo
- Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, , S1651/S1568 M&D Tower, 1-5-45 Yushima, Bunkyo-ku, Tokyo 1138519, Japan; Department of Otorhinolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiji Honda
- Department of Otorhinolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiichi Goshima
- Faculty of International Social Sciences, Division of International Social Sciences, Yokohama National University, Kanagawa, Japan
| | - Norihiko Inoue
- Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, , S1651/S1568 M&D Tower, 1-5-45 Yushima, Bunkyo-ku, Tokyo 1138519, Japan; Department of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, Tokyo, Japan
| | - Daisuke Shinjo
- Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, , S1651/S1568 M&D Tower, 1-5-45 Yushima, Bunkyo-ku, Tokyo 1138519, Japan.
| | - Takeshi Tsutsumi
- Department of Otorhinolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, , S1651/S1568 M&D Tower, 1-5-45 Yushima, Bunkyo-ku, Tokyo 1138519, Japan
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3
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Wang W, Yellamsetty A, Edmonds RM, Barcavage SR, Bao S. COVID-19 vaccination-related tinnitus is associated with pre-vaccination metabolic disorders. Front Pharmacol 2024; 15:1374320. [PMID: 38841369 PMCID: PMC11150672 DOI: 10.3389/fphar.2024.1374320] [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: 01/22/2024] [Accepted: 04/29/2024] [Indexed: 06/07/2024] Open
Abstract
Cases of tinnitus have been reported following administration of COVID-19 vaccines. The aim of this study was to characterize COVID-19 vaccination-related tinnitus to assess whether there is a causal relationship, and to examine potential risk factors for COVID-19 vaccination-related tinnitus. We analyzed a survey on 398 cases of COVID-19 vaccination-related tinnitus, and 699,839 COVID-19 vaccine-related reports in the Vaccine Adverse Effect Reporting System (VAERS) database that was retrieved on 4 December 2021. We found that following COVID-19 vaccination, 1) tinnitus report frequencies for Pfizer, Moderna and Janssen vaccines in VAERS are 47, 51 and 70 cases per million full vaccination; 2) the symptom onset was often rapid; 3) more women than men reported tinnitus and the sex difference increased with age; 4) for 2-dose vaccines, the frequency of tinnitus was higher following the first dose than the second dose; 5) for 2-dose vaccines, the chance of worsening tinnitus symptoms after second dose was approximately 50%; 6) tinnitus was correlated with other neurological and psychiatric symptoms; 7) pre-existing metabolic syndromes were correlated with the severity of the reported tinnitus. These findings suggest that COVID-19 vaccination increases the risk of tinnitus, and metabolic disorders is a risk factor for COVID-19 vaccination-related tinnitus.
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Affiliation(s)
- Weihua Wang
- Department of Physiology and Department of Otolaryngology—Head and Neck Surgery, University of Arizona College of Medicine, Tucson, AZ, United States
| | - Anusha Yellamsetty
- Department of Audiology, College of Health and Human Sciences, San José State University, San José, CA, United States
| | | | | | - Shaowen Bao
- Department of Physiology and Department of Otolaryngology—Head and Neck Surgery, University of Arizona College of Medicine, Tucson, AZ, United States
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4
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Kim JK, Tawk K, Kim JM, Djalilian HR, Abouzari M. Google Trends Analysis of Otologic Symptom Searches Following COVID-19. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2024; 36:475-482. [PMID: 38745683 PMCID: PMC11090093 DOI: 10.22038/ijorl.2024.75617.3532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 03/16/2024] [Indexed: 05/16/2024]
Abstract
Introduction COVID-19 infection was accompanied by otologic symptoms, a pattern that was captured early by Google Trends. The objective of this study is to investigate searches for otologic symptoms and identify correlations with the pandemic onset. Materials and Methods Search interest for otologic symptoms was gathered using Google Trends from two years before and two years following the pandemic start date. A two-tailed Mann-Whitney U test was used to identify significant changes and effect size. Results In total, search interest for 14 terms was collected, with significant changes identified in 11. Six terms showed increased search interest, with the most significant rises observed for headache (r=0.589, p<0.001), dizziness (r=0.554, p<0.001), and tinnitus (r=0.410, p<0.001). Search interest decreased for five terms, with the most notable declines found in searches for migraine headache (r=0.35, p<0.001) and phonophobia (r=0.22, p=0.002). No significant changes were seen in ear pressure (p=0.142), neck pain (p=0.935), and sudden hearing loss (p=0.863) searches. Conclusion COVID-19 infection is often accompanied otologic symptoms and holds a diagnostic role. Fluctuating search interest may be attributed to a true increase in cases, media trends, or people's desires to stay informed. Google Trends robustly captured trends in search interest and presented itself as a valuable epidemiological tool.
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Affiliation(s)
- Joshua K. Kim
- School of Medicine, Duke University, Durham, NC, United States.
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, CA, United States.
| | - Karen Tawk
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, CA, United States.
| | - Jonathan M. Kim
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, CA, United States.
| | - Hamid R. Djalilian
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, CA, United States.
- Department of Biomedical Engineering, University of California, Irvine, CA, United States.
| | - Mehdi Abouzari
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, CA, United States.
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5
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Ciorba A, Bianchini C, Caranti A, Skarżyński PH, Pelucchi S, Hatzopoulos S. Incidence of Audiological Adverse Effects Induced by COVID-19 Vaccines: A Preliminary Study. EAR, NOSE & THROAT JOURNAL 2024; 103:208-210. [PMID: 34587817 DOI: 10.1177/01455613211048975] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Andrea Ciorba
- Department of ENT & Audiology, University of Ferrara, Ferrara, Italy
| | - Chiara Bianchini
- Department of ENT & Audiology, University of Ferrara, Ferrara, Italy
| | - Alberto Caranti
- Department of ENT & Audiology, University of Ferrara, Ferrara, Italy
| | - Piotr H 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
| | - Stefano Pelucchi
- Department of ENT & Audiology, University of Ferrara, Ferrara, Italy
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6
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Thai-Van H, Bagheri H, Valnet-Rabier MB. Sudden Sensorineural Hearing Loss after COVID-19 Vaccination: A Review of the Available Evidence through the Prism of Causality Assessment. Vaccines (Basel) 2024; 12:181. [PMID: 38400164 PMCID: PMC10892268 DOI: 10.3390/vaccines12020181] [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: 12/29/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
Sudden sensorineural hearing loss (SSNHL), a rare audiological condition that accounts for 1% of all cases of sensorineural hearing loss, can cause permanent hearing damage. Soon after the launch of global COVID-19 vaccination campaigns, the World Health Organization released a signal detection about SSNHL cases following administration of various COVID-19 vaccines. Post-marketing studies have been conducted in different countries using either pharmacovigilance or medico-administrative databases to investigate SSNHL as a potential adverse effect of COVID-19 vaccines. Here, we examine the advantages and limitations of each type of post-marketing study available. While pharmacoepidemiological studies highlight the potential association between drug exposure and the event, pharmacovigilance approaches enable causality assessment. The latter objective can only be achieved if an expert evaluation is provided using internationally validated diagnostic criteria. For a rare adverse event such as SSNHL, case information and quantification of hearing loss are mandatory for assessing seriousness, severity, delay onset, differential diagnoses, corrective treatment, recovery, as well as functional sequelae. Appropriate methodology should be adopted depending on whether the target objective is to assess a global or individual risk.
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Affiliation(s)
- Hung Thai-Van
- Department of Audiology and Otoneurological Evaluation, Hospices Civils de Lyon, 69003 Lyon, France;
- Institut Pasteur, Institut de l’Audition, 75015 Paris, France
- Faculté de Médecine, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Haleh Bagheri
- Department of Medical and Clinical Pharmacology, Centre Régional de Pharmacovigilance de Toulouse, CIC1436, Hôpital Universitaire de Toulouse, 31000 Toulouse, France;
| | - Marie-Blanche Valnet-Rabier
- Department of Clinical Pharmacology, Centre Régional de Pharmacovigilance et d’Information sur les Médicaments, Centre Hospitalier Universitaire de Besançon, 25000 Besançon, France
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7
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Messina S, Natale P, Graziano G, Galleggiante S, Strippoli GFM, Petruzzi M. Oral manifestations after vaccinations: A systematic review of observational studies. Oral Dis 2024. [PMID: 38321527 DOI: 10.1111/odi.14883] [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: 07/31/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE This study aimed to assess the prevalence and types of oral adverse events following immunization (AEFIs) in people who received at least one dose of any type of vaccine. MATERIALS AND METHODS We conducted a bibliographic search about oral AEFIs in MEDLINE, Embase, PubMed, and Ovid from database inception to November 07, 2022. Risk of bias was assessed using the MURAD or the Quality In Prognosis Studies tools. Random-effects proportional meta-analysis was applied. RESULTS A total of 119 studies involving 343 people were eligible. These reported AEFIs occurred following administration of the coronavirus disease 2019 vaccine, anti-influenza vaccine, hepatitis B vaccine, and anti-smallpox vaccine. The most common to be affected in vaccinated people were buccal mucosa (63.1%; 95% confidence interval (CI) 33.4-88.2) and lips (55.7%; 95% CI, 41.1-69.8). The most prevalent oral AEFIs were ulceration (55.2%; 95% CI 24.4-84.0), swelling (65.2%; 95% CI 34.9-89.8), and burning sensation (18.3%; 95% CI 7.9-31.8). CONCLUSIONS The mechanisms underlying oral AEFIs should be further investigated to promptly recognize oral manifestations and provide optimal management for people undergoing vaccination.
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Affiliation(s)
- Sabrina Messina
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Patrizia Natale
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari, Bari, Italy
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giusi Graziano
- Center for Outcomes Research and Clinical Epidemiology (CORESEARCH), Pescara, Italy
| | - Sara Galleggiante
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Giovanni F M Strippoli
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari, Bari, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
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8
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Ammar H, Le Beller C, Bouccara D, Malinvaud D, Jouffroy R, Lillo-Le Louet A. Vestibular disorders following BNT162b2 mRNA COVID-19 vaccination: A retrospective case series. Fundam Clin Pharmacol 2024; 38:192-204. [PMID: 37473782 DOI: 10.1111/fcp.12942] [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: 03/27/2023] [Revised: 06/18/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND There are few publications regarding manifestations of vestibular disorders (VDs) following BNT162b2 mRNA COVID-19 vaccination. PURPOSE We describe cases of VD potentially related to BNT162b2 vaccination and calculate its reporting rate, in order to enlarge knowledge about this adverse effect. METHODS A retrospective analysis of cases of VD following BNT162b2 vaccination reported to the pharmacovigilance centre of Georges-Pompidou European Hospital (France), in 2021 was performed. In order to identify these cases from the pharmacovigilance database containing all our registered cases, we used the Standardised MedDRA Query (SMQ) 'vestibular disorders'. Then we analysed cases with vestibular symptoms, based on the association of typical manifestations. The reporting rate was calculated based on the number of VD cases and the number of vaccinated patients. RESULTS Among 6608 cases reported to our centre related to COVID-19 vaccines during 2021, 34 VDs associated with BNT162b2 administration were included. They were mainly reported in females (79%), 62% occurred after the first dose and 32% were serious. Symptoms had completely resolved in 13 cases (38%). Vertigo was the most common symptom followed by balance disorders. Three patients received second dose without reappearance of VD. The final diagnosis was reported in 10 patients (six cases of vestibular neuritis, two cases of central VD, two cases of benign paroxysmal positional vertigo). The regional reporting rate was 26 [95% CI: 17-34] cases of VD per 1 million persons vaccinated. CONCLUSION Although the relationship between vaccination and VD cannot be established, clinicians should be aware of this rare adverse effect.
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Affiliation(s)
- Helmi Ammar
- Pharmacovigilance Regional Centre, Hôpital Européen Georges Pompidou, AP-HP-Université Paris Cité, Paris, France
| | - Christine Le Beller
- Pharmacovigilance Regional Centre, Hôpital Européen Georges Pompidou, AP-HP-Université Paris Cité, Paris, France
| | - Didier Bouccara
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, Paris, France
- Unité CNRS UMR 8002, INCC - Integrative Neuroscience and Cognition Group, Université Paris Cité, Paris, France
| | - David Malinvaud
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, Paris, France
- Unité CNRS UMR 8002, INCC - Integrative Neuroscience and Cognition Group, Université Paris Cité, Paris, France
| | - Romain Jouffroy
- Intensive Care Unit, Ambroise Paré Hospital, Assistance Publique Hôpitaux Paris and Paris Saclay University, Paris, France
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport - EA7329, INSEP - Paris University, Paris, France
- Centre de recherche en Epidémiologie et Santé des Populations - U1018 INSERM - Paris Saclay University, Paris, France
- EA 7525 Université des Antilles, Fort de France, France
| | - Agnès Lillo-Le Louet
- Pharmacovigilance Regional Centre, Hôpital Européen Georges Pompidou, AP-HP-Université Paris Cité, Paris, France
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Shin J, Shim SR, Lee J, Ryu HS, Kim JY. Otorhinolaryngologic complications after COVID-19 vaccination, vaccine adverse event reporting system (VAERS). Front Public Health 2024; 11:1338862. [PMID: 38269374 PMCID: PMC10807421 DOI: 10.3389/fpubh.2023.1338862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/18/2023] [Indexed: 01/26/2024] Open
Abstract
Background There have been reports of otolaryngological adverse event following immunization (AEFI) such as instances of olfactory and gustatory dysfunction following COVID-19 vaccination. This study aimed to analyze otolaryngological AEFIs following COVID-19 vaccination. Methods This study was conducted with a secondary data analysis that the Vaccine Adverse Events Reporting System (VAERS) and the COVID-19 Data Tracker, which are both administered by the Centers for Disease Control and Prevention in the US. Using Medical Dictionary for Regulatory Activities (MedDRA) concepts, AEFIs included: Considering the overall frequency and similarity of symptoms in the first 153 PTs, they were grouped into major 19 AEFIs groups. The incidence rates (IRs) of AEFIs per 100,000 were calculated on individual and cumulative AEFIs levels, involving people who received complete primary series and an updated bivalent booster dose with one of the available COVID-19 vaccines in the US. The proportions of AEFIs by age, sex, and vaccine manufacturer were reported. We also calculated the proportional reporting ratio (PRR) of AEFIs. Results We identified 106,653 otorhinolaryngologic AEFIs from the VAERS database, and a total of 226,593,618 people who received complete primary series in the US. Overall, the IR of total Otorhinolaryngologic AEFIs was 47.068 of CPS (completed primary series) and 7.237 UBB (updated bivalent booster) per 100,000. For most symptoms, being female was associated with statistically significant higher AEFIs. Upon examining the impact of different vaccine manufacturers, the researchers found that Janssen's vaccine exhibited higher IRs for hearing loss (5.871), tinnitus (19.182), ear infection (0.709), dizziness (121.202), sinusitis (2.088), epistaxis (4.251), anosmia (5.264), snoring (0.734), allergies (5.555), and pharyngitis (5.428). The highest PRRs were for Anosmia (3.617), Laryngopharyngeal Reflux - Acid Reflux (2.632), and Tinnitus -Ringing in the ears (2.343), in that order, with these three significantly incidence than other background noises. Conclusion This study, utilizing an extensive sample sizes, represents a significant step toward comprehensively characterizing the otolaryngological AEFIs associated with COVID-19 vaccinations. This large-scale analysis aims to move beyond isolated case reports and anecdotal evidence, providing a robust and detailed portrait of the otolaryngological AEFIs landscape in response to COVID-19 vaccinations.
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Affiliation(s)
- Jieun Shin
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
- Konyang Medical data Research group-KYMERA, Konyang University Hospital, Daejeon, Republic of Korea
| | - Sung Ryul Shim
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
- Konyang Medical data Research group-KYMERA, Konyang University Hospital, Daejeon, Republic of Korea
| | - Jaekwang Lee
- Department of Emergency Medicine, College of Medicine, Konyang University Hospital, Daejeon, Republic of Korea
| | - Hyon Shik Ryu
- Department of Emergency Medicine, College of Medicine, Konyang University Hospital, Daejeon, Republic of Korea
| | - Jong-Yeup Kim
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
- Konyang Medical data Research group-KYMERA, Konyang University Hospital, Daejeon, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konyang University Hospital, Daejeon, Republic of Korea
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10
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Liew XW, Tang ZHM, Ong YQC, See KC. Hearing Loss after COVID-19 and Non-COVID-19 Vaccination: A Systematic Review. Vaccines (Basel) 2023; 11:1834. [PMID: 38140238 PMCID: PMC10748333 DOI: 10.3390/vaccines11121834] [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: 10/17/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: Vaccine safety is an important topic with public health implications on a global scale. The purpose of this study was to systematically review available literature assessing sensorineural hearing loss (SNHL) incidence and severity following both coronavirus disease 2019 (COVID-19) and non-COVID-19 vaccinations, as well as prognosis and outcomes. (2) Methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Relevant publications evaluating post-vaccination SNHL were selected from PubMed and Embase, searching from inception to July 2023. (3) Results: From 11 observational studies, the incidence of post-vaccination SNHL was low for both COVID-19 and non-COVID-19 vaccines, ranging from 0.6 to 60.77 per 100,000 person-years, comparable to all-cause SNHL. (4) Conclusions: The incidence rates of SNHL following COVID-19 and non-COVID-19 vaccinations remained reassuringly low. Most patients experienced improved hearing function in the weeks to months following vaccination. This study underscores the importance and safety of vaccinations and encourages ongoing surveillance and detailed reporting of hearing loss cases post-vaccination.
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Affiliation(s)
- Xin Wei Liew
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 169856, Singapore; (X.W.L.); (Z.H.M.T.); (Y.Q.C.O.)
| | - Zer Han Malcolm Tang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 169856, Singapore; (X.W.L.); (Z.H.M.T.); (Y.Q.C.O.)
| | - Yan Qing Cherie Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 169856, Singapore; (X.W.L.); (Z.H.M.T.); (Y.Q.C.O.)
| | - Kay Choong See
- Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, Singapore 119228, Singapore
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11
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Wang CC, Young YH. Comparing the recurrence of audio-vestibular disorders following breakthrough infection of COVID-19 vs. those following vaccine administration. Am J Otolaryngol 2023; 44:103970. [PMID: 37467676 DOI: 10.1016/j.amjoto.2023.103970] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/13/2023] [Accepted: 07/04/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE The term "breakthrough infection" of COVID-19 indicates that subjects who previously received COVID-19 vaccination became infected with COVID-19. This study compared the recurrence of audio-vestibular disorders following breakthrough infection of COVID-19 vs. those following vaccine administration. PATIENTS AND METHODS Fifty patients with previous known audio-vestibular disorders visited our clinic due to recurrence of inner ear symptoms following breakthrough infection of COVID-19 and were assigned to Group A. Another 50 patients who had recurrent inner ear symptoms following COVID-19 vaccination were assigned to Group B for comparison. The post-breakthrough infection interval is defined from date of breakthrough infection to the onset of inner ear symptoms, while the post-vaccination interval means the time from date of vaccination to the onset of inner ear symptoms. These two intervals were calculated and then compared. RESULTS The time from latest vaccination to the breakthrough infection of COVID-19 was 4 m (median), likely due to waning of IgG response. To the onset of inner ear symptoms, the post-breakthrough infection interval was 40d (median) for Group A, which was significantly longer than 10d (median) of the post-vaccination interval for Group B. CONCLUSION The post-breakthrough infection interval (median, 40d) is significantly longer than the post-vaccination interval (median, 10d) to exacerbate pre-existing audio-vestibular disorders. The reason is probably because an interval of 40d is related to IgG peak response following COVID-19 breakthrough infection, while that of 10d is responsible for IgG production after COVID-19 vaccination.
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Affiliation(s)
- Chih-Ching Wang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ho Young
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei, Taiwan.
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12
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Valnet-Rabier MB, Tebacher M, Gautier S, Micallef J, Salvo F, Pariente A, Bagheri H. Pharmacovigilance signals from active surveillance of mRNA platform vaccines (tozinameran and elasomeran). Therapie 2023; 78:499-507. [PMID: 37012149 PMCID: PMC10007713 DOI: 10.1016/j.therap.2023.03.005] [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: 01/30/2023] [Accepted: 03/07/2023] [Indexed: 03/13/2023]
Abstract
INTRODUCTION Two severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccines, tozinameran/BNT162b2 (Comirnaty®, Pfizer-BioNTech) and elasomeran/mRNA-1273 (Spikevax®, Moderna), were approved by the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) at the end of 2020, less than a year after the start of the coronavirus disease 2019 (COVID-19) pandemic. In France, the health authorities have requested an intensive vaccination campaign, accompanied by a reinforced and active pharmacovigilance surveillance. This surveillance and analysis of real-life data, based on spontaneous reports received by the French Network of Regional PharmacoVigilance Centers (RFCRPV), has enabled to identify numerous pharmacovigilance signals. Some of them, such as myocarditis and heavy menstrual bleeding, have been confirmed as adverse effects of these vaccines. METHOD We propose a descriptive review of the main pharmacovigilance signals identified by the RFCRPV concerning vaccines from the mRNA platform. RESULTS Most pharmacovigilance signals were common to both mRNA vaccines: myocarditis, menstrual disorders, acquired haemophilia, Parsonage-Turner syndrome, rhizomelic pseudo-polyarthritis and hearing disorders. Other signals were more specific, such as arterial hypertension with tozinameran or delayed reaction site injection with elasomeran. CONCLUSION This non-exhaustive review illustrates the experience of RFCRPV in identifying and monitoring pharmacovigilance signals related to mRNA vaccines in France during the COVID-19 pandemics, and the crucial role of pharmacological and clinical expertise in this area. It also highlights the predominant contribution of spontaneous reporting in the generation of pharmacovigilance signals, particularly for serious and rare adverse events not detected before marketing.
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Affiliation(s)
| | - Martine Tebacher
- Centre de pharmacovigilance de Strasbourg, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France
| | - Sophie Gautier
- Centre de pharmacovigilance Nord pas de Calais, service de pharmacologie médicale, CHU, 59000 Lille, France
| | - Joelle Micallef
- Centre de pharmacovigilance de Marseille, service de pharmacologie clinique et pharmacovigilance, AMU, APHM, 13000 Marseille, France
| | - Francesco Salvo
- Université de Bordeaux, Inserm, BPH, U1219, Team AHeaD, 33000 Bordeaux, France; Service de pharmacologie médicale, centre de pharmacovigilance de Bordeaux, CHU de Bordeaux, 33000 Bordeaux, France
| | - Antoine Pariente
- Université de Bordeaux, Inserm, BPH, U1219, Team AHeaD, 33000 Bordeaux, France; Service de pharmacologie médicale, centre de pharmacovigilance de Bordeaux, CHU de Bordeaux, 33000 Bordeaux, France
| | - Haleh Bagheri
- Service de pharmacologie médicale, CIC1436, Centre de pharmacovigilance de Toulouse, CHU Toulouse, 31000 Toulouse, France.
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13
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Asadi M, Naderi D, Jahanshahi F. Sudden sensorineural hearing loss after receiving an inactivated viral vaccine, Sinopharm: Two-case report. SAGE Open Med Case Rep 2023; 11:2050313X231191237. [PMID: 37576350 PMCID: PMC10413890 DOI: 10.1177/2050313x231191237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
The prevalence of Coronavirus Disease 2019 is a global threat. Due to the high mortality rate caused by this disease, the vaccination is mandatory to protect patients against it and reduce the mortality. Rapid development and widespread use of vaccines have raised the possibility of adverse side effects over the course of administration and follow-up. In this study, we investigated an adverse event of sudden sensorineural hearing loss in two patients receiving first dose of Sinopharm, an inactivated viral vaccine. Both patients experienced sudden hearing loss in their left ear some days after receiving the first dose of the Sinopharm and had normal otoscopic examinations in both ears and mild to severe sensorineural hearing loss was reported in the left ear. After imaging evaluation with magnetic resonance imaging which showed no pathologic points. Two patients were treated with prednisolone and valacyclovir. Both patients experienced response and had good prognosis in their follow-up. Our study showed that there is no direct evidence of an association between Coronavirus Disease 2019 vaccination. A viral infection can cause sudden sensorineural hearing loss and should be considered as a possible side effect after vaccination. Although the number of side effects reported in clinical trials has been very low, long-term follow-up of patients is needed to assess the vaccine's safety, given the incidence of these cases.
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Affiliation(s)
- Mahboobe Asadi
- Department of Otolaryngology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Delaram Naderi
- Student Research Committee, Allied of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Jahanshahi
- Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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14
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Lin D, Selleck AM. Tinnitus cases after COVID-19 vaccine administration, one institution's observations. Am J Otolaryngol 2023; 44:103863. [PMID: 36989754 PMCID: PMC10036149 DOI: 10.1016/j.amjoto.2023.103863] [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: 02/24/2023] [Accepted: 03/19/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVE After the role out of the COVID-19 vaccine in the United States, there has been increase in case reports of tinnitus attributed to the vaccine reported. We present our institution's experience over the initial 13 month period the vaccines were available. STUDY DESIGN Retrospective chart review. SETTING Tertiary academic otology and general otolaryngology practice. PATIENTS Patients who received a COVID-19 vaccine and a tinnitus diagnosis code. INTERVENTIONS Observation, steroids (oral and intratympanic), diagnostic imaging and audiometry. MAIN OUTCOME MEASURES Patients who received a COVID-19 vaccine in the time frame of 12/1/2020-12/31/21 with a diagnosis of tinnitus, an audiogram, and at least one visit with one of our Otolaryngologists were included in the study. Twenty-seven of the 1254 patients identified met these criteria. The patients ranged in age from 41 to 84 years old including seven male and twenty female patients. Sixteen received the Pfizer vaccine, seven received the Moderna vaccine and four patients received the Janssen vaccine. CONCLUSIONS No definite correlation could be established between COVID-19 vaccine and tinnitus. Any concurrent sudden hearing loss should be treated as usual with oral or intratympanic steroids. Health care providers should be aware of the tinnitus onset and if new or recent onset, to refer for prompt audiogram and Otolaryngology evaluation.
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Affiliation(s)
- Doris Lin
- University of North Carolina at Chapel Hill, 170 Manning Drive, Campus Box 7070, Chapel Hill, NC 27599-7070, United States of America.
| | - Anne Morgan Selleck
- University of North Carolina at Chapel Hill, 170 Manning Drive, Campus Box 7070, Chapel Hill, NC 27599-7070, United States of America.
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15
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Dorney I, Bobak L, Otteson T, Kaelber DC. Prevalence of New-Onset Tinnitus after COVID-19 Vaccination with Comparison to Other Vaccinations. Laryngoscope 2023; 133:1722-1725. [PMID: 36098476 PMCID: PMC9539087 DOI: 10.1002/lary.30395] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/21/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate how often patients are diagnosed with new-onset tinnitus within 21 days after COVID-19 vaccination in comparison to after three other common vaccinations: influenza, Tdap (tetanus, diphtheria, and acellular pertussis), and polysaccharide pneumococcus. METHODS The TriNetX Analytics Network, a federated health research network that aggregates the de-identified electronic health record (EHR) data of over 78 million patients, was queried for patients receiving each vaccination. Instances of new-onset tinnitus within 21 days of vaccination were recorded and reported. RESULTS Out of 2,575,235 patients receiving a first dose of the mRNA COVID-19 vaccine without any prior tinnitus diagnosis, 0.038% (95% CI: 0.036%-0.041%) of patients had a new diagnosis of tinnitus within 21 days. There was a higher risk of a new tinnitus diagnosis after the influenza vaccine (RR: 1.95, 95% CI: 1.72-2.21), Tdap vaccine (RR: 2.36, 95% CI: 1.93-2.89), and pneumococcal vaccine (RR: 1.97, 95% CI: 1.48-2.64) than after the first dose of the COVID-19 vaccine. There was a lower risk of a new tinnitus diagnosis after the second dose of COVID-19 than after the first dose (RR: 0.80, 95% CI: 0.71-0.91). CONCLUSION The rate of newly diagnosed tinnitus acutely after the first dose of the COVID-19 vaccine is very low. There was a higher risk of newly diagnosed tinnitus after influenza, Tdap, and pneumococcal vaccinations than after the COVID-19 vaccine. The present findings can help to address COVID-19 vaccine hesitancy during the ongoing pandemic. LEVEL OF EVIDENCE Level 3 Laryngoscope, 133:1722-1725, 2023.
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Affiliation(s)
- Ian Dorney
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Lukas Bobak
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Todd Otteson
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - David C Kaelber
- Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- The Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, Ohio, USA
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16
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Zoccali F, Petrella C, Zingaropoli MA, Fiore M, Ralli M, Minni A, Barbato C. Neurofilament Expression as a Biomarker of Post-COVID-19 Sudden Sensorineural Hearing Loss. Diseases 2023; 11:92. [PMID: 37489444 PMCID: PMC10366716 DOI: 10.3390/diseases11030092] [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: 06/05/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023] Open
Abstract
Sudden sensorineural hearing loss (SSHL) affects a patient's quality of life and requires rapid treatment. The etiology is viral, vascular, and autoimmune, even though, in most cases, it remains idiopathic SSHL. Since 2019, several different complications have been identified following COVID-19 infection. The post-COVID-19 ENT manifestations reported in the literature are sore throat, headache, pharyngeal erythema, nasal obstruction, rhinorrhea, upper respiratory tract infection, and tonsil enlargement. Cases of SSHL, vestibular neuronitis, and audio-vestibular disorders (such as tinnitus, dizziness, and vertigo) have also been reported, albeit in a smaller percentage of patients. We reported our experience of a case of post-COVID-19 SSHL in the absence of any other type of post-COVID symptoms or brain and internal auditory canal magnetic resonance imaging and magnetic resonance angiography modifications. We aimed to identify a serological biomarker of sudden sensorineural hearing loss, and we also dosed and monitored the value of the serum neurofilament light (NfL). the best of our knowledge, this is the first report that associates SSHL and the serological increase in NfL as a potential biomarker of neuronal-disease-related damage.
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Affiliation(s)
- Federica Zoccali
- Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Carla Petrella
- Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Maria Antonella Zingaropoli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale del Policlinico 155, 00185 Rome, Italy
| | - Marco Fiore
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Antonio Minni
- Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
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17
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Shi X, Liu X, Sun Y. The Pathogenesis of Cytomegalovirus and Other Viruses Associated with Hearing Loss: Recent Updates. Viruses 2023; 15:1385. [PMID: 37376684 DOI: 10.3390/v15061385] [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: 05/08/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Virus infection is one of the most common etiologies of hearing loss. Hearing loss associated with viral infection can be unilateral or bilateral, mild or severe, sudden or progressive, and permanent or recoverable. Many viruses cause hearing loss in adults and children; however, the pathogenesis of hearing loss caused by viral infection is not fully understood. This review describes cytomegalovirus, the most common virus causing hearing loss, and other reported hearing loss-related viruses. We hope to provide a detailed description of pathogenic characteristics and research progress on pathology, hearing phenotypes, possible associated mechanisms, treatment, and prevention measures. This review aims to provide diagnostic and treatment assistance to clinical workers.
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Affiliation(s)
- Xinyu Shi
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Xiaozhou Liu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yu Sun
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, China
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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18
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Chiba Y, Takahashi Y, Kawakita R, Deguchi K, Masaki T. Cytotoxic Lesions of the Corpus Callosum (CLOCC) Suggesting Exacerbation by Heterogeneous COVID-19 Booster Vaccination. Cureus 2023; 15:e41105. [PMID: 37519563 PMCID: PMC10382211 DOI: 10.7759/cureus.41105] [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: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
Cytotoxic lesions of the corpus callosum (CLOCC) is a disease entity associated with reversible lesions of the corpus callosum on magnetic resonance imaging (MRI). CLOCC is caused by a variety of etiologies, but CLOCC after vaccination is extremely rare. Four prior cases of CLOCC after the first dose of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine have been reported; these were localized to the splenium and showed early clinical and neuroradiological recovery. We experienced an unusual case in which a heterogeneous COVID-19 booster vaccination caused rather severe CLOCC damage. A 74-year-old Japanese woman presented with ataxia, high fever, and hearing loss several days after her third vaccination against COVID-19. This booster was an mRNA-1273 while her first and second vaccinations were both BNT162b2 type. SARS-CoV-2 real-time reverse transcriptase polymerase chain reaction (RT-PCR) analysis was negative, but serum SARS-CoV-2 S-IgG antibodies were elevated. Her cerebrospinal fluid (CSF) showed an elevated cell count and high levels of protein and interleukin-6 (IL-6). Brain MRI showed CLOCC spreading throughout the body of the corpus callosum. After the exclusion of other potential causes, the diagnosis of vaccination-related CLOCC was made. Six months later, recovery of clinical and MRI findings remained incomplete. It was suggested that the patient's CLOCC might have been caused by the increase in CSF IL-6 due to an enhanced immune response from the heterogeneous vaccination, resulting in more severe damage to the corpus callosum than usual.
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Affiliation(s)
- Yuta Chiba
- Gastroenterology and Neurology, Kagawa University, Kita-gun, JPN
| | | | - Rie Kawakita
- Gastroenterology and Neurology, Kagawa University, Kita-gun, JPN
| | - Kazushi Deguchi
- Gastroenterology and Neurology, Kagawa University, Kita-gun, JPN
| | - Tsutomu Masaki
- Gastroenterology and Neurology, Kagawa University, Kita-gun, JPN
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19
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Leong S, Teh BM, Kim AH. Characterization of otologic symptoms appearing after COVID-19 vaccination. Am J Otolaryngol 2023; 44:103725. [PMID: 36525812 PMCID: PMC9721195 DOI: 10.1016/j.amjoto.2022.103725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Anecdotal reports of sudden sensorineural hearing loss (SSNHL) following COVID-19 vaccination have emerged in the otolaryngology community. Studies have demonstrated no association between COVID-19 vaccination and SSNHL. We aim to characterize the spectrum of otologic symptoms following COVID-19 vaccination. METHODS A cross-sectional study of patients seen in the otology clinic at an academic center was performed. Patients completed a questionnaire on the development of new otologic symptoms within 4 weeks of COVID-19 vaccination. Diagnostic and audiometric data was collected retrospectively for patients reporting otologic symptoms. RESULTS Between May and July 2021, 500 patients were screened. Median age was 56.6 years old, with 59.4 % female and 40.2 % male. 420 patients (84.0 %) were vaccinated, with 58.4 % receiving Pfizer, 29.1 % receiving Moderna, and 3.8 % receiving Johnson & Johnson. 61 patients (14.5 %) reported one or more otologic symptoms within 4 weeks of vaccination, including 21 (5.0 %) with hearing loss, 26 (6.2 %) with tinnitus, 33 (7.9 %) with dizziness, and 19 (4.5 %) with vertigo. Of the 16 patients (3.2 %) reporting tinnitus with no associated hearing loss, 8 were diagnosed with subjective tinnitus and 4 were diagnosed with temporomandibular joint syndrome. Of the 18 patients reporting hearing loss, 11 had exacerbations of underlying pathologies (e.g. Meniere's disease, presbycusis) and 7 were newly diagnosed with SSNHL (1.4 %). CONCLUSIONS Patients reporting otologic symptoms following COVID-19 vaccination received various diagnoses of uncertain etiology. The incidence of SSNHL in these patients is comparable to the general otology patient population. Additional studies are required to determine the incidence of specific diagnoses following vaccination.
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Affiliation(s)
- Stephen Leong
- Columbia University Vagelos College of Physicians & Surgeons, New York, NY, United States of America
| | - Bing M Teh
- Department of Otolaryngology/Head and Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States of America; Department of Otolaryngology-Head & Neck Surgery, Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Ana H Kim
- Department of Otolaryngology/Head and Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States of America.
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20
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Yan HY, Young YH. Vertigo/dizziness following COVID-19 vaccination. Am J Otolaryngol 2023; 44:103723. [PMID: 36502671 PMCID: PMC9721153 DOI: 10.1016/j.amjoto.2022.103723] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 11/28/2022] [Indexed: 12/07/2022]
Abstract
PURPOSE This study assessed the vertigo/dizziness in patients following COVID-19 vaccination. PATIENTS AND METHODS From July 2021 to June 2022, totaling 50 patients with dizzy spells following COVID-19 vaccination by AZ (AstraZeneca-Oxford University, AZD1222), BNT (Pfizer-BioNTech, BNT162b2) or Moderna (Moderna, mRNA-1273) vaccine were enrolled in this study. The interval from vaccination to the onset of vertigo/dizziness was compared with inter-episodic interval of vertigo/dizziness in the same patients, but without vaccination, during past one year (2020). RESULTS The incidences of severe systemic complication per 106 shots were 0.86 for Moderna vaccine, 1.22 for AZ vaccine, and 1.23 for BNT vaccine. Conversely, rate of post-vaccination vertigo/dizziness was noted in the Moderna group (66 %), followed by the AZ group (20 %) and the BNT (14 %) group, meaning that type of COVID-19 vaccine may affect various organ systems. The median time to the onset of vertigo/dizziness following vaccination is 10d, which is consistent with the onset of IgG production, and significantly less than inter-episodic interval (84d) in the same patients without vaccination. CONCLUSION Post-vaccination vertigo/dizziness can manifest as exacerbation of previous neurotological disorder. The median time to the onset of vertigo/dizziness following COVID-19 vaccination is 10d. Since the outcome is fair after supportive treatment, the immunomodulatory effect of the vaccines does not undermine the necessity of the COVID-19 vaccination.
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Affiliation(s)
- Hong-Yu Yan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ho Young
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan; Deparment of Otolaryngology, Far Eastern Memorial Hospital, New Taipei, Taiwan.
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21
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Hosseini R, Askari N. A review of neurological side effects of COVID-19 vaccination. Eur J Med Res 2023; 28:102. [PMID: 36841774 PMCID: PMC9959958 DOI: 10.1186/s40001-023-00992-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 01/04/2023] [Indexed: 02/27/2023] Open
Abstract
Following the COVID-19 virus epidemic, extensive, coordinated international research has led to the rapid development of effective vaccines. Although vaccines are now considered the best way to achieve collective safety and control mortality, due to the critical situation, these vaccines have been issued the emergency use licenses and some of their potential subsequence side effects have been overlooked. At the same time, there are many reports of side effects after getting a COVID-19 vaccine. According to these reports, vaccination can have an adverse event, especially on nervous system. The most important and common complications are cerebrovascular disorders including cerebral venous sinus thrombosis, transient ischemic attack, intracerebral hemorrhage, ischemic stroke, and demyelinating disorders including transverse myelitis, first manifestation of MS, and neuromyelitis optica. These effects are often acute and transient, but they can be severe and even fatal in a few cases. Herein, we have provided a comprehensive review of documents reporting neurological side effects of COVID-19 vaccines in international databases from 2020 to 2022 and discussed neurological disorders possibly caused by vaccination.
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Affiliation(s)
- Roya Hosseini
- grid.412503.10000 0000 9826 9569Department of Biology, Faculty of Sciences, Shahid Bahonar University of Kerman, P.O.Box 76135-133, Kerman, Islamic Republic of Iran
| | - Nayere Askari
- Department of Biology, Faculty of Sciences, Shahid Bahonar University of Kerman, P.O.Box 76135-133, Kerman, Islamic Republic of Iran. .,Immunoregulation Research Center, Shahed University, Tehran, Islamic Republic of Iran.
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22
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Fisher R, Tarnovsky Y, Hirshoren N, Kaufman M, Stern Shavit S. The association between COVID-19 vaccination and idiopathic sudden sensorineural hearing loss, clinical manifestation and outcomes. Eur Arch Otorhinolaryngol 2023:10.1007/s00405-023-07869-2. [PMID: 36799975 PMCID: PMC9936109 DOI: 10.1007/s00405-023-07869-2] [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: 09/20/2022] [Accepted: 02/03/2023] [Indexed: 02/18/2023]
Abstract
PURPOSE Previous data demonstrated an increased incidence of Idiopathic Sensorineural Hearing Loss (ISSNHL) in 2021 compared to 2019-2020, suggesting an association with the anti-COVID-19 vaccine. We aimed to assess our center's incidence and compare the clinical manifestations and outcomes of vaccinated vs. unvaccinated patients. METHODS A retrospective chart review of all patients diagnosed with ISSNHL during 2021 was conducted and compared to patients who presented in 2018-2020. Patient demographics, audiometry features, vaccination status, and prognosis were evaluated. RESULTS Throughout 2021, 51 patients were diagnosed with ISSNHL, compared with 31 during 2020, 38 in 2019, and 41 in 2018, demonstrating a 64%, 34%, and 24% increase, respectively. Among patients who presented in 2021, 13 (25.4%) received the anti-COVID-19 vaccine within 30 days before their presentation, and 4 received it within 96 h. Most presented after receiving the second or third dose. Patient characteristics, audiometry features, and prognosis did not significantly differ between vaccinated and unvaccinated patients. CONCLUSIONS A marked incline was seen in the 2021 ISSNHL incidence at our medical center, of which 25% of cases were within a month post-anti-COVID-19 vaccination. No significant difference was found in clinical manifestations and outcomes between vaccinated and nonvaccinated patients. While other justifications could be sought, an association cannot be ruled out, and further research is needed.
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Affiliation(s)
- Ran Fisher
- Department of Otolaryngology, Head and Neck Surgery (HNS), Hadassah Medical Center and the Hebrew University School of Medicine, Ein-Kerem, 91120, Jerusalem, Israel
| | - Yehuda Tarnovsky
- Department of Otolaryngology-Head and Neck Surgery, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nir Hirshoren
- Department of Otolaryngology, Head and Neck Surgery (HNS), Hadassah Medical Center and the Hebrew University School of Medicine, Ein-Kerem, 91120, Jerusalem, Israel
| | - Michal Kaufman
- Department of Otolaryngology, Head and Neck Surgery (HNS), Hadassah Medical Center and the Hebrew University School of Medicine, Ein-Kerem, 91120, Jerusalem, Israel
| | - Sagit Stern Shavit
- Department of Otolaryngology, Head and Neck Surgery (HNS), Hadassah Medical Center and the Hebrew University School of Medicine, Ein-Kerem, 91120, Jerusalem, Israel.
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23
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Cho HY, Hung CH, Kao YW, Shia BC, Chen M. Impact of COVID-19 Preventative Measures on Otolaryngology in Taiwan: A Nationwide Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3371. [PMID: 36834066 PMCID: PMC9959067 DOI: 10.3390/ijerph20043371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Taiwan always had low case rates of COVID-19 compared with other countries due to its immediate control and preventive measures. However, the effects of its policies that started on 2020 for otolaryngology patients were unknown; therefore, the aim of this study was to analyze the nationwide database to know the impact of COVID-19 preventative measures on the diseases and cases of otolaryngology in 2020. METHOD A case-compared, retrospective, cohort database study using the nationwide database was collected from 2018 to 2020. All of the information from outpatients and unexpected inpatients with diagnoses, odds ratios, and correlation matrix was analyzed. RESULTS The number of outpatients decreased in 2020 compared to in 2018 and 2019. Thyroid disease and lacrimal system disorder increased in 2020 compared to 2019. There was no difference in carcinoma in situ, malignant neoplasm, cranial nerve disease, trauma, fracture, and burn/corrosion/frostbite within three years. There was a highly positive correlation between upper and lower airway infections. CONCLUSIONS COVID-19 preventative measures can change the numbers of otolaryngology cases and the distributions of the disease. Efficient redistribution of medical resources should be developed to ensure a more equitable response for the future.
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Affiliation(s)
- Hsiao-Yun Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Fu Jen Catholic University Hospital, Fu Jen Catholic University, No. 69, Guizi Road, Taishan Distict, New Taipei City 24352, Taiwan
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, No. 510, Zhongzhen Road, Xinzhuang District, New Taipei City 24205, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei 24205, Taiwan
| | - Chia-Hung Hung
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, No. 510, Zhongzhen Road, Xinzhuang District, New Taipei City 24205, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei 24205, Taiwan
- Department of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan
| | - Yi-Wei Kao
- Artificial Intelligence Development Center, Fu Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City 24205, Taiwan
- Department of Applied Statistics and Information Science, Ming Chuan University, Taoyuan City 32462, Taiwan
| | - Ben-Chang Shia
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, No. 510, Zhongzhen Road, Xinzhuang District, New Taipei City 24205, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City 24205, Taiwan
| | - Mingchih Chen
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, No. 510, Zhongzhen Road, Xinzhuang District, New Taipei City 24205, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City 24205, Taiwan
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Aldè M, Di Berardino F, Ambrosetti U, Barozzi S, Piatti G, Zanetti D, Pignataro L, Cantarella G. Audiological and vestibular symptoms following SARS-CoV-2 infection and COVID-19 vaccination in children aged 5-11 years. Am J Otolaryngol 2023; 44:103669. [PMID: 36283164 PMCID: PMC9583622 DOI: 10.1016/j.amjoto.2022.103669] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/15/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE The present study assessed the prevalence of audio-vestibular symptoms following SARS-COV-2 infection or COVID-19 vaccination among children, comparing the two groups. A further aim was to evaluate whether children with pre-existing unilateral hearing loss were more prone to adverse events. MATERIALS AND METHODS This retrospective study included children aged 5-11 years with normal hearing or a proven history of unilateral hearing loss who contracted SARS-CoV-2 or received two doses of COVID-19 vaccine. Tinnitus, hyperacusis, aural fullness, otalgia, otorrhea, new-onset hearing loss, vertigo and dizziness were investigated as possible complications of SARS-CoV-2 infection or the COVID-19 vaccine. RESULTS This study included 272 children (143 boys, 129 girls), with a mean age of 7.8 ± 2.3 years. Among these, 120 were affected by pre-existing unilateral hearing loss. The most common audio-vestibular symptoms reported by children following SARS-CoV-2 infection and COVID-19 vaccination were aural fullness (33/132, 25 %) and dizziness (5/140, 3.6 %), respectively. All symptoms following COVID-19 vaccination resolved within 24 h. Compared to children who received the COVID-19 vaccine, those infected with SARS-CoV-2 had a higher prevalence of tinnitus (p = 0.009), hyperacusis (p = 0.003), aural fullness (p < 0.001), otalgia (p < 0.001), otorrhea (p < 0.001), and vertigo (p = 0.006). Two girls also experienced new-onset unilateral sensorineural hearing loss following SARS-CoV-2 infection. Children with a known history of unilateral hearing loss did not have a higher prevalence of audio-vestibular symptoms than children with normal hearing. CONCLUSIONS Our results suggest that the COVID-19 vaccine is safe and can be recommended for children with unilateral hearing loss without fear of possible audio-vestibular sequelae.
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Affiliation(s)
- Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Federica Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Umberto Ambrosetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Stefania Barozzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Gioia Piatti
- Department of Pathophysiology and Transplantation, University of Milan and Unit of Bronchopneumology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Diego Zanetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Gabr T, Kotait M, Moaty AS. Audiovestibular and vaccination complications of COVID-19. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2022. [PMCID: PMC9389503 DOI: 10.1186/s43163-022-00290-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Abstract
Objectives
Since its first appearance in Wuhan December 2019, SARS-CoV2 virus received great attention due to its severe symptoms and high spread causing COVID-19 disease which spread all over the world like a pandemic. The causative virus is capable of human-to-human transmission via droplet and direct contact suggesting that upper respiratory tract is the main site to virus manifestations.
There is a great diversity in its clinical picture, although the severe respiratory and neurological symptoms are commonly present; however, other symptoms are present. Although otological manifestations are reported in many COVID-19 patients even in asymptomatic cases, they did not receive much attention compared with other critical manifestations. In this article, we paid our attention specifically to the otological manifestations of COVID-19 and their relevance either to the virus infection, treatment, or vaccination through literature review.
Conclusion
COVID-19 disease has a deleterious effect on the inner ear. This effect is not only due to SARS-Cov-2 infection, but it could be also due to the ototoxic drugs used for treatment. The COVID-19 vaccinations are found to be implicated in the otological symptoms in some cases.
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Jeong J, Yoon PH. Sudden sensorineural hearing loss with intralabyrinthine hemorrhage after COVID-19 vaccination. Hum Vaccin Immunother 2022; 18:2097462. [PMID: 35793501 DOI: 10.1080/21645515.2022.2097462] [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: 12/15/2022] Open
Abstract
Otologic symptoms of sudden sensorineural hearing loss (SSNHL) have been reported after Coronavirus disease 2019 (COVID-19) vaccinations. However, the association between SSNHL and COVID-19 vaccination has not been clearly established. SSNHL with vertigo can be induced by intralabyrinthine hemorrhage (ILH). The case of a 61-year-old female who was diagnosed SSNHL with ILH after COVID-19 vaccination is presented here. She visited the emergency department for left sudden hearing loss and vertigo that had occurred the previous day. She had received a third booster COVID-19 mRNA vaccination one day prior to the visit; symptoms occurred 6 hours after vaccination. On pure tone audiometry, her hearing threshold indicated deafness in the left ear. A lesion assumed to be ILH was observed on temporal magnetic resonance imaging. She received an oral steroid followed by salvage treatment with intratympanic steroid injection. Three months after symptom onset, her hearing threshold remained deaf with slight improvement at low frequencies in the left ear. Because the symptoms of and prognosis for SSNHL may be worse and vertigo may occur in patients with SSNHL and ILH, careful treatment is required.
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Affiliation(s)
- Junhui Jeong
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Pyeong Ho Yoon
- Department of Radiology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
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27
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Yan MM, Zhao H, Li ZR, Chow JW, Zhang Q, Qi YP, Wu SS, Zhong MK, Qiu XY. Serious adverse reaction associated with the COVID-19 vaccines of BNT162b2, Ad26.COV2.S, and mRNA-1273: Gaining insight through the VAERS. Front Pharmacol 2022; 13:921760. [PMID: 36419624 PMCID: PMC9676979 DOI: 10.3389/fphar.2022.921760] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 10/04/2022] [Indexed: 09/05/2023] Open
Abstract
Background and purpose: Serious adverse events following immunization (AEFI) associated with the COVID-19 vaccines, including BNT162b2 (Pfizer-BioNTech), Ad26.COV2.S (Janssen), and mRNA-1273 (Moderna), have not yet been fully investigated. This study was designed to evaluate the serious AEFI associated with these three vaccines. Methods: A disproportionality study was performed to analyze data acquired from the Vaccine Adverse Event-Reporting System (VAERS) between 1 January 2010 and 30 April 2021. The reporting odds ratio (ROR) method was used to identify the association between the COVID-19 vaccines BNT162b2, Ad26.COV2.S, and mRNA-1273 and each adverse event reported. Moreover, the ratio of the ROR value to the 95% CI span was applied to improve the credibility of the ROR. The median values of time from vaccination to onset (TTO) for the three vaccines were analyzed. Results: Compared with BNT162b2 and mRNA-1273, Ad26.COV2.S vaccination was associated with a lower death frequency (p < 0.05). Ad26.COV2.S vaccination was associated with a lower birth defect and emergency room visit frequency than BNT162b2 (p < 0.05). There were 6,605, 830, and 2,292 vaccine recipients who suffered from COVID-19-related symptoms after vaccination with BNT162b2, Ad26.COV2.S, and mRNA-1273, respectively, including people who were infected by COVID-19, demonstrated a positive SARS-CoV-2 test, and were asymptomatic. Serious AEFI, including thromboembolism, hemorrhage, thrombocytopenia, cardiac arrhythmia, hypertension, and hepatotoxicity, were associated with all three vaccines. Cardiac failure and acute renal impairment events were associated with BNT162b2 and mRNA-1273, while seizure events were associated with BNT162b2 and Ad26.COV2.S. The median values of TTO associated with the three vaccinations were similar. Conclusion: These findings may be useful for health workers and the general public prior to inoculation, especially for patients with underlying diseases; however, the risk/benefit profile of these vaccines remains unchanged. The exact mechanism of SARS-CoV-2 vaccine-induced AEFI remains unknown, and further studies are required to explore these phenomena.
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Affiliation(s)
- Ming-Ming Yan
- Clinical Pharmacy Department, Huashan Hospital, Fudan University, Shanghai, China
| | - Hui Zhao
- Clinical Pharmacy Department, Huashan Hospital, Fudan University, Shanghai, China
| | - Zi-Ran Li
- Clinical Pharmacy Department, Huashan Hospital, Fudan University, Shanghai, China
| | - Jun-Wei Chow
- Clinical Pharmacy Department, Huashan Hospital, Fudan University, Shanghai, China
- School of Pharmacy, Fudan University, Shanghai, China
| | - Qian Zhang
- Clinical Pharmacy Department, Huashan Hospital, Fudan University, Shanghai, China
| | - Yu-Peng Qi
- Clinical Pharmacy Department, Huashan Hospital, Fudan University, Shanghai, China
| | - Shu-Shan Wu
- University of Nebraska Medical Center College of Pharmacy, Omaha, United States
| | - Ming-Kang Zhong
- Clinical Pharmacy Department, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiao-Yan Qiu
- Clinical Pharmacy Department, Huashan Hospital, Fudan University, Shanghai, China
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Muacevic A, Adler JR. Uncommon Side Effects of COVID-19 Vaccination in the Pediatric Population. Cureus 2022; 14:e30276. [PMID: 36258808 PMCID: PMC9573128 DOI: 10.7759/cureus.30276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction The rapid development of vaccines followed the Coronavirus disease 2019 (COVID-19) pandemic. There is still significant vaccine hesitancy, especially among parents. Large-scale pediatric population-based studies or reviews about vaccine side effects are limited. Data sources and methods The Centers for Disease Control and Prevention (CDC) recommends recipients or their providers notify possible adverse events to the Vaccine Adverse Event Reporting System (VAERS). We evaluated Delaware state data from the VAERS system for the pediatric age group. Results A total of 111 reports were reviewed, with summaries of the reported key side effects discussed, including seizures, myocarditis, stroke, multisystem inflammatory syndrome in children (MIS-C), chest pain, hematuria, menstrual disorder, appendicitis, behavioral and otological side effects, etc. Conclusions We noted the approximate prevalence of reported adverse events to be <0.2%. Further studies with larger sample sizes or those focused on each key side effect are needed to evaluate these side effects in detail. An open discussion about the possible side effects and reinforcing the individual, family, and community benefits are key to promoting COVID-19 vaccine acceptance.
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Chen C, Fu F, Ding L, Xiao J. Hearing disorder following
COVID
‐19 vaccination: A pharmacovigilance analysis using the Vaccine Adverse Event Reporting System. J Clin Pharm Ther 2022; 47:1789-1795. [PMID: 36089844 PMCID: PMC9539140 DOI: 10.1111/jcpt.13767] [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: 06/08/2022] [Revised: 08/03/2022] [Accepted: 08/10/2022] [Indexed: 11/28/2022]
Abstract
What is known and objective Evidence on whether the coronavirus disease 2019 (COVID‐19) vaccination could cause hearing‐related adverse events is still conflicting. This study aims to access the association between COVID‐19 vaccine and hearing disorder. Methods The Vaccine Adverse Event Reporting System (VAERS) was queried between January 2020 to November 2021. The disproportionality pattern for hearing impairment of COVID‐19 vaccine was accessed by calculating the reporting odds ratio (ROR) and proportional reporting ratio (PRR). A further subgroup analysis based on the type of COVID‐19 vaccine and the doses administered was performed. In addition, the disproportionalities for hearing dysfunction between COVID‐19 and influenza vaccines were compared. Results and discussion A total of 14,956 reports of hearing‐related adverse events were identified with COVID‐19 vaccination and 151 with influenza vaccine during the analytic period in VAERS. The incidence of hearing disorder following COVID‐19 vaccination was 6.66 per 100,000. The results of disproportionality analysis revealed that the adverse events of hearing impairment, after administration of COVID‐19 vaccine, was significantly highly reported (ROR 2.38, 95% confidence interval [CI] 2.20–2.56; PRR: 2.35, χ2 537.58), for both mRNA (ROR 2.37, 95% CI 2.20–2.55; PRR 2.34, χ2 529.75) and virus vector vaccines (ROR 2.50, 95% CI 2.28–2.73; PRR 2.56, χ2 418.57). While the disproportional level for hearing dysfunction was quite lower in influenza vaccine (ROR 0.36, 95% CI 0.30–0.42; PRR 0.36, χ2 172.24). What is new and conclusion This study identified increased risk for hearing disorder following administration of both mRNA and virus vector COVID‐19 vaccines compared to influenza vaccination in real‐world settings.
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Affiliation(s)
- Congqin Chen
- Department of Pharmacy Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University Xiamen China
| | - Fang Fu
- Department of Pharmacy Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University Xiamen China
| | - Lingqing Ding
- Department of Pharmacy Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University Xiamen China
| | - Jie Xiao
- Department of Pharmacy Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University Xiamen China
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30
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Al-Ani RM. Ear, nose, and throat manifestations of COVID-19 and its vaccines. World J Clin Cases 2022; 10:8808-8815. [PMID: 36157654 PMCID: PMC9477042 DOI: 10.12998/wjcc.v10.i25.8808] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/01/2022] [Accepted: 07/25/2022] [Indexed: 02/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a highly infectious disease and was designated a pandemic by the World Health Organization (WHO) on March 11, 2020. There are no classical manifestations of the disease. The most prevalent symptoms include fever, cough, dyspnea, myalgia and headache. The main route of transmission of the severe acute respiratory syndrome coronavirus-2 is through the upper respiratory tract. Therefore, it is not strange to find different ear, nose and throat (ENT) symptoms in individuals infected with this virus. Olfactory dysfunction is a common feature of COVID-19; either it is the only presenting symptom or it accompanies other manifestations of the disease. Other otolaryngological features such as sudden sensorineural hearing loss (SSNHL), dysphonia, nasal obstruction, sore throat, etc. are less frequent manifestations of COVID-19. These features, in addition, to being presented early in the disease process, certain long-standing symptoms like parosmia, dysphonia, and persistent deafness, are other characteristics of the disease. Geographical variation in otorhinolaryngological prevalence is another problem with this debilitating disease. Local and systemic adverse effects (local site injection pain, fever, myalgia, headache, and others) of the COVID-19 vaccines are more frequent than otolaryngological side effects (anosmia, hyposmia, Bell’s palsy, SSNHL, etc.). We aimed in this review to summarize the early and persistent ENT symptoms of COVID-19 or after the various COVID-19 vaccines.
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Affiliation(s)
- Raid M Al-Ani
- Department of Surgery/Otolaryngology, University of Anbar, College of Medicine, Ramadi 31001, Anbar, Iraq
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31
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Gerb J, Becker-Bense S, Zwergal A, Huppert D. Vestibular syndromes after COVID-19 vaccination: a prospective cohort study. Eur J Neurol 2022; 29:3693-3700. [PMID: 36056895 PMCID: PMC9538778 DOI: 10.1111/ene.15546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/05/2022] [Accepted: 08/23/2022] [Indexed: 11/28/2022]
Abstract
Background and purpose Dizziness and vertigo are common symptoms after COVID‐19‐vaccination. We aimed to prospectively evaluate objective central or peripheral vestibular function in patients with dizziness, vertigo, and postural symptoms that started or worsened after COVID‐19‐vaccination. Methods Of 4137 patients who presented between January 2021 and April 2022 at the German Center for Vertigo and Balance Disorders, Ludwig Maximilian University of Munich, we identified 72 patients (mean age = 47 years) with enduring vestibular symptoms following COVID‐19 vaccination. All underwent medical history‐taking, and neurological and neuro‐otological workup with bithermal caloric test, video head‐impulse test, orthoptics, and audiometry. Diagnoses were based on international criteria. The distribution of diagnoses was compared to a cohort of 39,964 patients seen before the COVID‐19 pandemic. Results Symptom onset was within the first 4 weeks postvaccination. The most prevalent diagnoses were somatoform vestibular disorders (34.7%), vestibular migraine (19.4%), and overlap syndromes of both (18.1%). These disorders were significantly overrepresented compared to the prepandemic control cohort. Thirty‐six percent of patients with somatoform complaints reported a positive history of depressive or anxiety disorders. Nine patients presented with benign paroxysmal positional vertigo, three with acute unilateral vestibulopathy, and seven with different entities (vestibular paroxysmia, Ménière disease, polyneuropathy, ocular muscular paresis). Causally related central vestibular deficits were lacking. Novel peripheral vestibular deficits were found in four patients. Conclusions Newly induced persistent vestibular deficits following COVID‐19 vaccination were rare. The predominant causes of prolonged vestibular complaints were somatoform vestibular disorders and vestibular migraine, possibly triggered or aggravated by stress‐related circumstances due to the COVID‐19 pandemic or vaccination. An increase of other central or peripheral vestibular syndromes after COVID‐19 vaccination was not observed.
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Affiliation(s)
- Johannes Gerb
- German Center for Vertigo and Balance Disorders-DSGZ, Ludwig-Maximilians University Munich, Munich, Germany.,Department of Neurology, Ludwig-Maximilians University Munich, Munich, Germany
| | - Sandra Becker-Bense
- German Center for Vertigo and Balance Disorders-DSGZ, Ludwig-Maximilians University Munich, Munich, Germany
| | - Andreas Zwergal
- German Center for Vertigo and Balance Disorders-DSGZ, Ludwig-Maximilians University Munich, Munich, Germany.,Department of Neurology, Ludwig-Maximilians University Munich, Munich, Germany
| | - Doreen Huppert
- German Center for Vertigo and Balance Disorders-DSGZ, Ludwig-Maximilians University Munich, Munich, Germany
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Yoon J, Song MS, Lee SY, Park MK, Lee JH, Oh SH, Lee MY, Suh MW. Patterns of vestibular function in patients with dizziness after COVID-19 vaccination; dual tertiary referral center study. Acta Otolaryngol 2022; 142:668-674. [PMID: 36384386 DOI: 10.1080/00016489.2022.2140191] [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: 11/18/2022]
Abstract
BACKGROUND Although dizziness is a common symptom after vaccination, the mechanism, and prognosis are not well understood. AIMS/OBJECTIVES This study aimed to investigate patients with dizziness after COVID-19 vaccination by analyzing objective information. METHODS A retrospective study of patients who visited the outpatient clinics of two institutes with a complaint of dizziness occurring within 72 h after a COVID-19 vaccination. RESULTS In most cases, patients experienced only a single event of dizziness, and the subjective symptom was relieved after a few weeks. All patients decreased gain of vestibular ocular reflex (VOR). The vestibular function test results showed signs of central vestibulopathy in some cases. We separated patients into two groups; the direction-fixed nystagmus (DFN) group and the direction-changing nystagmus (DCN) group. All patients showed decreased gain on the rotational chair test (RCT). The DFN group showed an 80% decrease in video head impulse test (vHIT) gain, whereas the DCN group only showed a decrease of 25%. In RCT, 66% of the DFN group showed asymmetry compared to 20% showing asymmetry in the DCN group. CONCLUSION AND SIGNIFICANCE The patients who suffered from dizziness after the COVID-19 vaccination exhibited decreased VOR gain and in some cases signs of central vestibulopathy.
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Affiliation(s)
- Joonsik Yoon
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Min Seok Song
- Department of Otorhinolaryngology-Head & Neck Surgery, Dankook University Hospital, Cheonan, South Korea
| | - Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Jun Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Seung Ha Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Min Young Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, Dankook University Hospital, Cheonan, South Korea
| | - Myung-Whan Suh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
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Safety of COVID-19 Vaccines: Spotlight on Neurological Complications. Life (Basel) 2022; 12:life12091338. [PMID: 36143376 PMCID: PMC9502976 DOI: 10.3390/life12091338] [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: 07/17/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/21/2022] Open
Abstract
The COVID-19 pandemic has led to unprecedented demand on the global healthcare system. Remarkably, at the end of 2021, COVID-19 vaccines received approvals for human use in several countries worldwide. Since then, a solid base for response in the fight against the virus has been placed. COVID-19 vaccines have been shown to be safe and effective drugs. Nevertheless, all kinds of vaccines may be associated with the possible appearance of neurological complications, and COVID-19 vaccines are not free from neurological side effects. Neurological complications of COVID-19 vaccination are usually mild, short-duration, and self-limiting. However, severe and unexpected post-vaccination complications are rare but possible events. They include the Guillain-Barré syndrome, facial palsy, other neuropathies, encephalitis, meningitis, myelitis, autoimmune disorders, and cerebrovascular events. The fear of severe or fatal neurological complications fed the “vaccine hesitancy” phenomenon, posing a vital communication challenge between the scientific community and public opinion. This review aims to collect and discuss the frequency, management, and outcome of reported neurological complications of COVID-19 vaccines after eighteen months of the World Health Organization’s approval of COVID-19 vaccination, providing an overview of safety and concerns related to the most potent weapon against the SARS-CoV-2.
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Analysis of Adverse Effects of COVID-19 Vaccines in Spain following Booster Dose. Vaccines (Basel) 2022; 10:vaccines10091397. [PMID: 36146475 PMCID: PMC9504129 DOI: 10.3390/vaccines10091397] [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: 07/18/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
The present study evaluates the adverse effects of three vaccines: AstraZeneca (Vaxzevria), Pfizer/BioNTech (Comirnaty) and Moderna (Spikevax) according to the dose. From 733 participants collected, the vaccine schedule was as follows: 330 (45%) received a double dose of the AstraZeneca vaccine, 382 (52.1%) received a double dose of Pfizer, 18 (2.5%) received a heterologous prime boost and 3 (0.4%) received a single dose. Pfizer and Moderna vaccines were administered as a third dose in 70 and 121 individuals, respectively. Local and systemic reactions observed in the three vaccines were mild to moderate in severity. Only one AstraZeneca recipient (0.3%) presented a serious adverse effect: blurred vision. Adverse events were more frequent after the first dose of AstraZeneca and after the second dose of Pfizer. As the third dose, Moderna causes more adverse effects than Pfizer regardless of the type of vaccine previously administered, whereas the reactogenicity of a third dose of Pfizer is slightly higher in the group previously vaccinated with Pfizer than in that group with AstraZeneca. In short, secondary effects of the third dose of COVID-19 vaccines were similar to those after dose 2, but their frequency depends on the type of vaccine and the combinations of vaccines.
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Zoccali F, Cambria F, Colizza A, Ralli M, Greco A, de Vincentiis M, Petrella C, Fiore M, Minni A, Barbato C. Sudden Sensorineural Hearing Loss after Third Dose Booster of COVID-19 Vaccine Administration. Diagnostics (Basel) 2022; 12:diagnostics12092039. [PMID: 36140441 PMCID: PMC9498132 DOI: 10.3390/diagnostics12092039] [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: 07/13/2022] [Revised: 08/12/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) was declared a pandemic due to its rapid spread worldwide, and its vaccination campaign is considered one of the most historic public hygiene measures in modern medicine. Sudden sensorineural hearing loss (SSHL) is a common emergency that affects patient’s quality of life and requires rapid treatment with steroids. The etiology could be viral or vascular even though in most cases it remains unknown (idiopathic SSHL). During the SARS-CoV-2 vaccination campaign, several rare but serious adverse events have been reported including thrombosis with thrombocytopenia syndrome, myocarditis, and Guillain-Barré Syndrome. ENT adverse events after vaccination were reported too, including cases of sudden sensorineural hearing loss (SSHL), vestibular neuronitis and audio vestibular disorders (such as tinnitus, dizziness, and vertigo). For the first time here, we reported two cases of SSHL after third administration of COVID-19 mRNA vaccine. Even if there is not clear evidence of an association between SSHL and vaccination, adverse effects should be kept in mind since viral infection could be the etiology of SSHL.
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Affiliation(s)
- Federica Zoccali
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
- Correspondence: (F.Z.); (A.M.); (C.B.)
| | - Francesca Cambria
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
| | - Andrea Colizza
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
| | | | - Carla Petrella
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| | - Marco Fiore
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| | - Antonio Minni
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
- Correspondence: (F.Z.); (A.M.); (C.B.)
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
- Correspondence: (F.Z.); (A.M.); (C.B.)
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Beukes E, Manchaiah V, Pyykkö N, Pyykkö I. Adverse COVID-19 vaccination effects in Finnish patients with Ménière's disease: a cross-sectional study. F1000Res 2022; 11:893. [PMID: 36483315 PMCID: PMC9706144 DOI: 10.12688/f1000research.113143.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 01/13/2023] Open
Abstract
Background: The association between reporting adverse coronavirus disease 2019 (COVID-19) vaccination effects and those with a history of audiovestibular difficulties is unknown. The aim of this research is therefore to investigate adverse vaccination effects in adults with a history of Ménière's disease. Specifically, the incidence of adverse effects, the factors associated with those reporting adverse effects and the relationship between the reporting of audiovestibular and other adverse effects. Methods: A mixed-methods exploratory cross-sectional survey study design was used. Data were collected from 333 members of the Finnish Ménière Association. The survey was designed to obtain demographic information that may be associated with having adverse effects or not, vaccination-specific information and adverse vaccination effects. Both health and audiovestibular adverse events were identified. Data analysis included comparing those reporting and not reporting adverse vaccination effects. Results: The mean age was 63 years with 81% being female. Of the 327 respondents who had one of the COVID-19 vaccinations (Comirnatry/ Pfizer, Astra Zeneca, or Moderna), 203 (62%) reported no adverse effects. The type of or number of vaccinations were not related to the reporting of adverse effects. The most frequently reported adverse effects were injection site tenderness (38%), arm pain (21%), fever (15%) and headaches (15%). Post-vaccination tinnitus and vertigo (both 7%) were the most frequently reported audiovestibular-related symptoms, followed by aural fullness (6%) and hearing loss (4%). Those reporting previous pre-vaccination vertigo were more likely to have post-vaccination vertigo. The presence of post-vaccination tinnitus, hearing loss, and aural fullness, predicted the presence of post-vaccination vertigo. Conclusions: A small proportion of patients with a history of Ménière's disease may experience adverse post-vaccination effects. Further research is required to explore whether adverse post-vaccination audiovestibular effects are more prevalent in those with a history of otological disorders compared with the general population.
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Affiliation(s)
- Eldre Beukes
- Vision and Hearing Sciences Research Group, Anglia Ruskin University, Cambridge, Cambridgeshire, CB1 1TP, UK
- Virtual Hearing Lab, Virtual Hearing Lab, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, Colorado, USA, Aurora, Colorado, USA
| | - Vinaya Manchaiah
- Virtual Hearing Lab, Virtual Hearing Lab, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, Colorado, USA, Aurora, Colorado, USA
- Department of Otolaryngology–Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- UC Health Hearing and Balance, University of Colorado Hospital, Aurora, Colorado, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, Gauteng, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Nora Pyykkö
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Ilmari Pyykkö
- Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland
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Schmid MB, Bächinger D, Pangalu A, Straumann D, Dlugaiczyk J. Acute Unilateral Peripheral Vestibulopathy After COVID-19 Vaccination: Initial Experience in a Tertiary Neurotology Center. Front Neurol 2022; 13:917845. [PMID: 35847228 PMCID: PMC9283640 DOI: 10.3389/fneur.2022.917845] [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: 04/11/2022] [Accepted: 06/06/2022] [Indexed: 01/14/2023] Open
Abstract
ObjectiveThe aim of the present study was to identify patients who developed acute unilateral peripheral vestibulopathy (AUPVP) after COVID-19 vaccination.MethodsFor this single-center, retrospective study, we screened the medical records of our tertiary interdisciplinary neurotology center for patients who had presented with AUPVP within 30 days after COVID-19 vaccination (study period: 1 June−31 December 2021). The initial diagnosis of AUPVP was based on a comprehensive bedside neurotological examination. Laboratory vestibular testing (video head impulse test, cervical and ocular vestibular evoked myogenic potentials, dynamic visual acuity, subjective visual vertical, video-oculography, caloric testing) was performed 1–5 months later.ResultsTwenty-six patients were diagnosed with AUPVP within the study period. Of those, n = 8 (31%) had developed acute vestibular symptoms within 30 days after COVID-19 vaccination (mean interval: 11.9 days, SD: 4.8, range: 6–20) and were thus included in the study. The mean age of the patients (two females, six males) was 46 years (SD: 11.7). Seven patients had received the Moderna mRNA vaccine and one the Pfizer/BioNTech mRNA vaccine. All patients displayed a horizontal(-torsional) spontaneous nystagmus toward the unaffected ear and a pathological clinical head impulse test toward the affected ear on initial clinical examination. Receptor-specific laboratory vestibular testing performed 1–5 months later revealed recovery of vestibular function in two patients, and heterogeneous lesion patterns of vestibular endorgans in the remaining six patients.Discussion and ConclusionsThe present study should raise clinicians' awareness for AUPVP after COVID-19 vaccination. The relatively high fraction of such cases among our AUPVP patients may be due to a certain selection bias at a tertiary neurotology center. Patients presenting with acute vestibular symptoms should be questioned about their vaccination status and the date of the last vaccination dose. Furthermore, cases of AUPVP occurring shortly after a COVID-19 vaccination should be reported to the health authorities to help determining a possible causal relationship.
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Affiliation(s)
- Marc Basil Schmid
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - David Bächinger
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Athina Pangalu
- Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Dominik Straumann
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Julia Dlugaiczyk
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- *Correspondence: Julia Dlugaiczyk
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Current Evidence in SARS-CoV-2 mRNA Vaccines and Post-Vaccination Adverse Reports: Knowns and Unknowns. Diagnostics (Basel) 2022; 12:diagnostics12071555. [PMID: 35885461 PMCID: PMC9316835 DOI: 10.3390/diagnostics12071555] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 01/14/2023] Open
Abstract
The novel mRNA vaccinations against COVID-19 are gaining worldwide attention for their potential efficacy, as well as for the diagnosis of some post-vaccination-reported adverse reactions. In this state-of-the-art review article, we present the current evidence regarding mainly the diagnosis of spontaneous allergic reactions, the skin occurrences, the vascular, blood, endocrine and heart events, the respiratory reports, the gastrointestinal, hepatic and kidney events, the reproductive and pregnancy issues and the muscle events, as well as the ear, eye, neurologic and psychiatric events following mRNA vaccination against COVID-19. We further present some evidence regarding the mRNA strategies, we provide important information for side effects associated with the spike protein based LNP-mRNA vaccine and its adjuvants, as well as evidence for all the possible dangerous roles of the spike protein, and we discuss our expert opinion on the knowns and the unknowns towards the topic.
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Harpaz R, DuMouchel W, Van Manen R, Nip A, Bright S, Szarfman A, Tonning J, Lerch M. Signaling COVID-19 Vaccine Adverse Events. Drug Saf 2022; 45:765-780. [PMID: 35737293 PMCID: PMC9219360 DOI: 10.1007/s40264-022-01186-z] [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] [Accepted: 05/08/2022] [Indexed: 12/18/2022]
Abstract
Introduction Statistical signal detection is a crucial tool for rapidly identifying potential risks associated with pharmaceutical products. The unprecedented environment created by the coronavirus disease 2019 (COVID-19) pandemic for vaccine surveillance predisposes commonly applied signal detection methodologies to a statistical issue called the masking effect, in which signals for a vaccine of interest are hidden by the presence of other reported vaccines. This masking effect may in turn limit or delay our understanding of the risks associated with new and established vaccines. Objective The aim is to investigate the problem of masking in the context of COVID-19 vaccine signal detection, assessing its impact, extent, and root causes. Methods Based on data underlying the Vaccine Adverse Event Reporting System, three commonly applied statistical signal detection methodologies, and a more advanced regression-based methodology, we investigate the temporal evolution of signals corresponding to five largely recognized adverse events and two potentially new adverse events. Results The results demonstrate that signals of adverse events related to COVID-19 vaccines may be undetected or delayed due to masking when generated by methodologies currently utilized by pharmacovigilance organizations, and that a class of advanced methodologies can partially alleviate the problem. The results indicate that while masking is rare relative to all possible statistical associations, it is much more likely to occur in COVID-19 vaccine signaling, and that its extent, direction, impact, and roots are not static, but rather changing in accordance with the changing nature of data. Conclusions Masking is an addressable problem that merits careful consideration, especially in situations such as COVID-19 vaccine safety surveillance and other emergency use authorization products. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-022-01186-z.
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Affiliation(s)
- Rave Harpaz
- Oracle Health Sciences, Burlington, MA, USA.
| | | | | | | | | | | | - Joseph Tonning
- U.S. Public Health Service/U.S. FDA retired, Silver Spring, MD, USA
| | - Magnus Lerch
- Oracle Health Sciences, Burlington, MA, USA.,Lenolution GmbH, Berlin, Germany
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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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Ekobena P, Rothuizen LE, Bedussi F, Guilcher P, Meylan S, Ceschi A, Girardin F, Dao K. Four cases of audio-vestibular disorders related to immunisation with SARS-CoV-2 mRNA vaccines. Int J Audiol 2022:1-5. [PMID: 35510657 DOI: 10.1080/14992027.2022.2056721] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To gain medical insight into the clinical course and safety of otolaryngologic disorders following immunisation with severe acute respiratory coronavirus (SARS-CoV-2) mRNA-based vaccines. DESIGN Case description. STUDY SAMPLE We report four cases of transient audio-vestibular symptoms, which occurred shortly after inoculation of two BNT162b2 (Pfizer-BioNTech®) and mRNA-1273 (Moderna®) vaccines. RESULTS Hearing loss was unilateral in all cases and recovered at least partially: it was associated with persistent gait instability in two cases, after 1 and 7 months. Trigger mechanisms underpinning audio-vestibular impairment remain uncertain. Immune tolerance mechanisms with off-target innate activation of T-lymphocytes may be involved in vestibulocochlear nerve disorders, as for other cranial nerves involvement. CONCLUSIONS The occurrence of audio-vestibular manifestations following mRNA-based vaccines needs ENT monitoring to support their causality in such rare vaccine-related adverse events. Audio-vestibular disorders appeared of transitory nature, including hearing loss, and should not deter further efforts in large-scale vaccination campaigns against SARS-CoV-2.
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Affiliation(s)
- Pierre Ekobena
- Department of Laboratory Medicine and Pathology, Service of Clinical Pharmacology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Laura E Rothuizen
- Department of Laboratory Medicine and Pathology, Service of Clinical Pharmacology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Francesca Bedussi
- Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Pierre Guilcher
- Department of Otorhinolaryngology, Head & Neck Surgery, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Sylvain Meylan
- Department of Medicine, Infectious Diseases Service, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Alessandro Ceschi
- Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - François Girardin
- Department of Laboratory Medicine and Pathology, Service of Clinical Pharmacology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Kim Dao
- Department of Laboratory Medicine and Pathology, Service of Clinical Pharmacology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
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Pisani D, Gioacchini FM, Viola P, Scarpa A, Astorina A, Re M, Marcianò G, Manti F, Anzivino R, Chiarella G. Audiovestibular Disorders after COVID-19 Vaccine: Is There an Association? Audiol Res 2022; 12:212-223. [PMID: 35645194 PMCID: PMC9149883 DOI: 10.3390/audiolres12030024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 01/04/2023] Open
Abstract
The SARS-CoV-2 vaccination campaign is probably one of the most historic public hygiene measures in modern medicine. The drama of the pandemic has forced the scientific community to accelerate the development and commercialization of vaccines, thereby enhancing the phases of active surveillance. Among the adverse events following immunization (AEFI) reported, those of an audiovestibular interest, such as sudden sensorineural hearing loss (SSNHL), tinnitus, dizziness, and vertigo, constitute a very small percentage. There are many plausible etiological hypotheses, and scientific research needs to pay more attention to the correct collection of data, which up until now have often been inadequate and fragmented, on which to base future studies. SSNHL, new onset tinnitus, vertigo, and dizziness require a prompt evaluation, while the proposed treatment is the same as it is for events unrelated to vaccination. These are uncommon adverse events, and the risk rates for these diseases have not increased in conjunction with the COVID-19 vaccinations, therefore there is no justification of any hesitation towards the vaccination campaign.
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Affiliation(s)
- Davide Pisani
- Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (D.P.); (A.A.); (G.C.)
| | - Federico Maria Gioacchini
- Ear, Nose, and Throat Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Conca 71, 60020 Ancona, Italy; (F.M.G.); (M.R.)
| | - Pasquale Viola
- Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (D.P.); (A.A.); (G.C.)
| | - Alfonso Scarpa
- Department of Medicine and Surgery, University of Salerno, 84084 Fisciano, Italy;
| | - Alessia Astorina
- Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (D.P.); (A.A.); (G.C.)
| | - Massimo Re
- Ear, Nose, and Throat Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Conca 71, 60020 Ancona, Italy; (F.M.G.); (M.R.)
| | - Gianmarco Marcianò
- Department of Health Science, University Magna Graecia, 88100 Catanzaro, Italy;
| | - Francesco Manti
- U.O.C. Radiodiagnostics, Magna Graecia University, 88100 Catanzaro, Italy;
| | | | - Giuseppe Chiarella
- Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (D.P.); (A.A.); (G.C.)
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Saunders GH, Beukes E, Uus K, Armitage CJ, Kelly J, Munro KJ. Shedding Light on SARS-CoV-2, COVID-19, COVID-19 Vaccination, and Auditory Symptoms: Causality or Spurious Conjunction? Front Public Health 2022; 10:837513. [PMID: 35296050 PMCID: PMC8919951 DOI: 10.3389/fpubh.2022.837513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/25/2022] [Indexed: 01/08/2023] Open
Abstract
There are reports of associations between SARS-CoV2, COVID-19, COVID-19 vaccines, and auditory symptoms (hearing difficulty, tinnitus). However, most studies have relied on self-report and lack baseline and/or non-COVID control groups. This makes it problematic to differentiate if symptoms are associated with SARS-CoV2, COVID-19, the vaccine, psychosocial factors or recall bias. In this study, we differentiate these by comparing hearing and tinnitus survey data collected pre- and during the pandemic. The survey conducted during the pandemic asked about the onset and change in three types of symptom. Type One—known association (loss of smell, memory/concentration issues, persistent fatigue), Type Two—indeterminate association (auditory symptoms), and Type Three—no established association with COVID-19 (toothache). We hypothesized that if auditory symptoms are directly associated with COVID-19, their onset and change would be similar to Type One symptoms, but if indirectly associated (reflecting psychosocial factors and/or recall bias) would be more similar to Type Three symptoms. Of the 6,881 individuals who responded, 6% reported confirmed COVID-19 (positive test), 11% probably had COVID-19, and 83% reported no COVID-19. Those with confirmed or probable COVID-19 more commonly reported new and/or worsened auditory symptoms than those not reporting COVID-19. However, this does not imply causality because: (1) new auditory symptoms coincided with COVID-19 illness among just 1/3 of those with confirmed or probable COVID-19, and another 1/3 said their symptoms started before the pandemic—despite reporting no symptoms in the pre-pandemic survey. (2) >60% of individuals who had COVID-19 said it had affected their Type 3 symptoms, despite a lack of evidence linking the two. (3) Those with confirmed COVID-19 reported more Type 1 symptoms, but reporting of Type 2 and Type 3 symptoms did not differ between those with confirmed COVID-19 and those without COVID-19, while those who probably had COVID-19 most commonly reported these symptom types. Despite more reports of auditory symptoms in confirmed or probable COVID-19, there is inconsistent reporting, recall bias, and possible nocebo effects. Studies that include appropriate control groups and use audiometric measures in addition to self-report to investigate change in auditory symptoms relative to pre-COVID-19 are urgently needed.
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Affiliation(s)
- Gabrielle H Saunders
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, United Kingdom
| | - Eldre Beukes
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Kai Uus
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, United Kingdom
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom.,National Institute for Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Manchester, United Kingdom.,Manchester University National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Jack Kelly
- Centre for Biostatistics, University of Manchester, Manchester, United Kingdom
| | - Kevin J Munro
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, United Kingdom.,Manchester University National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
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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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45
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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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Garg RK, Paliwal VK. Spectrum of neurological complications following COVID-19 vaccination. Neurol Sci 2022; 43:3-40. [PMID: 34719776 PMCID: PMC8557950 DOI: 10.1007/s10072-021-05662-9] [Citation(s) in RCA: 122] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/08/2021] [Indexed: 12/12/2022]
Abstract
COVID-19 vaccines have brought us a ray of hope to effectively fight against deadly pandemic of COVID-19 and hope to save lives. Many vaccines have been granted emergency use authorizations by many countries. Post-authorization, a wide spectrum of neurological complications is continuously being reported following COVID-19 vaccination. Neurological adverse events following vaccination are generally mild and transient, like fever and chills, headache, fatigue, myalgia and arthralgia, or local injection site effects like swelling, redness, or pain. The most devastating neurological post-vaccination complication is cerebral venous sinus thrombosis. Cerebral venous sinus is frequently reported in females of childbearing age, generally following adenovector-based vaccination. Another major neurological complication of concern is Bell's palsy that was reported dominantly following mRNA vaccine administration. Acute transverse myelitis, acute disseminated encephalomyelitis, and acute demyelinating polyneuropathy are other unexpected neurological adverse events that occur as result of phenomenon of molecular mimicry. Reactivation of herpes zoster in many persons, following administration of mRNA vaccines, has been also recorded. Considering the enormity of recent COVID-19-vaccinated population, the number of serious neurological events is miniscule. Large collaborative prospective studies are needed to prove or disprove causal association between vaccine and neurological adverse events occurring vaccination.
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Affiliation(s)
- Ravindra Kumar Garg
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh India PIN-226003
| | - Vimal Kumar Paliwal
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareli road, Lucknow, India
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Daher GS, Nassiri AM, Vanichkachorn G, Carlson ML, Neff BA, Driscoll CLW. New onset tinnitus in the absence of hearing changes following COVID-19 infection. Am J Otolaryngol 2022; 43:103208. [PMID: 34536917 PMCID: PMC8429075 DOI: 10.1016/j.amjoto.2021.103208] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/05/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND A variety of neurosensory symptoms including tinnitus have been associated with COVID-19 infection. While most cases of tinnitus are associated with hearing loss, here we report a case of severe tinnitus following COVID-19 infection with normal thresholds through 8000 Hz. CASE REPORT A 49-year-old male presented with new onset severe tinnitus following COVID-19 infection. Tinnitus was bilateral, constant and nonpulsatile. Audiometric evaluation revealed normal threshold through 8000 Hz, with mild hearing loss at 16,000 Hz. Conservative measures including masking strategies failed to mitigate symptoms. A trial of gabapentin 300 mg twice per day improved tinnitus with no notable side effects. CONCLUSION This patient may represent a subpopulation of patients who suffer from severe tinnitus following COVID-19 infection in the setting of largely normal hearing. The pathophysiology may be distinct from the more common hearing loss associated tinnitus and perhaps neuromodulators may play a larger role in mitigating tinnitus in this patient subset.
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Affiliation(s)
- Ghazal S Daher
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States of America
| | - Ashley M Nassiri
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States of America
| | - Greg Vanichkachorn
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States of America
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States of America
| | - Brian A Neff
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States of America
| | - Colin L W Driscoll
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States of America.
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Finsterer J, Scorza FA, Fiorini AC. Impaired hearing following SARS-CoV-2 vaccinations. Int J Infect Dis 2021; 115:215-216. [PMID: 34896579 PMCID: PMC8654803 DOI: 10.1016/j.ijid.2021.12.317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/02/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Josef Finsterer
- Department of Neuroscience. University of Sao Paolo (UNIFESP/EPM), Sao Paulo, Brazil.
| | - Fulvio A Scorza
- Department of Neuroscience. University of Sao Paolo (UNIFESP/EPM), Sao Paulo, Brazil.
| | - Ana C Fiorini
- Programa de Estudos Pós-Graduado em Fonoaudiologia, Pontifícia Universidade Católica de São Paulo (PUC-SP), Brazil; Departamento de Fonoaudiologia, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil.
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Abstract
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 and presents with pneumonia as the most frequent and serious manifestation. COVID-19 vaccination is an important and urgent interest globally due to COVID-19's rapid spread and high rates of mortality and morbidity. Vestibular neuritis (VN) is an acute vestibular syndrome that causes acute and spontaneous vertigo due to unilateral vestibular deafferentiation, leading to nausea or vomiting and unsteadiness that can last from days to weeks. Reactivation of latent type 1 herpes simplex virus, autoimmune disorders, and microvascular ischemia are hypothesized to be etiologies. Herein, the case of a 54-year-old man who developed VN within three days after COVID-19 vaccination is presented. There have been no reports of VN after vaccination for COVID-19 or other viral diseases. Although the association between VN and COVID-19 vaccination remains unclear, clinicians should be aware that VN may occur as an adverse event of COVID-19 vaccination.
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Affiliation(s)
- Junhui Jeong
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea,CONTACT Junhui Jeong Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang10444, Korea
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Labyrinthite post-vaccinale anti-COVID19 révélatrice d’une GPA. Rev Med Interne 2021. [PMCID: PMC8610739 DOI: 10.1016/j.revmed.2021.10.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Dans le contexte de la pandémie à SARS-CoV-2, des manifestations audio-vestibulaires post-infection à Covid-19 ont été rapportées [1]. Depuis l’apparition des vaccins, quelques cas d’atteinte de l’oreille interne survenus dans les 30 jours suivants la vaccination par vaccin à ARNm [2] sont également décrits. Nous présentons ici le cas unique d’une labyrinthite révélant une vascularite nécrosante à ANCA imputable au vaccin ChAdOx1 nCoV-19. Observation Une patiente de 67 ans, sans antécédent ORL connu, en rémission d’un cancer du sein BRCA2-muté, a présenté fin mars 2021 une otite moyenne aiguë compliquée en avril d’une labyrinthite bilatérale. Elle avait reçu une injection de vaccin ChAdOx1 nCoV-19 le 6 mars 2021. 3 lignes d’antibiotiques ont été administrés avant que le diagnostic de labyrinthite ne soit posé. L’otoscopie mettait en évidence des tympans inflammatoires et l’audiogramme une surdité mixte bilatérale. L’IRM des conduits auditifs internes montrait un épaississement non nodulaire mais rehaussé de la paroi latérale gauche du cavum le long de la fossette de Rosenmüller et du trajet tubaire associé à un comblement des pyramides pétreuses droite et gauche. Les biopsies profondes de l’oreille droite montraient une inflammation subaiguë sans granulome. Les analyses microbiologiques étaient stériles. Devant l’apparition d’arthralgies inflammatoires des poignets et genoux et un amaigrissement de 3 kg, une maladie de système était suspectée. Elle était apyrétique et ne présentait pas d’autre signe ORL, ni de manifestations ophtalmologique, respiratoire ou neurologique. On observait une anémie inflammatoire (CRP à 39,6 mg/l) sans autre cytopénie, sans anomalie de la fonction rénale (dont protéinurie ou hématurie) ni des tests hépatiques. Les sérologies VIH, syphilis, borréliose étaient négatives. Les ANCA-PR3 étaient rendus positifs à un taux de 18 UI/ml et on trouvait un anticoagulant circulant de type lupique sans autre anti phospholipide. Les AAN étaient négatifs et l’exploration du complément normale. L’IRM cérébrale montrait quelques hypersignaux non spécifiques de la substance blanche supratentorielle. L’analyse du LCR ne décrivait pas de profil inflammatoire et les PCR virales VZV et HSV intrathécales étaient indétectables. Le scanner thoraco-abdomino-pelvien objectivait des micronodules pulmonaires. Le traitement a consisté en un assaut de corticoïdes IV relayé d’une corticothérapie orale à 1 mg/kg/j de prednisone suivi d’une décroissance progressive. La patiente rapporte une disparition des otalgies et une amélioration de l’audition dès les premiers jours de traitement parallèlement à la normalisation du syndrome inflammatoire. L’hydrops tympanique a disparu et l’amélioration fonctionnelle a été documentée par l’audiogramme. Discussion La labyrinthite associée aux vascularites à ANCA est bien établie même s’il s’agit d’une manifestation peu fréquente dans le cadre de l’expression ORL de la granulomatose avec polyangéite. Le lien entre pathologie infectieuse et vascularite nécrosante systémique est souvent évoqué mais sans preuve directe [3]. Des réactions dysimmunitaires et inflammatoires ont été rapportées à la suite d’infections notamment virale ; et la pandémie COVID-19 a permis de rouvrir le débat sur le rôle immunogène de l’ARN virale. Avec plus de 3 milliards de personnes vaccinées pour le SARS-CoV2, ces manifestations dysimmunitaires constituent un pourcentage très faible d’effets indésirables qui semblent s’exprimer dans des conditions prédisposantes ou dans des populations particulières. Des cas de labyrinthite et de vascularites à ANCA ont été rapportées en lien avec une infection à Covid19. La pharmacovigilance rapporte 6 autres cas de labyrinthite en France et 373 dans le monde imputable à un vaccin anti-SARS-CoV2. On en compte un en France parmi les 118 rapportés dans le monde avec le vaccin ChAdOx1 nCoV-19. À notre connaissance, cette observation est la première à témoigner de l’association entre labyrinthite et vascularite à ANCA imputable au vaccin anti-SARS-CoV2. Conclusion La labyrinthite associée aux vascularites à ANCA-PR3 imputable au vaccin ChAdOx1 nCoV-19 est une manifestation exceptionnelle. Cette atteinte uniquement ORL a été de bon pronostic et semble corticosensible à l’image des vascularites nécrosantes à ANCA localisée à la sphère ORL.
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