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Fancello V, Fancello G, Genovese E, Pelucchi S, Palma S, Bianchini C, Ciorba A. Auditory Screening in Newborns after Maternal SARS-CoV-2 Infection: An Overview. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050834. [PMID: 37238382 DOI: 10.3390/children10050834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND AND AIM Several viruses have previously been reported to be responsible for congenital hearing loss; therefore, since the beginning of the SARS-CoV-2 infection pandemic, various reports have investigated a possible link. The aim of this review is to assess the possible link between maternal COVID-19 infection and congenital hearing loss. METHODS This systematic review was performed using PRISMA criteria, searching Medline and Embase databases from March 2020 to February 2023. A total of 924 candidate papers were identified; however, considering the specific selection criteria, only nine were selected for additional analysis. RESULTS The overall number of children born from mothers infected with COVID-19 during pregnancy identified through this review was 1687. The confirmed cases of hearing loss were 0.7% (12/1688); a description of its nature (sensorineural vs. conductive) is missing in the selected studies, and the follow-up period is variable across the analyzed papers. Surprisingly, a large proportion of false positives were recorded at the first stage of screening, which resulted normal at the re-test. CONCLUSIONS Currently, a correlation between congenital hearing loss and SARS-CoV-2 infection cannot be definitively established. Further studies are desirable to provide additional evidence on this topic.
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Affiliation(s)
- Virginia Fancello
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Giuseppe Fancello
- Department of Otorhinolaryngology, Careggi University Hospital, 50134 Florence, Italy
| | - Elisabetta Genovese
- ENT & Audiology Department, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Stefano Pelucchi
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Silvia Palma
- ENT & Audiology Department, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Chiara Bianchini
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Andrea Ciorba
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44124 Ferrara, Italy
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Rajanna LB, Raina S, Bhatia R, Tripathi S, Bayad HC, Ranjan R, Srivastava A, Chahar OS. Gestational Mild COVID-19 Infection Associated Neonatal Hearing Loss: A Case-Control Study from North India. Indian J Otolaryngol Head Neck Surg 2023:1-6. [PMID: 37362118 PMCID: PMC10109224 DOI: 10.1007/s12070-023-03786-2] [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: 04/01/2023] [Accepted: 04/05/2023] [Indexed: 06/28/2023] Open
Abstract
COVID-19 infection during pregnancy is potentially dangerous to neonatal hearing, as it is the period of organogenesis, and associated hyperthermia may cause vascular damage, disruption of cell migration, and death of the dividing neuroblasts. To investigate the possible association between neonatal hearing loss and gestational mild COVID-19 infection. A prospective case-control study was conducted at a tertiary healthcare centre in North India from March 2020 to Oct 2022. Cases included the neonates born to COVID-19-positive mothers were subjected to hearing screening at 1, 3 and 6 months using otoacoustic emission (OAE) and automated auditory brainstem response (AABR). Similar protocol was applied to controls, i.e., neonates borne to mothers with no gestational history of COVID infection. Results were analyzed statistically. Our study reported that the statistical difference between groups A (n = 942) and B (n = 942) for gestational COVID-19 infection and neonatal hearing loss was insignificant at 1 month (p-value 0.272 for OAE and p-value 0.634 for AABR) and also insignificant at 3 and 6 months (p-value 0.679 for AABR, for both). The association between gestational mild COVID-19 infection during gestation and neonatal hearing loss is statistically insignificant at initial screening as well as sequential screenings.
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Affiliation(s)
- Lohith Banavara Rajanna
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Sheetal Raina
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Ritika Bhatia
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Shailendra Tripathi
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Himanshu Chhagan Bayad
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Ranjeet Ranjan
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Anchita Srivastava
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
| | - Omvir Singh Chahar
- Department of ENT, Head and Neck Surgery, Command Hospital Central Command, Cariappa Road, Lucknow, Uttar Pradesh 226002 India
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Goulioumis A, Angelopoulou M, Kourelis K, Mourtzouchos K, Tsiakou M, Asimakopoulos A. Hearing screening test in neonates born to COVID-19-positive mothers. Eur J Pediatr 2023; 182:1077-1081. [PMID: 36565323 PMCID: PMC9789365 DOI: 10.1007/s00431-022-04770-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/17/2022] [Accepted: 12/17/2022] [Indexed: 12/25/2022]
Abstract
SARS-CoV-2, the responsible virus for the COVID-19 pandemic, has demonstrated neurotropic properties indicated by cases presenting with auditory and vestibular system insults. The expression of ACE-2 receptors in the placenta and the detection of IgM antibodies against the virus in the fetuses of pregnant women suffering from COVID-19 render vertical transmission of the infection to the fetus possible. Thus, our study aims to examine whether, similar to other viruses like CMV, SARS-CoV-2 is responsible for congenital hearing loss. This is a retrospective study in a regional pediatric hospital. The medical records of newborns (n = 111) born by mothers positive for COVID-19 during pregnancy who underwent screening hearing tests with Transient Evoked Otoacoustic Emissions (TEOAE) and Automatic Auditory Brainstem Response (AABR) from February 2020 to June 2022 were reviewed. Neonates with additional aggravating factors for congenital hearing loss were excluded from the study. For the study period, nine mothers were found positive during the first trimester, twenty mothers in the second trimester, and eighty-three mothers in the third trimester. TEOAEs test and AABR test scored PASS bilaterally in all neonates tested. CONCLUSION Infection with COVID-19 during pregnancy was not a risk factor for hearing loss, similar to other studies. WHAT IS KNOWN • The pathogenetic mechanism of the viral-induced impairment of the organ of Corti includes direct damage to the hair cells and indirect damage due to the induction of the innate inflammatory response. • Early data suggested that the SARS-CoV-2 virus also has neurotropic properties with manifestations from the sensory epithelia. WHAT IS NEW • Although the intrauterine infection remains controversial, the expression of the ACE-2 receptor on the placenta and the detection of IgM antibodies, as well as the covid-19 genome in fetuses, make the vertical transmission tenable. • In our study, the newborn hearing screening results indicate that COVID-19 infection during pregnancy is not a risk factor for hearing loss.
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Affiliation(s)
- Anastasios Goulioumis
- Department of Otorhinolaryngology, Pediatric Hospital "Karamandanio", Erythrou Stavou 40, 26331, Patras, Greece.
| | - Maria Angelopoulou
- Department of Otorhinolaryngology, Pediatric Hospital "Karamandanio", Erythrou Stavou 40, 26331, Patras, Greece
| | - Konstantinos Kourelis
- Department of Otorhinolaryngology, Pediatric Hospital "Karamandanio", Erythrou Stavou 40, 26331, Patras, Greece
| | - Konstantinos Mourtzouchos
- Department of Otorhinolaryngology, Pediatric Hospital "Karamandanio", Erythrou Stavou 40, 26331, Patras, Greece
| | - Magdalini Tsiakou
- Department of Otorhinolaryngology, Pediatric Hospital "Karamandanio", Erythrou Stavou 40, 26331, Patras, Greece
| | - Athanasios Asimakopoulos
- Department of Otorhinolaryngology, Pediatric Hospital "Karamandanio", Erythrou Stavou 40, 26331, Patras, Greece
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Tanyeri Toker G, Kumbul YC, Cetinkol AE, Aslan H, Baba P, Oncel MY. Is Gestational COVID-19 a Risk Factor for Congenital Hearing Loss? Otol Neurotol 2023; 44:115-120. [PMID: 36624586 PMCID: PMC9835235 DOI: 10.1097/mao.0000000000003761] [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] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of this study was to investigate whether COVID-19 during pregnancy is a risk factor for congenital hearing loss. STUDY DESIGN Retrospective cohort. SETTING Tertiary referral center. PATIENTS Hearing screening test results of 60,223 newborns between March 2020 and May 2021 were screened using the national database. Newborn babies of 570 pregnant women with positive COVID-19 PCR test during pregnancy who met the study criteria were included in the gestational COVID-19 group, and 570 healthy newborns born in the same period were included in the control group. INTERVENTION Diagnostic. MAIN OUTCOME MEASURE Results of up to three automatic auditory brainstem response tests in the first 30 days of life were used for newborn hearing screening. RESULTS When the gestational COVID-19 and control groups were compared in terms of demographic data, there was no statistically significant difference for any of the variables (maternal age, gestational age, birth weight, neonate gender, mode of delivery, p > 0.05 for all variables). Of the mothers in the gestational COVID-19 group, 62 (10.9%) had COVID-19 in the first trimester, 181 (31.8%) in the second trimester, and 327 (57.3%) in the third trimester. When the first and second test results of newborn hearing screening were compared between the groups, the number of babies with hearing loss was higher in the gestational COVID-19 group than in the control group (p = 0.025; odds ratio, 1.357; 95% confidence interval, 1.039-1.774; p = 0.006; odds ratio, 4.924; 95% confidence interval, 1.410-17.193, respectively). For the third test results, hearing loss was detected in only one baby in both groups (p = 0.284). When the first, second, and third test results for newborn hearing screening were compared according to the trimesters when COVID-19 positivity was identified, the difference between trimesters was not found to be statistically significant (p > 0.05). CONCLUSION To the best of our knowledge, this is the largest study in the literature of the impact of COVID-19 on newborn hearing. The findings in the study suggest that gestational COVID-19 is not a risk factor for permanent congenital hearing loss. However, because the risk of detecting hearing loss is high in the first 15 days, we emphasize the importance of the third screening test.
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Affiliation(s)
- Gokce Tanyeri Toker
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir
| | | | - Ali Emre Cetinkol
- Izmir Provincial Directorate of Health Public Health Services Presidency
| | - Hale Aslan
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir
| | - Pinar Baba
- Division of Audiology, Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital
| | - Mehmet Yekta Oncel
- Division of Neonatology, Department of Pediatrics, Izmir Katip Celebi University School of Medicine, Izmir, Turkey
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Apa E, Presutti MT, Rossi C, Roversi MF, Neri S, Gargano G, Bianchin G, Polizzi V, Caragli V, Monzani D, Berardi A, Palma S, Genovese E. Monitoring of Auditory Function in Newborns of Women Infected by SARS-CoV-2 during Pregnancy. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020194. [PMID: 36832324 PMCID: PMC9954415 DOI: 10.3390/children10020194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Gestational SARS-CoV-2 infection can impact maternal and neonatal health. The virus has also been reported to cause newborn sensorineural hearing loss, but its consequences for the auditory system are not fully understood. OBJECTIVE The aim of this study was to evaluate the impact of maternal SARS-CoV-2 infection during pregnancy on newborn' hearing function during the first year of life. METHODS An observational study was conducted from 1 November 2020 to 30 November 2021 at University Modena Hospital. All newborns whose mother had been infected by SARS-CoV-2 during pregnancy were enrolled and underwent audiological evaluation at birth and at 1 year of age. RESULTS A total of 119 neonates were born from mothers infected by SARS-CoV-2 during pregnancy. At birth, five newborns (4.2%) presented an increased threshold of ABR (Auditory Brainstem Evoked Response), but the results were confirmed only in 1.6% of cases, when repeated 1 month later, while the ABR thresholds in all other children returned to normal limits. At the 1-year follow-up, no cases of moderate or severe hearing loss were observed, while concomitant disorders of the middle ear were frequently observed. CONCLUSIONS Maternal SARS-CoV-2 infection, regardless of the trimester in which it was contracted, appears not to induce moderate or severe hearing loss in infants. It is important to clarify the possible effect of the virus on late-onset hearing loss and future research is needed.
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Affiliation(s)
- Enrico Apa
- Otorhinolaryngology Unit, Department of Medical and Surgical Sciences for Children and Adults, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
| | - Maria Teresa Presutti
- Infectious Disease Unit, Department of Medical and Surgical Sciences, Sant’Orsola-Malpighi Hospital, University of Bologna, 40100 Bologna, Italy
| | - Cecilia Rossi
- Neonatal Intensive Care Unit, Department of Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
| | - Maria Federica Roversi
- Neonatal Intensive Care Unit, Department of Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
| | - Salvatore Neri
- Neonatal Intensive Care Unit, Department of Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
| | - Giancarlo Gargano
- Department of Obstetrics and Paediatrics, Santa Maria Nuova Hospital, Centre for Clinical and Basic Research (IRCCS), 42121 Reggio Emilia, Italy
| | - Giovanni Bianchin
- Department of Audiology, Santa Maria Nuova Hospital, Centre for Clinical and Basic Research (IRCCS), 42123 Reggio Emilia, Italy
| | - Valeria Polizzi
- Department of Audiology, Santa Maria Nuova Hospital, Centre for Clinical and Basic Research (IRCCS), 42123 Reggio Emilia, Italy
| | - Valeria Caragli
- Otorhinolaryngology Unit, Department of Medical and Surgical Sciences for Children and Adults, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
| | - Daniele Monzani
- ENT, Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Borgo Roma Hospital, 37100 Verona, Italy
| | - Alberto Berardi
- Neonatal Intensive Care Unit, Department of Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
| | - Silvia Palma
- Audiology, Primary Care Department; AUSL of Modena, 41100 Modena, Italy
- Correspondence: (S.P.); (E.G.)
| | - Elisabetta Genovese
- Otorhinolaryngology Unit, Department of Medical and Surgical Sciences for Children and Adults, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
- Correspondence: (S.P.); (E.G.)
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Khoza-Shangase K. Cochleovestibular findings linked to COVID-19: A scoping review for clinical care planning in South Africa. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2022; 69:e1-e12. [PMID: 36073075 PMCID: PMC9452924 DOI: 10.4102/sajcd.v69i2.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 12/15/2022] Open
Abstract
Background On 30 January 2020, the World Health Organization (WHO) officially declared an outbreak of the coronavirus disease 2019 (COVID-19) to be a global health emergency. Research has focused on the impact and response to life-threatening symptoms of COVID-19 across the lifespan; however, there is a need to investigate the effects of COVID-19 on the cochleovestibular system, as viral infections are known to impact this system. This is particularly important for contexts where resources are limited and prioritisation of resources requires strong risk versus benefit evaluations. Objective Therefore, the purpose of this scoping review was to investigate published evidence on the impact of COVID-19 on the cochleovestibular system across the lifespan in order to allow for strategic clinical care planning in South Africa, where capacity versus demand challenges exist. Methods Electronic bibliographic databases such as CINAHL, EBSCOHost, MEDLINE, ProQuest, PubMed, Scopus and ScienceDirect were searched for peer-reviewed publications between January 2020 and January 2022. These had to be published in English and related to the impact of COVID-19 on the cochleovestibular system, where the question was: ‘what evidence has been published on the impact of COVID-19 on the cochleovestibular system?’ Review selection and characterisation was performed by the researcher with an independent review by a colleague using pretested forms. Results Of a total of 24 studies that met the inclusion criteria, the current scoping review revealed limited conclusive published evidence linking COVID-19 to permanent hearing function symptoms. Current evidence supports the possibility of COVID-19, similar to other viral infections in adults, impacting the cochleovestibular system and causing tinnitus, vertigo and sudden sensorineural hearing loss (SSNHL), with the symptoms being generally temporary and resolving either partially or completely following therapy with steroids, with very inconclusive findings in the paediatric population. Conclusion These findings raise global implications for properly designed studies, which include longitudinal follow-up of cases across the lifespan, examining this link with some focus on establishing the pathophysiologic mechanisms at play as well. In the meanwhile, current findings raise the value of polymerase chain reaction (PCR) testing for all patients presenting with unexplained cochleovestibular symptoms during the pandemic, as these may be the only presenting symptoms indicating COVID-19, thus requiring careful treatment and management.
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Affiliation(s)
- Katijah Khoza-Shangase
- Department of Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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Meng X, Zhu K, Wang J, Liu P. Can SARS-CoV-2 positive pregnant women affect the hearing of their newborns: A systematic review. Am J Otolaryngol 2022; 43:103523. [PMID: 35691051 PMCID: PMC9161687 DOI: 10.1016/j.amjoto.2022.103523] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 01/08/2023]
Abstract
The 2019 coronavirus disease (COVID-19) pandemic has caused over 500 million confirmed cases (including pregnant women) worldwide. Recently, hearing status in newborns born to mothers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has received attention. This systematic review outlines the current knowledge regarding the effects of maternal SARS-CoV-2 infection during pregnancy on newborn hearing. Intrauterine SARS-CoV-2 infection has the potential to affect the auditory system of the newborn due to intrauterine hypoxia and vertical transmission. SARS-CoV-2 might have a greater influence on hearing loss (HL) in newborns during the second and third trimesters of pregnancy. Therefore, all newborns whose mothers had COVID-19 during pregnancy should be evaluated for cochlear function, regardless of whether their mothers were symptomatic at the time of the disease. However, the understanding of this issue is not consistent and remains controversial. Since early identification and intervention of congenital HL are crucial to the language development of newborns, newborns should be provided with audiological evaluation by various approaches, including Tele-audiology, in the COVID-19 era.
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Veeranna SA, Youngblood PL, Bradshaw L, Marx CG. COVID-19 during pregnancy and its impact on the developing auditory system. Am J Otolaryngol 2022; 43:103484. [PMID: 35533437 PMCID: PMC9066709 DOI: 10.1016/j.amjoto.2022.103484] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/01/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND This study compared distortion product otoacoustic emissions (DPOAEs) and click-evoked auditory brainstem responses (ABRs) recorded from infants whose mother had Covid-19 during pregnancy (Covid-19 group) to infants whose mother did not have Covid-19 (Control group) during pregnancy. METHODS This study retrospectively examined records of infants in the Covid-19 group (n = 15) and control group (n = 46) who had distortion product otoacoustic emissions (DPOAEs) and click-evoked auditory brainstem responses (ABRs) recorded as part of their clinical assessment. DPOAE amplitudes, absolute latencies (I, III, and V), and I-V interpeak intervals were examined. RESULTS DPOAE amplitudes were similar between the Covid-19 group and the control group. The absolute latency of wave I was similar between groups. But absolute latencies III and V and I-V interpeak intervals of the Covid-19 group were significantly prolonged compared to the control group. CONCLUSION Covid-19 infection and its complications during pregnancy may not affect the cochlear function but may affect the functioning of the auditory brainstem.
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