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José MR, Ortega JDS, Baran JBC, Lüders D, Gonçalves CGDO, Zeigelboim BS, Taveira KVM, Polanski JF, Santos RS, Corrêa CDC, de Araujo CM. Relationship Between Chloroquine or Hydroxychloroquine Use and Hearing Disorders: A Systematic Review and Meta-Analysis. J Audiol Otol 2024; 28:126-145. [PMID: 38382520 PMCID: PMC11065553 DOI: 10.7874/jao.2023.00157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/21/2023] [Accepted: 08/16/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Chloroquine and its analog hydroxychloroquine are derivatives of 4-aminoquinoline and are regularly used in the treatment of malaria and autoimmune diseases. Among the side effects of these drugs, alterations associated with the auditory system are frequently mentioned. Thus, the aim of this systematic review is to systematically review publications on hearing disorders and chloroquine or hydroxychloroquine use. MATERIALS AND METHODS Inclusion criteria were observational or interventional studies on audiological assessment in participants who were using chloroquine or hydroxychloroquine. The methodological quality was independently assessed by two reviewers using the Meta-Analysis of Statistics: assessment and review Instrument. The certainty of the evidence was assessed using the GRADE tool. RESULTS A total of 1,372 non-duplicate papers were screened, out of which 17 were included in the final qualitative synthesis, and 5 studies in the meta-analysis. The odds ratio for the two subgroups evaluated did not show significance with no heterogeneity between the effects observed between the different diseases (I2=0%) and obtaining the global estimate of 0.76 (95% confidence interval [CI]=0.41-1.39; p>0.05). Despite the inclusion of papers with different disease samples, the heterogeneity observed in the analysis was low (I2= 0%) and prediction interval (95% PI=0.32-1.80; p>0.05) remained close to that estimated by the CI (95% CI=0.41-1.39; p>0.05). The certainty of the evidence assessed by the GRADE tool was considered very low due to the risk of bias, indirect evidence, and imprecision. CONCLUSIONS The findings of this study suggest that the use of chloroquine/hydroxychloroquine is not associated with hearing disorders.
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Affiliation(s)
- Maria Renata José
- Department of Speech, Language and Hearing Sciences, São Paulo State University (UNESP), Marília, São Paulo, Brazil
- Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, Curitiba, Paraná, Brazil
| | - Jéssica da Silva Ortega
- Graduation in Speech, Language and Hearing Sciences, Tuiuti University of Paraná, Curitiba, Paraná, Brazil
| | - Jordana Batista Correia Baran
- Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, Curitiba, Paraná, Brazil
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Paraná, Brazil
| | - Débora Lüders
- Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, Curitiba, Paraná, Brazil
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Paraná, Brazil
| | | | - Bianca Simone Zeigelboim
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Paraná, Brazil
| | - Karinna Veríssimo Meira Taveira
- Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, Curitiba, Paraná, Brazil
- Department of Morphology - Center of Biosciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - José Fernando Polanski
- Department of Otorhinolaryngology-Head and Neck Surgery, Federal University of Paraná, and Mackenzie Evangelical School of Medicine, Curitiba, Paraná, Brazil
| | - Rosane Sampaio Santos
- Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, Curitiba, Paraná, Brazil
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Paraná, Brazil
| | - Camila de Castro Corrêa
- Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, Curitiba, Paraná, Brazil
- Department of Speech, Language and Hearing Sciences, Centro Universitário Planalto do Distrito Federal, Brasília, Distrito Federal, Brazil
| | - Cristiano Miranda de Araujo
- Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, Curitiba, Paraná, Brazil
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Paraná, Brazil
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Arruda de Souza Alcarás P, Alves Corazza MC, Vianna L, Miranda de Araújo C, Corazza LA, Zeigelboim BS, Moreira de Lacerda AB. Auditory and Vestibular Findings in Brazilian Adults Affected by COVID-19: An Exploratory Study. Audiol Neurootol 2023; 28:466-477. [PMID: 37490870 PMCID: PMC11251666 DOI: 10.1159/000531207] [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: 02/21/2023] [Accepted: 05/15/2023] [Indexed: 07/27/2023] Open
Abstract
INTRODUCTION The aim of the study was to describe auditory and vestibular findings in Brazilian adults after COVID-19 in a municipality from the outskirts of the São Paulo state. METHODS This was a transversal and exploratory study comprising sixteen participants infected by the SARS-CoV-2 virus, confirmed through RT-PCR detection, aged 20 to 55 years. Subjects underwent anamnesis, vestibular and auditory testing. Fisher's exact test was used to evaluate medication use, chemical and physical exposure, and occupational risk and McNemar test was used to compare auditory and vestibular symptoms pre- and post-COVID-19. RESULTS Most patients were women (75%) and had been exposed to the virus over 90 days before testing (50%). 18.8% used hydroxychloroquine, 68.8% used ivermectin, and 87.5% used azithromycin to treat COVID-19. Auditory complaints were reported by 31.2% and vestibular by 18.7%. There was no statistical difference before and after the disease. Other reported symptomatology was hair loss, pain, fatigue, memory loss, difficulty to concentrate, and headache. Auditory findings were relevant in contralateral acoustic reflex, in the distortion-product otoacoustic emissions, and in the brainstem auditory evoked potential, characterizing a neurosensorial compromise. 43.74% of patients had altered vectonystagmography. When comparing both ears, no statistical relevance was found; however, when results were crossed with medication use and exposures, there was statistical relevance in the amplitude of the V wave for medications and absolute latency of the V wave to exposure to physical agents. DISCUSSION/CONCLUSION This study demonstrated auditory and vestibular findings of neurosensorial nature, considering hearing and of a peripheral vestibulopathy. As it is a study of transversal nature, it is not possible to extend results to general population; yet it may be a finding to future studies.
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Affiliation(s)
| | - Maria Cristina Alves Corazza
- Post-Graduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
- Faculty of Medicine, University of Western São Paulo, Presidente Prudente, Brazil
| | - Larissa Vianna
- Post-Graduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
| | | | - Luíza Alves Corazza
- Neurology Department, Hospital Santa Marcelina de Itaquera, São Paulo, São Paulo, Brazil
| | | | - Adriana Bender Moreira de Lacerda
- Post-Graduate Program in Communication Disorders, Tuiuti University of Paraná, Curitiba, Brazil
- l’École d’Orthophonie et d’Audiologie, Université de Montreal (CA), Montreal, QC, Canada
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