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Yih WK, Duffy J, Su JR, Bazel S, Fireman B, Hurley L, Maro JC, Marquez P, Moro P, Nair N, Nelson J, Smith N, Sundaram M, Vasquez-Benitez G, Weintraub E, Xu S, Shimabukuro T. Tinnitus after COVID-19 vaccination: Findings from the vaccine adverse event reporting system and the vaccine safety datalink. Am J Otolaryngol 2024; 45:104448. [PMID: 39096568 DOI: 10.1016/j.amjoto.2024.104448] [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: 06/27/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024]
Abstract
PURPOSE To assess the occurrence of tinnitus following COVID-19 vaccination using data mining and descriptive analyses in two U.S. vaccine safety surveillance systems. METHODS Reports of tinnitus after COVID-19 vaccination to the Vaccine Adverse Event Reporting System (VAERS) from 2020 through 2024 were examined using empirical Bayesian data mining and by calculating reporting rates. In the Vaccine Safety Datalink (VSD) population, ICD-10 coded post-vaccination medical visits were examined using tree-based data mining, and tinnitus visit incidence rates during post-vaccination days 1-140 were calculated by age group for COVID-19 vaccines and for comparison, influenza vaccine. RESULTS VAERS data mining did not find disproportionate reporting of tinnitus for any COVID-19 vaccine. VAERS received up to 84.82 tinnitus reports per million COVID-19 vaccine doses administered. VSD tree-based data mining found no signals for tinnitus. VSD tinnitus visit incidence rates after COVID-19 vaccines were similar to those after influenza vaccine except for the group aged ≥65 years (Moderna COVID-19 vaccine, 165 per 10,000 person-years; Pfizer-BioNTech COVID-19 vaccine, 154; influenza vaccine, 135). CONCLUSIONS Overall, these findings do not support an increased risk of tinnitus following COVID-19 vaccination but cannot definitively exclude the possibility. Descriptive comparisons between COVID-19 and influenza vaccines were limited by lack of adjustment for potential confounding factors.
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Affiliation(s)
- W Katherine Yih
- Harvard Pilgrim Health Care Institute and Department of Population Medicine, Harvard Medical School, Boston, MA, United States of America
| | - Jonathan Duffy
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
| | - John R Su
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Samaneh Bazel
- Office of Biostatistics and Pharmacovigilance, Food and Drug Administration, Silver Spring, MD, United States of America
| | - Bruce Fireman
- Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Laura Hurley
- Ambulatory Care Services, Denver Health and Hospitals, Denver, CO, United States of America; Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Judith C Maro
- Harvard Pilgrim Health Care Institute and Department of Population Medicine, Harvard Medical School, Boston, MA, United States of America
| | - Paige Marquez
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Pedro Moro
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Narayan Nair
- Office of Biostatistics and Pharmacovigilance, Food and Drug Administration, Silver Spring, MD, United States of America
| | - Jennifer Nelson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States of America
| | - Ning Smith
- Kaiser Permanente Northwest, Portland, OR, United States of America
| | - Maria Sundaram
- Marshfield Clinic Research Institute, Marshfield, WI, United States of America
| | | | - Eric Weintraub
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Stanley Xu
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America
| | - Tom Shimabukuro
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Carmona-Cervelló M, León-Gómez BB, Dacosta-Aguayo R, Lamonja-Vicente N, Montero-Alía P, Molist G, Ayet A, Chacón C, Costa-Garrido A, López-Lifante VM, Zamora-Putin V, Liutsko L, García-Sierra R, Fornés A, Moreno-Gabriel E, Massanella M, Muñoz-Moreno JA, Rodríguez-Pérez MC, Mateu L, Prats A, Mataró M, Boigues M, Quirant B, Prado JG, Martínez-Cáceres E, Violán C, Torán-Monserrat P. Long COVID: cognitive, balance, and retina manifestations. Front Med (Lausanne) 2024; 11:1399145. [PMID: 39036098 PMCID: PMC11260168 DOI: 10.3389/fmed.2024.1399145] [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: 03/11/2024] [Accepted: 06/11/2024] [Indexed: 07/23/2024] Open
Abstract
Background The neurological symptoms of Long COVID (LC) and the impact of neuropsychological manifestations on people's daily lives have been extensively described. Although a large body of literature describes symptoms, validating this with objective measures is important. This study aims to identify and describe the effects of Long COVID on cognition, balance, and the retinal fundus, and determine whether the duration of symptoms influences cognitive impairment. Methods This cross-sectional study involved LC volunteers with cognitive complaint from public health centers in northern Barcelona who participated between January 2022 and March 2023. This study collected sociodemographic characteristics, information on substance use, comorbidities, and clinical data related to COVID-19. We measured five cognitive domains using a battery of neuropsychological tests. Balance was assessed through posturography and retinal vascular involvement by retinography. Results A total of 166 people with LC and cognitive complaints participated, 80.72% were women and mean age was 49.28 ± 8.39 years. The most common self-reported symptoms were concentration and memory deficit (98.80%), brain fog (82.53%) and insomnia (71.17%). The 68.67% presented cognitive deficit in at least one domain, with executive functions being the most frequent (43.98%). The 51.52% of the participants exhibited a dysfunctional pattern in balance, and 9.2% showed some alteration in the retina. There were no statistically significant differences between cognitive impairment and symptom duration. Conclusion Our findings contribute to a more comprehensive understanding of the pathology associated with Long COVID. They highlight the diversity of self-reported symptoms, the presence of abnormal balance patterns, and some cognitive impairment. These findings underscore the necessity of addressing the clinical management of this condition in primary care through follow-up and the pursuit of multidisciplinary and comprehensive treatment.
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Affiliation(s)
- Meritxell Carmona-Cervelló
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
| | - Brenda Biaani León-Gómez
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
| | - Rosalia Dacosta-Aguayo
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Noemí Lamonja-Vicente
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
- Grup de Recerca en Impacte de les Malalties Cròniques i les Seves Trajectòries (GRIMTra), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
| | - Pilar Montero-Alía
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
- Multidisciplinary Research Group in Health and Society (GREMSAS), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
| | - Gemma Molist
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
- Faculty of Medicine, University of Vic-Central University of Vic, Barcelona, Spain
| | - Aitana Ayet
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
| | - Carla Chacón
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
- Grup de Recerca en Impacte de les Malalties Cròniques i les Seves Trajectòries (GRIMTra), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
| | - Anna Costa-Garrido
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
| | - Victor M. López-Lifante
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
- Multidisciplinary Research Group in Health and Society (GREMSAS), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
- Palau-Solità Healthcare Centre, Institut Català de la Salut, Palau-Solità Plegamans, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Valeria Zamora-Putin
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
- Palau-Solità Healthcare Centre, Institut Català de la Salut, Palau-Solità Plegamans, Barcelona, Spain
| | - Liudmila Liutsko
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
| | - Rosa García-Sierra
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
- Multidisciplinary Research Group in Health and Society (GREMSAS), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antònia Fornés
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
| | - Eduard Moreno-Gabriel
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
- Multidisciplinary Research Group in Health and Society (GREMSAS), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
- Department of Social Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Massanella
- IrsiCaixa-AIDS Research Institute, Can Ruti Campus, Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Red Española de investigación en Covid Persisitente, Barcelona, Spain
| | - Jose A. Muñoz-Moreno
- Infectious Diseases Department, Fundació Lluita Contra les Infeccions, Germans Trias i Pujol Hospital, Barcelona, Spain
- Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - M. Carmen Rodríguez-Pérez
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
- Multidisciplinary Research Group in Health and Society (GREMSAS), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
| | - Lourdes Mateu
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Red Española de investigación en Covid Persisitente, Barcelona, Spain
- Infectious Diseases Department, Fundació Lluita Contra les Infeccions, Germans Trias i Pujol Hospital, Barcelona, Spain
| | - Anna Prats
- Infectious Diseases Department, Fundació Lluita Contra les Infeccions, Germans Trias i Pujol Hospital, Barcelona, Spain
| | - Maria Mataró
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Marc Boigues
- Immunology Department, FOCIS Center of Excellence, Universitat Autònoma de Barcelona, Barcelona, Spain
- Immunology Division, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
- Department of Cellular Biology, Physiology and Immunology,Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Bibiana Quirant
- Immunology Department, FOCIS Center of Excellence, Universitat Autònoma de Barcelona, Barcelona, Spain
- Immunology Division, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
- Department of Cellular Biology, Physiology and Immunology,Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Julia G. Prado
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- IrsiCaixa-AIDS Research Institute, Can Ruti Campus, Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Eva Martínez-Cáceres
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- Immunology Department, FOCIS Center of Excellence, Universitat Autònoma de Barcelona, Barcelona, Spain
- Immunology Division, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Concepción Violán
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- Grup de Recerca en Impacte de les Malalties Cròniques i les Seves Trajectòries (GRIMTra), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Instituto de Salud Carlos III, Madrid, Spain
| | - Pere Torán-Monserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- Multidisciplinary Research Group in Health and Society (GREMSAS), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
- Department of Medicine, Faculty of Medicine,Universitat de Girona, Girona, Spain
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Kelleni MT. Repurposing metformin to manage idiopathic or long COVID Tinnitus: self-report adopting a pathophysiological and pharmacological approach. Inflammopharmacology 2024; 32:945-948. [PMID: 38294616 PMCID: PMC11006725 DOI: 10.1007/s10787-023-01421-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/24/2023] [Indexed: 02/01/2024]
Abstract
Chronic tinnitus is a common neurological disorder that affects millions of patients globally with no available successful pharmacotherapy. It can be extremely bothersome to some patients to the extent that it occasionally qualifies as a disability that can hinder them from leading a normal life. In this short communication, the author discusses how he suffered from idiopathic tinnitus and how he managed to adopt a combined pathophysiological and pharmacological approach to the reason for the first time in the medical literature that low-dose metformin might be safely and effectively repurposed to manage at least a subset of tinnitus patients while discussing the potential role of adenosine receptor agonists as potential future tinnitus therapeutics.
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Affiliation(s)
- Mina T Kelleni
- Pharmacology Department, College of Medicine, Minia University, Minya, 61111, Egypt.
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4
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Schmachtenberg T, Königs G, Roder S, Müller F, Müllenmeister C, Schröder D, El-Sayed I. How do people with long COVID utilize COVID-19 vaccination and rehabilitation services and what are their experiences with these services? results of a qualitative study with 48 participants from Germany. BMC Public Health 2024; 24:915. [PMID: 38549052 PMCID: PMC10976759 DOI: 10.1186/s12889-024-18380-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Studies estimate that at least 7.5% of adults are affected by long-term symptoms such as fatigue or cognitive impairment after the acute phase of COVID-19. COVID-19 vaccination may reduce the risk of long COVID. Rehabilitation can have a positive impact on recovery. This study aims to present the experiences of people with long COVID with COVID-19 vaccination and rehabilitation. Such research is important because perceptions of these measures can impact healthcare utilization and health status. METHODS 48 adults with long COVID participated in this qualitative study, 25 of them in one-on-one interviews and 23 in focus groups. Participants were recruited via calls for participation on the websites and social media channels of two university hospitals and with the help of respondents' networks. The conversations were audio-recorded, transcribed, and analyzed using qualitative content analysis. Subsequently, the results were compared, interpreted, and discussed by scientific literature. RESULTS 35 study participants reported that they had received a COVID-19 vaccination and 16 of them stated that they had utilized a rehabilitation service. These participants had varying experiences with COVID-19 vaccination and rehabilitation. Nine of them stated that they developed long COVID despite vaccination before COVID-19. Ten participants reported vaccine reactions, and two participants reported severe side effects. Two participants reported persistent deterioration of their long COVID symptoms after vaccination. This led to uncertainty about the safety, benefits, and handling of COVID-19 vaccination. However, most participants perceived the vaccine as effective regarding milder COVID-19 sequelae. Four participants felt their rehabilitation was helpful and four participants felt it was unhelpful. Two persons found the combination of inpatient rehabilitation and rehabilitation sport helpful. CONCLUSIONS Several implications can be derived from this study: (1) researchers should explore the effects of COVID-19 vaccination on long COVID symptoms; (2) vaccination campaigns should be more responsive to the perspectives of people with long COVID on vaccination; (3) care planners should build rehabilitation facilities specialized in long COVID; (4) rehabilitation providers should train their professionals regarding long COVID and develop rehabilitation programs tailored to different clinical pictures. TRIAL REGISTRATION German register for clinical trials DRKS00026007, 09 September 2021.
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Affiliation(s)
- Tim Schmachtenberg
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany.
- Department of Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Gloria Königs
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Sascha Roder
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
- Department of Social Work, University of Applied Sciences and Arts Bielefeld, Interaktion 1, 33619, Bielefeld, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
- Department of Family Medicine, College of Human Medicine, Michigan State University, 15 Michigan St NE, Grand Rapids, 49503, East Lansing, MI, USA
| | - Christina Müllenmeister
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Dominik Schröder
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Iman El-Sayed
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
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5
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Schröder D, Heinemann S, Heesen G, Hummers E, Schmachtenberg T, Dopfer-Jablonka A, Vahldiek K, Klawonn F, Klawitter S, Steffens S, Mikuteit M, Niewolik J, Müller F. Association of long COVID with health-related Quality of Life and Social Participation in Germany: Finding from an online-based cross-sectional survey. Heliyon 2024; 10:e26130. [PMID: 38380019 PMCID: PMC10877341 DOI: 10.1016/j.heliyon.2024.e26130] [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: 05/07/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 02/22/2024] Open
Abstract
Purpose This study aims to examine the health-related Quality of Life (hrQoL) and social participation in participants with Long COVID compared to participants without symptoms after COVID-19 and participants with no prior SARS-CoV-2 infection. Methods A cross-sectional online survey was conducted in Germany. The non-random sample consists of participants 18 years or older. Participants were divided in three groups: Lg COVID with a prior SARS-CoV-2 infection and new or persistent symptoms 28 days after infection, ExCOVID with a prior SARS-CoV-2 infection and without new or persistent symptoms after 28 days, and NoCOVID when participants had no prior SARS-CoV-2 infection. EQ-5D-3L was used as hrQoL measure and the Index for the Assessment of Health Impairments (IMET) to reflect social participation. Descriptive and inferential statistics were performed. Results A total of 3188 participants were included in the analysis (1421 Lg COVID, 260 ExCOVID, 1507 NoCOVID). Lg COVID was associated with the lowest EQ-5D-3L index values (p < 0.001), Visual Analogue Scale (VAS) scores (p < 0.001), and IMET (p < 0.001) scores followed by NoCOVID and ExCOVID. After adjusting for sociodemographic and medical conditions in a multivariable model Long COVID was still associated with lower hrQoL compared to NoCOVID (p < 0.001). About 10% of Lg COVID participants showed no health impairments in all EQ-5D dimensions while 51.1% of NoCOVID and 60% of ExCOVID participants showed no health impairments. Conclusion This study highlights the impairments of persons with Long COVID on hrQoL and social participation compared to individuals without Long COVID in Germany. Trial registration German Clinical Trial Registry, DRKS00026007.
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Affiliation(s)
- Dominik Schröder
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Stephanie Heinemann
- Department of General Practice, University Medical Center, Göttingen, Germany
- Department of Geriatrics, University Medical Center, Göttingen, Germany
| | - Gloria Heesen
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Tim Schmachtenberg
- Department of General Practice, University Medical Center, Göttingen, Germany
- Department of Rheumatology and Immunology, Hannover Medical School, Germany
| | - Alexandra Dopfer-Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Germany
- German Center for Infection Research (DZIF), partner site Hannover-Braunschweig, Germany
| | - Kai Vahldiek
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
| | - Frank Klawonn
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
- Biostatistics Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Sandra Klawitter
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
| | - Sandra Steffens
- Department of Rheumatology and Immunology, Hannover Medical School, Germany
- Deans' Office, Curricular Development, Hannover Medical School, Germany
| | - Marie Mikuteit
- Department of Rheumatology and Immunology, Hannover Medical School, Germany
- Deans' Office, Curricular Development, Hannover Medical School, Germany
| | | | - Frank Müller
- Department of General Practice, University Medical Center, Göttingen, Germany
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA
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6
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Giussani G, Westenberg E, Garcia-Azorin D, Bianchi E, Yusof Khan AHK, Allegri RF, Atalar AÇ, Baykan B, Crivelli L, Fornari A, Frontera JA, Guekht A, Helbok R, Hoo FK, Kivipelto M, Leonardi M, Lopez Rocha AS, Mangialasche F, Marcassoli A, Özdag Acarli AN, Ozge A, Prasad K, Prasad M, Sviatskaia E, Thakur K, Vogrig A, Leone M, Winkler AS. Prevalence and Trajectories of Post-COVID-19 Neurological Manifestations: A Systematic Review and Meta-Analysis. Neuroepidemiology 2024; 58:120-133. [PMID: 38272015 DOI: 10.1159/000536352] [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: 07/17/2023] [Accepted: 01/03/2024] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION The aim of this systematic review and meta-analysis was to evaluate the prevalence of thirteen neurological manifestations in people affected by COVID-19 during the acute phase and at 3, 6, 9 and 12-month follow-up time points. METHODS The study protocol was registered with PROSPERO (CRD42022325505). MEDLINE (PubMed), Embase, and the Cochrane Library were used as information sources. Eligible studies included original articles of cohort studies, case-control studies, cross-sectional studies, and case series with ≥5 subjects that reported the prevalence and type of neurological manifestations, with a minimum follow-up of 3 months after the acute phase of COVID-19 disease. Two independent reviewers screened studies from January 1, 2020, to June 16, 2022. The following manifestations were assessed: neuromuscular disorders, encephalopathy/altered mental status/delirium, movement disorders, dysautonomia, cerebrovascular disorders, cognitive impairment/dementia, sleep disorders, seizures, syncope/transient loss of consciousness, fatigue, gait disturbances, anosmia/hyposmia, and headache. The pooled prevalence and their 95% confidence intervals were calculated at the six pre-specified times. RESULTS 126 of 6,565 screened studies fulfilled the eligibility criteria, accounting for 1,542,300 subjects with COVID-19 disease. Of these, four studies only reported data on neurological conditions other than the 13 selected. The neurological disorders with the highest pooled prevalence estimates (per 100 subjects) during the acute phase of COVID-19 were anosmia/hyposmia, fatigue, headache, encephalopathy, cognitive impairment, and cerebrovascular disease. At 3-month follow-up, the pooled prevalence of fatigue, cognitive impairment, and sleep disorders was still 20% and higher. At six- and 9-month follow-up, there was a tendency for fatigue, cognitive impairment, sleep disorders, anosmia/hyposmia, and headache to further increase in prevalence. At 12-month follow-up, prevalence estimates decreased but remained high for some disorders, such as fatigue and anosmia/hyposmia. Other neurological disorders had a more fluctuating occurrence. DISCUSSION Neurological manifestations were prevalent during the acute phase of COVID-19 and over the 1-year follow-up period, with the highest overall prevalence estimates for fatigue, cognitive impairment, sleep disorders, anosmia/hyposmia, and headache. There was a downward trend over time, suggesting that neurological manifestations in the early post-COVID-19 phase may be long-lasting but not permanent. However, especially for the 12-month follow-up time point, more robust data are needed to confirm this trend.
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Affiliation(s)
- Giorgia Giussani
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Erica Westenberg
- Department of Neurology, Center for Global Health, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - David Garcia-Azorin
- Department of Neurology, Hospital Clínico Universitario Valladolid, Valladolid, Spain
| | - Elisa Bianchi
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Abdul Hanif Khan Yusof Khan
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Arife Çimen Atalar
- Department of Neurology, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey
| | - Betul Baykan
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Lucia Crivelli
- Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina
| | - Arianna Fornari
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Jennifer A Frontera
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry and Russian National Research Medical University, Moscow, Russian Federation
| | - Raimund Helbok
- Neurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Neurology, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria
| | - Fan Kee Hoo
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Miia Kivipelto
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Ana Sabsil Lopez Rocha
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Francesca Mangialasche
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Alessia Marcassoli
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Aynur Ozge
- Mersin University School of Medicine, Mersin, Turkey
| | | | - Manya Prasad
- Clinical Research and Epidemiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ekaterina Sviatskaia
- Suicide Research and Prevention Department, Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russian Federation
| | - Kiran Thakur
- Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York, USA
| | - Alberto Vogrig
- Clinical Neurology, Santa Maria Della Misericordia University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Maurizio Leone
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Andrea Sylvia Winkler
- Department of Neurology, Center for Global Health, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
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7
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Schröder D, Schmachtenberg T, Heinemann S, Müllenmeister C, Roder S, El-Sayed I, Heesen G, Königs G, Dopfer-Jablonka A, Hummers E, Mikuteit M, Dopfer C, Grewendorf S, Niewolik J, Steffens S, Doze V, Klawonn F, Müller F. Parenting and Gender as Impact Factors for Social Participation, Quality of Life, and Mental Health in Long COVID. J Prim Care Community Health 2024; 15:21501319241255592. [PMID: 38805375 PMCID: PMC11135092 DOI: 10.1177/21501319241255592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVES This study aims to investigate the impact of gender and parental tasks on social participation, health-related quality of life (hrQoL), and mental health in persons with long COVID. METHODS A mixed-methods approach was followed including a cross-sectional web-based survey and semi-structured interviews. Multivariable linear regressions were used to quantify the effect of gender and parenting tasks on social participation, hrQoL, and mental health. Qualitative data from interviews with participants experiencing long COVID symptoms was analyzed using content analysis. RESULTS Data from 920 participants in the quantitative study and 25 participants in the qualitative study was analyzed. Parenting tasks were associated with increased impairments in family and domestic responsibilities in persons with long COVID compared to lower impairments in persons without long COVID (P = .02). The qualitative data indicate that coping with long COVID and pursuing parenting tasks limit participants' ability to perform leisure activities and attend social gatherings. In long COVID, men had higher anxiety symptoms than women, and in those without long COVID, the opposite was observed (P < .001). In the qualitative study, participants expressed feelings of dejection and pessimism about their future private, occupational, and health situations. No differences between the genders could be observed. CONCLUSIONS Long COVID is associated with impairments in family and domestic responsibilities in individuals who have parenting tasks. Among participants with long COVID, anxiety symptoms are higher in men than women.
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Affiliation(s)
- Dominik Schröder
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Tim Schmachtenberg
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Stephanie Heinemann
- Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
| | | | - Sascha Roder
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
- Department of Social Work, University of Applied Sciences and Arts, Bielefeld, Germany
| | - Iman El-Sayed
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Gloria Heesen
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Gloria Königs
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Alexandra Dopfer-Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Hannover-Braunschweig, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Marie Mikuteit
- Department of Dermatology and Allergology, Hannover Medical School, Hannover, Germany
| | - Christian Dopfer
- Department of Pediatric Pneumology, Allergology, and Neonatology, Hannover, Hannover Medical School, Germany
| | - Simon Grewendorf
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Jacqueline Niewolik
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Sandra Steffens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Valerie Doze
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Frank Klawonn
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
- Biostatistics Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA
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8
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Wang Q, Gu H, Tao Y, Zhao Y, Meng Z. Number of initial symptoms of SARS-CoV-2 infection is associated with the risk of otological symptoms: a retrospective study. BMC Infect Dis 2023; 23:862. [PMID: 38062350 PMCID: PMC10704705 DOI: 10.1186/s12879-023-08866-w] [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: 08/15/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The characteristics of otological symptoms in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are lacking. Almost no research has been conducted to explore the emergence of otological symptoms after coronavirus disease 2019 infection. The aims of this study were to investigate the prevalence and specific clinical characteristics of and risk factors for otological symptoms among patients with SARS-CoV-2 infection. METHODS We included two groups to investigate the prevalence and clinical characteristics of otological symptoms among patients with SARS-CoV-2 infection. The first sample (S1) was drawn retrospectively from four communities via questionnaires, and the second sample (S2) from an outpatient clinic. RESULTS A total of 189 participants were included in S1 (124 women [65.6%]; mean [standard deviation (SD)] age, 33.66 [13.56] years), and 47 in S2 (25 women [53.2%]; mean [SD] age, 45.28 [14.64] years). The most prevalent otological symptoms in S1 were dizziness (15.9%), tinnitus (7.9%), aural fullness (6.9%), otalgia (5.3%), hearing loss (1.6%), and otopyorrhoea (1.1%). Moreover, for each additional typical symptom of SARS-CoV-2 infection, the risk (odds ratio) of otological symptoms increased by 1.33 (95% confidence interval: 1.10-1.61, p = 0.003). The prevalence of aural fullness was higher in the unvaccinated group than that in the group receiving two or three vaccinations (p = 0.018). CONCLUSIONS Various otological symptoms may occur in patients with SARS-CoV-2 infection. The number of typical symptoms of SARS-CoV-2 infection is positively associated with the probability of otological symptoms. However, vaccination may reduce the probability of certain otological symptoms.
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Affiliation(s)
- Qiang Wang
- Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Hailing Gu
- Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Tao
- Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Zhao
- Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China.
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China.
| | - Zhaoli Meng
- Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China.
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China.
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9
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Obeidat FS, Alghwiri AA, Whitney SL. Predictors of Dizziness and Hearing Disorders in People with Long COVID. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1901. [PMID: 38003950 PMCID: PMC10673595 DOI: 10.3390/medicina59111901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Individuals report persistent symptoms after becoming infected by SARS-CoV-2 (COVID-19) that last for >4 weeks (long-COVID syndrome). Dizziness and hearing loss have been reported among long-COVID symptoms. However, little is known about the potential predictors of dizziness and hearing loss in individuals with long COVID. This study aimed to explore the presence and correlates of dizziness and hearing loss in a sample of people with long-COVID syndrome. Materials and Methods: Individuals aged 18 years and older who were infected with COVID-19 at least 8 weeks prior to the start of the study were included if they were not diagnosed with dizziness or hearing loss before getting COVID-19. Demographics and COVID-19-related information were collected. Participants completed the Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence (ABC) scale, Falls Efficacy Scale International (FES-I), Modified Fatigue Impact Scale (MFIS), and Medical Outcomes Study Short Form 12 (SF-12). Finally, hearing was assessed using pure-tone audiometry (PTA) in a subsample. Results: Two hundred and nine individuals (66% female) with a mean (SD) age of 27 (9) participated in the study. Perceived dizziness and hearing loss were reported in 26 and 15.3% of the sample, respectively. Logistic regression was conducted to identify potential predictors of dizziness and hearing loss separately. After controlling for age and severity of dizziness, female sex and high fatigue severity were associated with an increased likelihood of reporting dizziness (R2 = 31%). The severity of dizziness and neurological symptoms during the acute stage of COVID-19 were associated with an increased likelihood of reporting hearing loss (R2 = 10.4%) after controlling for age. Conclusions: Dizziness and hearing loss present in long COVID and can be disabling. Females with high levels of fatigue should be questioned about persistent dizziness. Hearing loss should be considered in individuals with neurological symptoms and severe dizziness as a consequence of long COVID.
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Affiliation(s)
- Faten S. Obeidat
- Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, University of Jordan, Amman 11942, Jordan
| | - Alia A. Alghwiri
- Department of Physiotherapy, School of Rehabilitation Sciences, University of Jordan, Amman 11942, Jordan
| | - Susan L. Whitney
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Department of Otolaryngology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
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10
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Mikuteit M, Baskal S, Klawitter S, Dopfer-Jablonka A, Behrens GMN, Müller F, Schröder D, Klawonn F, Steffens S, Tsikas D. Amino acids, post-translational modifications, nitric oxide, and oxidative stress in serum and urine of long COVID and ex COVID human subjects. Amino Acids 2023; 55:1173-1188. [PMID: 37516715 PMCID: PMC10564820 DOI: 10.1007/s00726-023-03305-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 07/16/2023] [Indexed: 07/31/2023]
Abstract
In this study, we investigated the status of amino acids, their post-translational modifications (PTM), major nitric oxide (NO) metabolites and of malondialdehyde (MDA) as a biomarker of oxidative stress in serum and urine samples of long COVID (LoCo, n = 124) and ex COVID (ExCo, n = 24) human subjects collected in 2022. Amino acids and metabolites were measured by gas chromatography-mass spectrometry (GC-MS) methods using stable-isotope labelled analogs as internal standards. There were no differences with respect to circulating and excretory arginine and asymmetric dimethylarginine (ADMA). LoCo participants excreted higher amounts of guanidino acetate than ExCo participants (17.8 ± 10.4 µM/mM vs. 12.6 ± 8.86 µM/mM, P = 0.005). By contrast, LoCo participants excreted lower amounts of the advanced glycation end-product (AGE) NG-carboxyethylarginine (CEA) than ExCo participants did (0.675 ± 0.781 µM/mM vs. 1.16 ± 2.04 µM/mM, P = 0.0326). The serum concentrations of MDA did not differ between the groups, indicating no elevated oxidative stress in LoCo or ExCo. The serum concentration of nitrite was lower in LoCo compared to ExCo (1.96 ± 0.92 µM vs. 2.56 ± 1.08 µM; AUC, 0.718), suggesting altered NO synthesis in the endothelium. The serum concentration of nitrite correlated inversely with the symptom anxiety (r = - 0.293, P = 0.0003). The creatinine-corrected urinary excretion of Lys and its metabolite L-5-hydroxy-Lys correlated positively with COVID toes (r = 0.306, P = 0.00027) and sore throat (r = 0.302, P = 0.0003). Our results suggest that amino acid metabolism, PTM and oxidative stress are not severely affected in long COVID. LoCo participants may have a lower circulating NO reservoir than ExCo.
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Affiliation(s)
- Marie Mikuteit
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- Hannover Medical School, Dean’s Office–Curriculum Development, Hannover, Germany
| | - Svetlana Baskal
- Hannover Medical School, Institute of Toxicology, Core Unit Proteomics, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| | - Sandra Klawitter
- Institute for Information Engineering, Ostfalia University of Applied Sciences, Wolfenbüttel, Germany
| | | | - Georg M. N. Behrens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Hannover, Germany
- Centre for Individualized Infection Medicine (CiiM), Hannover Medical School, Hannover, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
- Department of Family Medicine, Michigan State University, Grand Rapids, MI USA
| | - Dominik Schröder
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Frank Klawonn
- Institute for Information Engineering, Ostfalia University of Applied Sciences, Wolfenbüttel, Germany
- Biostatistics Research Group, Helmholtz Centre for Infection Research, Brunswick, Germany
| | - Sandra Steffens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- Hannover Medical School, Dean’s Office–Curriculum Development, Hannover, Germany
| | - Dimitrios Tsikas
- Hannover Medical School, Institute of Toxicology, Core Unit Proteomics, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
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11
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Fritz CG, Choi JS, Conway RM, Casale GG, Bojrab DI, Babu SC. Characterizing the most Popular Tinnitus Inquiries: Is Tinnitus Incidence on the Rise Since COVID-19? Otol Neurotol 2023; 44:e435-e442. [PMID: 37205864 PMCID: PMC10289074 DOI: 10.1097/mao.0000000000003902] [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] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Approximately 50 million US adults experience chronic tinnitus, yet search behaviors and topics of concern to these patients have not been investigated on a national level. STUDY DESIGN Observational. SETTING Online database and tertiary otology clinic. PATIENTS Nationwide and institutional samples. INTERVENTIONS None. MAIN OUTCOME MEASURE A search engine optimization tool was utilized to extract metadata on "People Also Ask" (PAA) questions pertaining to tinnitus. Website quality was assessed using JAMA benchmark criteria. Search volume trends were investigated along with institutional-level data on tinnitus incidence. RESULTS Of the 500 PAA questions assessed, the majority (54.0%) contained value-type content. The most popular question categories pertained to tinnitus treatment (29.3%), alternative treatment approaches (21.5%), technical details (16.9%), and timeline of symptoms (13.4%). Patients were most interested in treatment with wearable masking devices and most commonly searched for tinnitus as being attributable to a neurologic etiology. Online searches pertaining to unilateral tinnitus symptoms have increased >3-fold since the onset of the COVID-19 pandemic. Likewise, review of patient encounters at our tertiary otology clinic revealed a nearly 2-fold increase in tinnitus consultations since 2020. CONCLUSIONS Topics of interest and concern identified herein may inform the development of patient education materials and help guide clinical practice. Online search data suggest an increase in tinnitus searches since the onset of COVID-19, which did correlate clinically with an increase in tinnitus consultations at our institution.
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Affiliation(s)
- Christian G. Fritz
- Department of Otorhinolaryngology–Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
- Michigan Ear Institute, Farmington Hills, Michigan
| | | | - Robert M. Conway
- Michigan Ear Institute, Farmington Hills, Michigan
- Department of Otolaryngology, Head and Neck Surgery, Ascension Macomb-Oakland Hospital, Madison Heights, Michigan
| | | | - Dennis I. Bojrab
- Michigan Ear Institute, Farmington Hills, Michigan
- Neurotology Division, St John Providence Health System, Novi, Michigan
| | - Seilesh C. Babu
- Michigan Ear Institute, Farmington Hills, Michigan
- Department of Otolaryngology, Head and Neck Surgery, Ascension Macomb-Oakland Hospital, Madison Heights, Michigan
- Neurotology Division, St John Providence Health System, Novi, Michigan
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University, Detroit, Michigan
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12
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Bhat V, Onaivi ES, Sharma V. Endocannabinoid system components as potential neuroimmune therapeutic targets in tinnitus. Front Neurol 2023; 14:1148327. [PMID: 37305742 PMCID: PMC10248455 DOI: 10.3389/fneur.2023.1148327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Research interest in understanding tinnitus has increased severalfold in the last decade to find a cure for this auditory disorder. Hyperacusis can also accompany tinnitus, although the mechanisms involved in hyperacusis and tinnitus are different. Millions of people suffer from some degree of tinnitus with hearing loss. Tinnitus is believed to be a form of sensory epilepsy, spawning neuronal hyperactivity from the cochlear nucleus and inferior colliculus of the auditory brainstem region. Cannabis has been used for recreation, medicinal purposes, and served as an entheogen from time immemorial. With the current and increasing global medical and recreational cannabis legalization, there is renewed enthusiasm for the use of cannabinoid drugs, and the role of the endocannabinoid system (ECS) in several health disorders including tinnitus which is associated with COVID-19. The ECS signaling pathways have been proposed to affect the underlying pathophysiology of tinnitus. Cannabinoid receptors (CBRs) have been found in the auditory system, raising interest in ECS signaling in hearing and tinnitus. However, previous studies mostly in animal models of tinnitus did not investigate the involvement of CB2Rs but focused on CB1R-based responses, which suggested that CB1R ligands had no effect and may even be harmful and worsen tinnitus. With new molecular techniques and transgenic approaches used to dissect the complexity of the ECS, the role of ECS/CB2R neuroimmunological function in the auditory system and tinnitus is emerging. This perspective proposes the role of emerging neuroimmune crosstalk of the ECS in sound-sensing structures of the auditory system as a potential pharmacogenomic therapeutic target using cannabinoid CB2R ligands in tinnitus in the era of the COVID-19 pandemic.
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Affiliation(s)
- Vishweshwara Bhat
- Speech Language Pathology, William Paterson University, Wayne, NJ, United States
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13
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Kitsos D, Tzartos J, Korres G, Giannopapas V, Riga M, Stergiou C, Tsoga A, Grigoropoulos C, Paraskevas G, Zompola C, Nikolopoulos T, Giannopoulos S. IL-6 Serum Levels in COVID-19 Patients With Vertigo. Cureus 2023; 15:e35042. [PMID: 36942191 PMCID: PMC10024114 DOI: 10.7759/cureus.35042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction Dizziness and vertigo represent well-established symptoms of COVID-19. An overexpression of cytokines, a condition often described with the term "cytokine storm" or "hypercytokinemia", is a key characteristic of SARS-Cov-2 infection and plays a pivotal role in disease progression and prognosis. Among them, IL-6 is of major importance. Purpose The purpose of this study is to investigate any probable IL-6 serum titer difference in COVID-19 patients with vertigo (V+) or without vertigo (V-) admitted to the COVID-19 internal medicine departments of Attikon University Hospital, Athens, Greece, within 12 months. Methods The sample consisted of 52 COVID-19 patients who were diagnosed between January 1, 2020, and December 31, 2020. Of those, 31 reported vertigos during their admission (V+), while the remaining 21 COVID-19 patients did not complain of such symptoms (V-). Results Higher IL-6 serum levels post-COVID-19 infections lead to higher incidence rates of vertigo symptoms (p<.005), regardless of gender and age (p.005).
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Affiliation(s)
- Dimitrios Kitsos
- Department of Neurology, Attikon University Hospital, Athens, GRC
| | - John Tzartos
- Department of Neurology, Attikon University Hospital, Athens, GRC
| | - George Korres
- Department of Otolaryngology, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Vasileios Giannopapas
- Physical Therapy, University of West Attica, Athens, GRC
- Department of Neurology, Attikon University Hospital, Athens, GRC
| | - Maria Riga
- Department of Otorhinolaryngology-Head and Neck Surgery, Dammam Medical Complex, Dammam, SAU
| | | | - Anthi Tsoga
- Department of Neurology, Attikon University Hospital, Athens, GRC
| | | | | | | | - Thomas Nikolopoulos
- Department of Otorhinolaryngology, Attikon University Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
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14
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Katayama N, Yoshida T, Nakashima T, Ito Y, Teranishi M, Iwase T, Sugiura S, Goto K, Uchida Y, Taki Y, Nakada T, Tada A, Suzuki H, Nakano Y, Shimono M, Saji N, Kogure A, Shimizu E, Sone M, Hamajima N. Relationship between tinnitus and olfactory dysfunction: audiovisual, olfactory, and medical examinations. Front Public Health 2023; 11:1124404. [PMID: 37151589 PMCID: PMC10157476 DOI: 10.3389/fpubh.2023.1124404] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/16/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction Sensory dysfunctions and cognitive impairments are related to each other. Although a relationship between tinnitus and subjective olfactory dysfunction has been reported, there have been no reports investigating the relationship between tinnitus and olfactory test results. Methods To investigate the relationship between tinnitus and olfactory test results, we conducted sensory tests, including hearing and visual examinations. The subjects included 510 community-dwelling individuals (295 women and 215 men) who attended a health checkup in Yakumo, Japan. The age of the subjects ranged from 40 to 91 years (mean ± standard deviation, 63.8 ± 9.9 years). The participants completed a self-reported questionnaire on subjective tinnitus, olfactory function, and hearing function, as well as their lifestyle. The health checkup included smell, hearing, vision, and blood examinations. Results After adjusting for age and sex, the presence of tinnitus was significantly associated with subjective olfactory dysfunction, poor olfactory test results, hearing deterioration, vertigo, and headache. Additionally, high serum calcium levels and a low albumin/globulin ratio were significantly associated with low physical activity and nutrition. Women scored higher than men in olfactory and hearing examinations, but there was no gender difference in vision examinations. Conclusion Subjective smell dysfunction and poor smell test results were significantly associated with tinnitus complaints. Hearing and vision were associated even after adjusting for age and sex. These findings suggest that evaluating the mutual relationships among sensory organs is important when evaluating the influence of sensory dysfunctions on cognitive function.
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Affiliation(s)
- Naomi Katayama
- Department of Food Science, Nagoya Women's University, Nagoya, Japan
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tadao Yoshida
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tsutomu Nakashima
- Department of Rehabilitation, Ichinomiya Medical Treatment & Habilitation Center, Ichinomiya, Japan
- Department of Otorhinolaryngology, Center for Sensory Organ, National Center for Geriatrics and Gerontology, Obu, Japan
- Nagoya University, Nagoya, Japan
- *Correspondence: Tsutomu Nakashima
| | - Yasuki Ito
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Ophthalmology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Masaaki Teranishi
- Department of Otorhinolaryngology, Center for Sensory Organ, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Otorhinolaryngology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Takeshi Iwase
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Ophthalmology, Akita University Graduate School of Medicine, Akita, Japan
| | - Saiko Sugiura
- Department of Otorhinolaryngology, Center for Sensory Organ, National Center for Geriatrics and Gerontology, Obu, Japan
- Toyota Josui Mental Clinic, Toyota, Japan
| | - Kensuke Goto
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasue Uchida
- Department of Otorhinolaryngology, Center for Sensory Organ, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Otolaryngology, Aichi Medical University, Nagakute, Japan
| | - Yosuke Taki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takafumi Nakada
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Otorhinolaryngology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- Department of Otorhinolaryngology, Nishichita General Hospital, Tokai, Japan
| | - Ai Tada
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hirokazu Suzuki
- Department of Otorhinolaryngology, Center for Sensory Organ, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yuta Nakano
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mariko Shimono
- Department of Otorhinolaryngology, Center for Sensory Organ, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Naoki Saji
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Anna Kogure
- Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Emiko Shimizu
- Department of Rehabilitation, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Nagoya University, Nagoya, Japan
- Kishokai Medical Corporation, Nagoya, Japan
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15
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Degen C, Mikuteit M, Niewolik J, Joosten T, Schröder D, Vahldiek K, Mücke U, Heinemann S, Müller F, Behrens G, Klawonn F, Lenarz T, Dopfer-Jablonka A, Steffens S. Audiological profile of adult long COVID patients. Am J Otolaryngol 2022; 43:103579. [PMID: 35988361 PMCID: PMC9354445 DOI: 10.1016/j.amjoto.2022.103579] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/01/2022] [Indexed: 12/03/2022]
Abstract
Introduction Hearing loss is one of the self-reported symptoms of Long COVID patients, however data from objective and subjective audiological tests demonstrating diminished hearing in Long COVID patients has not been published. Materials and methods Respondents of a large Long COVID online survey were invited to the ENT-department for an otologic exam. The participants were split into three groups based on their history of SARS-CoV-2 infection and persistence of symptoms. Respondents with a history of a SARS-CoV-2 infection were allocated to the Long COVID group, if they reported persistent symptoms and to the Ex COVID group, if they had regained their previous level of health. Participants without a history of SARS-CoV-2 infection made up the No COVID control group. In total, 295 ears were examined with otoscopy, tympanograms, pure tone audiometry and otoacoustic emissions. Ears with known preexisting hearing loss or status post ear surgery, as well as those with abnormal otoscopic findings, non-type A tympanograms or negative Rinne test were excluded. Results Compared to the No COVID and Ex COVID groups, we did not find a clinically significant difference in either hearing thresholds or frequency specific TEOAEs. However, at 500 Hz the data from the left ear, but not the right ear showed a significantly better threshold in the Ex COVID group, compared to Long COVID and No COVID groups. Any of the other tested frequencies between 500 Hz and 8 kHz were not significantly different between the different groups. There was a significantly lower frequency-specific signal-to-noise-ratio of the TEOAEs in the Long COVID compared to the No COVID group at 2.8 kHz. At all other frequencies, there were no significant differences between the three groups in the TEOAE signal-to-noise-ratio. Conclusion This study detected no evidence of persistent cochlear damage months after SARS-CoV-2 infection in a large cohort of Long COVID patients, as well as those fully recovered.
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