Purpose COVID-19 associated hearing loss is still an ongoing matter of debate. No original studies exist on audiological effects of SARS-CoV-2 infection in hospitalized patients. The main objective was to determine whether SARS-CoV-2 may affect auditory function in clinically ill COVID-19 patients. Materials and Methods COVID-19 patients with moderate-severe disease and without prior history of hearing abnormalities were enrolled from a tertiary referral center, and matched with controls. Participants performed an audiometric evaluation, and thresholds were compared. Results 120 ears from 60 patients were enrolled. Patients with COVID-19 showed worse mean auditory thresholds starting from 1000 Hz through higher frequencies, when compared to controls ( 1000 Hz : 18.52 ± 5.49 dB HL in controls vs 25.36 ± 6.79 dB HL in COVID-19, p<0.001; 2000Hz : 17.50 ± 5.57 dB HL in controls vs 21.96 ± 7.05 dB HL in COVID-19, p=0.010; 3000Hz : 17.97 ± 8.07 dB HL in controls vs 25 ± 9.38 dB HL in COVID-19, p=0.003; 4000 Hz : 20.16 ± 10.12 dB HL in controls vs 29.55 ± 11.26 dB HL in COVID-19, p=0.001; 8000 Hz : 31.09 ± 12.75 dB HL in controls vs 40.71 ± 19.40 dB HL in COVID-19, p=0.030; Pure Tone Average : 20.42 ± 4.29 dB HL in controls vs 24.85 ± 5.62 dB HL in COVID-19, p=0.001). Statistical significance persisted after adjusting for confounders such as age, gender and various comorbidities (p<0.05). Conclusions SARS-CoV-2 may affect hearing in COVID-19 patients with moderate-severe disease. Results are in line with the previous suggested effects of COVID-19 on auditory system. This study is expected to encourage further research on this topic.

Objective: So far, no original studies explored non-randomized, standardized protocols for COVID-19 associated olfactory dysfunction. The main objective was to determine the efficacy of a new protocol for post-COVID olfactopathy while assessing the benefit of adding adjuvant therapies to olfactory training. Methods: Patients suffering from long-lasting post-COVID-19 olfactory dysfunction were evaluated. A non-randomized protocol based on individual nasal endoscopy findings and patient’s preferences was applied. Patients were assigned for olfactory training alone or olfactory training + adjuvant therapy. Participants performed olfactory objective and subjective evaluations at first consultation and 3 months after treatment, and results were compared. Results: A total of 47 patients were enrolled. All groups showed significant improvement in olfactory thresholds at 3-month follow-up suggesting protocol effectiveness (olfactory training group alone showed a mean threshold difference of 2.9, P < .001; Olfactory training + Topical Corticosteroid showed a mean threshold difference of 4, P = .006; Olfactory training + Topical Corticosteroid + Vitamin B complex showed a mean threshold difference of 4.4, P = .006; Olfactory training + Intranasal Vitamin A and E showed a mean threshold difference of 4.4, P < .001). Olfactory training alone showed lower mean olfactory threshold improvement, when compared to patients undergoing olfactory training + adjuvant therapy (olfactory training alone mean improvement 2.9 ± 2.3 vs olfactory training + adjuvants mean improvement 4.3 ± 2.458, P = .03). Conclusions: This is one of the first studies to demonstrate results in the treatment of post-COVID-19 persistent olfactory impairment. A customized approach based on endoscopy findings and patient’s preferences may be a valid option for the management of persistent post-COVID-19 olfactory disorder. Adjuvant therapy could be considered in addition to olfactory training, but further studies are needed in order to confirm their effectiveness in this setting. Level of evidence: 2c (outcomes research).

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IntroductionOlfactory dysfunction (OD) is often a devaluated sensorial affection. The objective evaluation of this dysfunction doesn't evaluate its compromise in patients' daily life. Therefore, the use of a Portuguesevalidated tool is of uttermost importance to objectively scale the pathology presented by these patients. ObjectiveWe aim to validate and cross-culturally adapt the Olfactory Disorders Questionnaire (ODQ) in the Portuguese language. MethodsA prospective study was carried out to evaluate and compare 56 consecutive patients who had olfactory disorders and 54 asymptomatic controls. A cross-cultural adaptation process was taken into account in order to transform the original English tool into a valid Portuguese version. We explored the psychometric properties of the European-Portuguese version of the Portuguese version of ODQ (PT-ODQ) concerning its internal consistency, reproducibility, feasibility, and discriminatory validity. ResultsCronbach alpha for the tool was 0.924 showing strong internal consistency. We also found a statistically significant difference in PT-ODQ between patients with olfactory disorders and patients without olfactory disorders, according to the Mann-Whitney test. ConclusionsThe PT-ODQ seems to be a valid tool for assessing the individual effect of olfactory disorders on patients' quality of life and, therefore, could be applied in olfactory disorders research and daily practice.