Auditory evaluation of infants born to COVID19 positive mothers

Abstract

COVID-19 infection can cause a wide spectrum of symptoms. The audio-vestibular system can also be involved, but there is still debate about this so findings need to be considered carefully. Furthermore, mother to fetus intrauterine transmission of COVID-19 infection in pregnant women is controversial. Few studies are available about the audio-vestibular symptomatology of newborns with intrauterine COVID19 exposure. Objectives This study investigates the possible correlation between the COVID19 gestational infection and hearing impairment onset in newborns. The involvement of hearing in COVID19 is verified so the timing and methodology of audiological evaluation of children can be planned. Methods Children were subject to newborn hearing screening and audiological evaluation. Newborn hearing screening is carried out prior to hospital discharge using the Automatic Transient Evoked Otoacoustic Emissions test. Audiological evaluation is performed within the child age of 4 months by using maternal, pregnancy, and perinatal case history, COVID19 case history, otoscopy, acoustic immittance test, Distortion Product Otoacoustic Emissions test, and the Auditory Brainstem Response test. Results 63 children were included in the study. 82.5% of these children were subjects of the newborn hearing screening program. The remaining 11 newborns were not subjected to hearing screening due to isolation measures and their audiological evaluation was carried out directly. Only one of 52 screened neonates showed a bilateral REFER test result but hearing threshold was normal at audiological evaluation. Audiological evaluation showed normal bilateral ABR thresholds in 59/63 children. Four children (6.3% of the total) had ABR threshold alterations but two showed normal threshold at ABR retest performed within 1 month of the first. The other two infants showed monolateral ABR alterations but one of these had a concomitant middle ear effusion. In conclusion, only one child (1.6% of the sample) had an altered ABR. This child had shown one positive SARS-CoV-2 swab in the absence of risk factors for hearing loss. Conclusion This study finds no evidence that maternal COVID19 infection is a risk factor in the development of congenital hearing loss in newborns.

Hearing Outcomes of Infants Born to Mothers With Active COVID-19 Infection

“…Furthermore, in the study by Ghiselli et al, only one child (1.9%) had bilateral refer results [29]. The above results are consistent with the JCHI indications that describe a reference standard of less than 4% for newborns that do not pass the first step of screening.…”

Can SARS-CoV-2 positive pregnant women affect the hearing of their newborns: A systematic review

“…Among these publications, Turkey is the major contribution, with 4 articles [7] , [21] , [26] , [28] . In the second place, 2 related papers were published from Italy [22] , [29] . Besides, there is 1 paper each from the United States and Egypt [25] , [27] .…”

“…Several studies have shown that maternal SARS-CoV-2 virus infection does not affect newborn hearing [22] , [27] , [28] , [29] . Ghiselli et al investigated 63 newborns whose mothers had been diagnosed with COVID-19 during pregnancy and found that 4 failed the first ABR test, but only 1 (1.6 %) had ABR alterations when they were re-examined 1 month later [22] . Mostafa et al conducted a retrospective cohort analysis with 921 newborns, and only 1 of the 34 newborns born to COVID-19-positive mothers failed the ARB test (2.9 %) [27] .…”

“…Several previous studies have examined the hearing screening outcomes of newborns whose mothers tested positive for SARS-CoV-2 during pregnancy, revealing an increased risk of HL in these newborns [7] , [21] . However, the literature also reported that positive women for SARS-CoV-2 during pregnancy did not affect the HL of the delivered newborns [22] . As a result, the impact of maternal SARS-CoV-2 infection on newborn HL is unknown and controversial.…”

Sensorineural Hearing Loss Post-COVID-19 Infection: An Update

“…The hypothesis of possible direct hearing damage has been explored through the audiological evaluation of newborns intrauterinely exposed to SARS-CoV-2. Nevertheless, a clear link between congenital infection and an increased risk of hearing loss has not been established [ 27 , 28 , 29 , 30 ].…”