Comparative Study of Audiovestibular Symptoms between Early and Late Variants of COVID-19

Abstract

Audiovestibular symptoms during the acute phase of the corona virus disease 2019 (COVID-19), have been reported for earlier waves of the pandemic, while no studies investigated nor compared audiovestibular manifestations during subsequent waves of COVID-19. In the current study, we aimed to compare the occurrence of audiovestibular symptoms associated with COVID-19 between the alpha/beta, delta, and omicron variants. An online questionnaire was distributed to individuals with confirmed test results for COVID-19. We asked participants to report whether they experienced audiovestibular symptoms during the acute phase of the disease. The study included 939 participants; 120 un-infected controls and infected participants during alpha/beta (n = 301), delta (n = 102), and omicron (n = 416) predominance periods. Self-reported audiovestibular symptoms were found to be statistically significantly different between un-infected controls and COVID-19 infected individuals in all analyzed variants. Furthermore, our results showed no significant differences in audiovestibular symptoms among individuals infected during alpha/beta, delta, and omicron waves. Although individuals infected during the delta variant predominance period reported higher percentages of audiovestibular symptoms (ranging from 11.8% to 26.5% for auditory symptoms and from 12.7% to 34.3% for vestibular symptoms) than for the alpha/beta (ranging from 6.3% to 18.9% for auditory symptoms and 8.3% to 29.9% for vestibular symptoms) and omicron (ranging from 9.6% to 21.2% for auditory and 12.5 to 29.1% for vestibular symptoms) variants, this did not achieve statistical significance. With regards to auditory symptoms, the most commonly reported symptoms were aural fullness followed by hearing loss and tinnitus. With regards to vestibular symptoms, dizziness was the most commonly reported symptom followed by vertigo and unsteadiness. Logistic regression revealed that experiencing auditory symptoms were associated with other neurological symptoms, back and joint pain, and chest pain as COVID-19 symptoms. Vestibular symptoms were associated with anemia, gender, fatigue, headache, and breathing difficulties. In conclusion, our study shows that audiovestibular symptoms are common during the acute phase of early and late COVID-19 variants with no significant differences between them.

Increased Incidence of Vestibular Disorders in Patients With SARS-CoV-2

“…The data we present demonstrate that individuals testing positive for COVID-19 are over twice as likely to develop vestibular symptoms compared to the general population. Although our data estimates the overall prevalence of vestibular disorder amongst these patients at between 1% and 3%, other studies have estimated the self-reported numbers to reach as high as over 40% ( 7 , 14 , 15 ). One must also consider individuals whose vestibular symptoms remain undiagnosed, those who did not seek medical attention for their vestibular symptoms during our observation window, and those who were never tested and diagnosed with COVID-19.…”

“…A prior study by Almishaal of 939 patients showed a statistically significant increase in subjective, self-reported incidence of audiovestibular symptoms in patients with COVID-19, but did not demonstrate significant differences between viral variants ( 15 ). However, it is difficult to assess the clinical significance of subjective, self-reported findings.…”

Acute labyrinthitis: a manifestation of COVID-19 in a teenager

“…Auditory symptoms were reported to inflict approximately 24% of COVID-19 patients, with aural fullness as the chief complaint, followed by tinnitus and hearing loss 17. In contrast, vestibular symptoms were reported in approximately 35% of COVID-19 patients.…”

“…Yet, detailed investigations, including imaging, are pertinent so as to avoid other causes of acute onset of hearing loss and vertigo, such as stroke or bleeding and intracranial tumour 19. Nevertheless, with the shift of variants causing COVID-19, reports on the rising number of patients presenting with audiovestibular symptoms have been demonstrated recently 17. Therefore, objective vestibular assessments are important to identify the affected vestibular end-organ, to monitor disease progression as well as treatment outcomes.…”

Complicaciones neurológicas periféricas en pacientes adultos Post-Covid-19, Revisión sistemática

“…Almishaal et al asociaron al mareo con el uso de medicamentos antirretrovirales y la hidroxicloroquina por su acción ototóxica (46). Por otro lado, Islamoglu et al, en su estudio de diplopía binocular horizontal, menciona que el paciente mejoró a los pocos días, indicando el tratamiento con hidroxicloroquina y azitromicina (47).…”