COVID-19 associated anxiety enhances tinnitus

Abstract

To investigate if the anxiety associated with coronavirus disease 2019 (COVID-19) is a promoting factor to tinnitus. A retrospective research design collected from 188 tinnitus patients, was used to compare the clinical characteristics of tinnitus between the patients in 2020 under pandemic pressure and those from the matching period in 2019. While anxiety was quantified using the Zung’s Self-rating Anxiety Scale (SAS), tinnitus severity was evaluated using the Tinnitus Handicap Inventory (THI) questionnaire and the test of tinnitus loudness (TL). The assessments were repeated after the sound therapy plus educational counselling (STEC) for 38 patients in 2020 and 58 patients in 2019 and compared with EC alone therapy for 42 patients in 2020 and 17 patients in 2019. A large increase in anxiety was evident in 2020 in both case rate and SAS. The treatment of both methods was less effective in 2020. SAS, THI and TL were all deteriorated after the EC alone treatment in 2020, while an improvement was seen in 2019. This suggests that EC alone could not counteract the stress by COVID-19 at all, and the stress, if not managed well, can significantly increase the severity of tinnitus and associated anxiety. By using the EC subgroup in virtual control, we conclude that anxiety can serve as a promoting factor to tinnitus. We believe that this is the first study report that confirm the causative/promotive role of anxiety on tinnitus during COVID-19 pandemic.

Is COVID-19 associated with self-reported audio-vestibular symptoms?

“…The reported onset or worsening in tinnitus, in both the test and control groups, could also be due to stress and anxiety, whether associated with diagnosis of COVID-19 or as a result of the pandemic (Beukes et al 2020;Xia et al 2021), rather than a direct impact of the virus. It is also possible that the shift from working in a distracting office atmosphere to working from home in a quieter soundscape can increase awareness of the tinnitus.…”

The Impact of COVID-19 Confinement on Tinnitus and Hearing Loss in Older Adults: Data From the LOST in Lombardia Study

“…Since females have been shown to be more susceptible than males to mental health consequences during the COVID-19 pandemic ( 4 ), an increase in tinnitus severity can be expected particularly in women. Thus, a few cohorts of tinnitus patients have shown an increase in tinnitus severity, assessed through validated questionnaires, possibly promoted by frustration or anxiety ( 9 , 10 ).…”

“…Although this systematic review included 33 studies, many of the research questions remained unanswered. In fact, no study evaluated the impact of the pandemic on the incidence of tinnitus, or on the severity of tinnitus, while changes in tinnitus severity were inferred from the findings of only a few investigations ( 5 , 9 , 10 ). Results were inconclusive on the role of SARS-CoV-2 infection on the occurrence, duration, or severity of tinnitus ( 11 ).…”

Effects of the coronavirus disease 2019 pandemic on subjective tinnitus perception

“…15 In our study, a difference was found in the THI scores between the pre-and peripandemic periods (p = 0.026), which is in line with the studies that found a relationship between tinnitus and mood. 11,21 Individuals with tinnitus complaints are unhappy, pessimistic, anxious, aggressive, stressed, and depressive due to tinnitus and can express that they have difficulty falling asleep. Tinnitus can prevent these individuals from enjoying life, focusing, and relaxing.…”