Evaluation of Disturbances in Hearing, Tinnitus, and Vestibular Symptoms as Signs of COVID-19 Infection

Abstract

BackgroundThere have been reports and studies indicating audiovestibular disturbances in COVID-19 patients with variations in the percentage of sensorineural hearing loss (SNHL). The purpose of this study is to compare the incidence of newly diagnosed SNHL, sudden idiopathic hearing loss (SIHL), tinnitus, and vestibular disturbances between infected and uninfected patients, as well as to identify population groups at risk.MethodsThis study used TriNetX to obtain statistics on COVID-19 (+) and COVID-19 (−) patients from 61 healthcare organizations. Propensity score with 1:1 matching was used to control confounding variables. This study evaluated the relative risk of developing audiovestibular disturbances up to 1 month after a COVID-19 test and further investigated the incidence in COVID-19 (+) subset groups.ResultsBetween COVID-19 (+) and COVID-19 (−) patients who had an audiogram, there was no statistically significant difference in SNHL or SIHL (SNHL: relative risk [RR] = 0.69, 95% confidence interval [CI] = 0.46–1.04; SIHL: RR = 1.00, 95% CI = 0.42–2.40). Race/ethnicity or specified comorbidity did not affect the incidence of SNHL or SIHL. There was a statistically significant difference in tinnitus and vestibular disturbances between the COVID-19 (+) and the COVID-19 (−) groups (RR = 1.29, 95% CI = 1.01–1.66; RR = 2.33, 95% CI = 2.19–2.48).ConclusionNew onset hearing loss is not more common in patients with a positive COVID-19 test than those with a negative COVID-19 test. Audiologic evaluation is needed to verify reported hearing disturbances. Although statistically significant in specific population groups, tinnitus and vestibular disturbances may not be clinically significant due to the low incidence.

Association between COVID‐19 and sensorineural hearing loss: Evidence from a Mendelian randomization study in European and East Asian population

“…However, a meta‐analysis based on 350 studies showed a low pooled prevalence (3%) of hearing impairment in COVID‐19 patients, which implied the limited effects of COVID‐19 infection on hearing loss 36 . In addition, some observational studies showed that there were no statistically significant differences in frequencies of hearing loss between the COVID‐19 positive patients and the control group 10–13 …”

“…36 In addition, some observational studies showed that there were no statistically significant differences in frequencies of hearing loss between the COVID-19 positive patients and the control group. [10][11][12][13] The inconsistent findings in previous observational studies examining the association between COVID-19 and hearing loss could be attributed to several factors: First, the sample size is too small, which affect the accuracy of the results. 37 The low prevalence of hearing impairment in COVID-19 patients make it difficult to collect enough samples.…”

“…[4][5][6] In addition, some meta-analyses and observational studies confirmed that COVID-19 can cause hearing loss 7,8 and some cases of hearing loss following SARS-CoV-2 infection have also been reported among children, 9 but other studies showed that the effect of COVID-19 on auditory symptoms was negligible. [10][11][12][13] Traditional epidemiological conclusions may be disturbed by confounding interference and reverse causation.…”

Complicações audiovestibulares na COVID-19: uma revisão integrativa

“…Por outro lado, alguns estudos não evidenciaram relação da infecção pelo SARS-COV-2 e o surgimento das complicações audiovestibulares, como no de África et al 29 , em que a perda auditiva não teve diferença estatística significativa relacionada a COVID-19 e no de Durgut et al 30 , em que não se encontrou efeitos nos limiares auditivos em pacientes com doença leve não hospitalizada de COVID-19. Além disso, foi determinado que a progressão da COVID-19 não contribuiu para a perda auditiva 31 .…”