REVIEW OF COVID-19 AND AUDIO-VESTIBULAR SYMPTOMS: WHAT WE KNOW SO FAR?

  • Bojana Bukurov Faculty of Medicine, University of Belgrade; Clinic for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Centre of Serbia, Belgrade, Republic of Serbia
Keywords: Covid-19, hearing loss, SARS-CoV-2, tinnitus, vertigo

Abstract


Introduction/Aim: Although we have already entered the third year of the pandemic, the pathophysiological mechanisms of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection are still not fully elucidated. While symptoms of smell and taste dysfunction have been associated with this infection from the beginning, not much has been reported on other sensory systems, in the first place the hearing and balance. The aim of this review paper is to summarize data from the literature and the latest publications and answer the question whether there is a causal link between COVID-19 and inner ear damage.
Methods: This review paper presents the latest data and evidence obtained from search of PubMed database by keywords: COVID-19, hearing loss, tinnitus and vertigo. The search identified more than 460 publications. After reviewing the title and abstract, most papers were excluded due to non-compliance with the eligibility criteria.
Results: A total of 16 papers fulfilled the eligibility criteria and were reviewed in their entirety. The results of the meta-analysis indicated that the incidence of hearing loss was 3.1% (Confidence Interval - CI: 0.01-0.09), of tinnitus 4.5% (CI: 0.012-0.153), and dizziness 12.2% (CI: 0.070-0.204).
Conclusion: Most published papers are characterized by limitations and high risk of bias (no control arm,
missing data, and no reference to confounding factors). For now, no certain causal relationship between this infection and damage to the senses of hearing and the sense of balance can be established.

References

1. World Health Organization. Coronavirus (COVID-19) Dashboard Overview. Available at: https://covid19.who.int/ (Last assessed April 8, 2022)

2. Meinhardt J, Radke J, Dittmayer C, Franz J, Thomas C, Mothes R, et al. Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19. Nat Neurosci 2021; 24(2):168-75. doi: 10.1038/s41593-020-00758-5

3. Ahmad I, Rathore FA. Neurological manifestations and complications of COVID-19: A literature review. J Clin Neurosci 2020; 77:8-12. doi: 10.1016/j.jocn.2020.05.017

4. Cohen BE, Durstenfeld A, Roehm PC. Viral causes of hearing loss: a review for hearing health professionals. Trends Hear 2014; 18:2331216514541361. doi:10.1177/2331216514541361

5. Hegemann SCA, Wenzel A. Diagnosis and Treatment of Vestibular Neuritis/Neuronitis or Peripheral Vestibulopathy (PVP)? Open Questions and Possible Answers. Otol Neurotol 2017; 38(5):626-31. doi:10.1097/MAO.0000000000001396

6. Chandrasekhar SS, Tsai Do BS, Schwartz SR, Bontempo LJ, Faucett EA, Finestone SA, et al. Clinical Practice Guideline: Sudden Hearing Loss (Update). Otolaryngol Head Neck Surg 2019;161(1_suppl):S1-S45. doi:10.1177/0194599819859885

7. Merchant SN, Durand ML, Adams JC. Sudden deafness: is it viral? ORL J OtorhinolaryngolRelat Spec 2008; 70(1):52-60; discussion 60-2. doi: 10.1159/000111048

8. Little C, Cosetti MK. A Narrative Review of Pharmacologic Treatments for COVID-19: Safety Considerations and Ototoxicity. Laryngoscope 2021; 131(7):1626-32. doi:10.1002/lary.29424

9. Formeister EJ, Wu MJ, Chari DA, Meek R 3rd, Rauch SD, Remenschneider AK, et al. Assessment of Sudden Sensorineural Hearing Loss After COVID-19 Vaccination. JAMA Otolaryngol Head Neck Surg 2022: e214414. doi:10.1001/jamaoto.2021.4414

10. Popadic D. PCR testing for SARS-CoV-2: Practice, recommendations, and dilemmas. Health Care 2020; 49(3):56-74. doi:10.5937/zdravzast49-28696

11. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009;62(10):1006-12. doi:10.1016/j.jclinepi.2009.06.005

12. Sriwijitalai W, Wiwanitkit V. Hearing loss and COVID-19: A note. Am J Otolaryngol 2020; 41(3):102473. doi:10.1016/j.amjoto.2020.102473  

13. Koumpa FS, Forde CT, Manjaly JG. Sudden irreversible hearing loss post COVID-19. BMJ Case Rep 2020;13(11):e238419.                                                                    

14. Degen C, Lenarz T, Willenborg K. Acute Profound Sensorineural Hearing Loss After COVID-19 Pneumonia. Mayo Clin Proc 2020; 95(8):1801-3. doi:10.1016/j.mayocp.2020.05.034  

15. Chern A, Famuyide AO, Moonis G, Lalwani AK. Bilateral Sudden Sensorineural Hearing Loss and Intralabyrinthine Hemorrhage in a Patient With COVID-19. Otol Neurotol 2021; 42(1): e10-e14. doi:10.1097/MAO.0000000000002860

16.Edwards M, Muzaffar J, Naik P, Coulson C. Catastrophic bilateral sudden sensorineural hearing loss following COVID-19. BMJ Case Rep 2021; 14(6):e243157. doi:10.1136/bcr-2021-243157

17. Ricciardiello F, Pisani D, Viola P, Cristiano E, Scarpa A, Giannone A, et al. Sudden Sensorineural Hearing Loss in Mild COVID-19: Case Series and Analysis of the Literature. Audiol Res 2021; 11(3):313-26. doi:10.3390/audiolres11030029

18. Chari DA, Parikh A, Kozin ED, Reed M, Jung DH. Impact of COVID-19 on Presentation of Sudden Sensorineural Hearing Loss at a Single Institution. Otolaryngol Head Neck Surg 2021; 165(1):163-5. doi:10.1177/0194599820974685

19. Fancello V, Hatzopoulos S, Corazzi V, Bianchini C, Skarżyńska MB, Pelucchi S, et al. SARS-CoV-2 (COVID-19) and audio-vestibular disorders. Int J ImmunopatholPharmacol 2021; 35:20587384211027373. doi: 10.1177/20587384211027373

20. Almishaal AA, Alrushaidan AA. Short- and Long-Term Self-Reported Audiovestibular Symptoms of SARS-CoV-2 Infection in Hospitalized and Nonhospitalized Patients. AudiolNeurootol 2022; 1-15. doi: 10.1159/000521963   

21.Korsten-Meijer AG, Wit HP, Albers FW. Evaluation of the relation between audiometric and psychometric measures of hearing after tympanoplasty. Eur Arch Otorhinolaryngol 2006; 263(3):256-62. doi: 10.1007/s00405-005-0983-5

22. Nordvik Ø, Heggdal POL, Brännström KJ, Aarstad AK, Aarstad HJ. Importance of personality and coping expectancy on patient-reported hearing disability, quality of lifeand distress level: a study of patients referred to an audiology service. Health Qual Life Outcomes 2021;19(1):168.

23. Jafari Z, Kolb BE, Mohajerani MH. Hearing Loss, Tinnitus, and Dizziness in COVID-19: A Systematic Review and Meta-Analysis. Can J Neurol Sci 2022; 49(2):184-95. doi:10.1017/cjn.2021.63

24. Chirakkal P, Al Hail AN, Zada N, Vijayakumar DS. COVID-19 and Tinnitus. Ear Nose Throat J 2021;100(2_suppl): 160S-162S. doi: 10.1177/0145561320974849

25. Beukes E, Ulep AJ, Eubank T, Manchaiah V. The Impact of COVID-19 and the Pandemic on Tinnitus: A Systematic Review. J Clin Med 2021; 10(13):2763. doi: 10.3390/jcm10132763

26. Mat Q, Noël A, Loiselet L, Tainmont S, Chiesa[1]Estomba CM, Lechien JR, Duterme JP. Vestibular Neuritis as Clinical Presentation of COVID-19. Ear Nose Throat J 2021: 145561321995021. doi:10.1177/0145561321995021

27. Almufarrij I, Munro KJ. One year on: an updated systematic review of SARS-CoV-2, COVID-19 and audio-vestibular symptoms. Int J Audiol 2021; 60(12):935-45. doi: 10.1080/14992027.2021.1896793

28. Almufarrij I, Uus K, Munro KJ. Does coronavirus affect the audio-vestibular system? A rapid systematic review. Int J Audiol 2020; 59(7):487-91. doi:10.1080/14992027.2020.1776406

29. Lough M, Almufarrij I, Whiston H, Munro KJ. Revised meta-analysis and pooled estimate of audio-vestibular symptoms associated with COVID-19. Int J Audiol 2021:1-5. doi: 10.1080/14992027.2021.1962552

30. Saunders GH, Beukes E, Uus K, Armitage CJ, Kelly J, Munro KJ. Shedding Light on SARS-CoV-2, COVID-19, COVID-19 Vaccination, and Auditory Symptoms: Causality or Spurious Conjunction? Front Public Health 2022; 10:837513. doi: 10.3389/fpubh.2022.837513

31. Marcus DK, Gurley JR, Marchi MM, Bauer C. Cognitive and perceptual variables in hypochondriasis and health anxiety: a systematic review. Clin Psychol Rev 2007;27(2):127-39. doi: 10.1016/j.cpr.2006.09.003

Published
2022/07/09
Section
Review article