Audio-Vestibular Profil of COVID-19; Systematic Review and Metaanalys

Document Type : Systematic Review

Authors

1 Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.

2 Department of Audiology, School of Rehabilitation Sciences,Iran University of Medical Sciences, Tehran, Iran.

3 Department of Audiology, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 Proteomic Research Center Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Introduction:
After more than a year of the COVID-19 pandemic, audio-vestibular problems have been reported as consequences. Several limited case report studies with different methodologies were published. This study aimed to describe the impact of COVID-19 on the auditory-vestibular system and communication problems in subjects with hearing impairment.
 
Materials and Methods:
The current systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. PubMed, Web of Science, and Google Scholar were searched to find relevant articles using combined keywords.
 
Results:
Out of 26 final studies, 20 studies dealt with the effects of COVID-19 on the auditory and vestibular system, and six articles examined the COVID-19 effects on hearing-impaired people and patients. In these studies, dizziness (17.8%), tinnitus (8.1%), and vertigo (2.8%) were common symptoms. Most studies were case reports (42.30%), and in terms of quality, nine studies (34.61%) were in the suitable quality group.
Conclusions:
COVID-19 might cause auditory-vestibular system problems by directly affecting the structures or functions of the inner ear or by weakening the immune system. The need for taking preventive measures during the COVID-19 pandemic has caused communication and social challenges, particularly for people with hearing loss.

Keywords

Main Subjects


  1. Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clinical immunology. 2020;215:108427.
  2. Khan M, Adil SF, Alkhathlan HZ, Tahir MN, Saif S, Khan M, et al. COVID-19: a global challenge with old history, epidemiology and progress so far. Molecules. 2021;26(1):39.
  3. Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host–virus interaction, and proposed neurotropic mechanisms. ACS chemical neuroscience. 2020;11(7):995-8.
  4. Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA neurology. 2020;77(6):683-90.
  5. Lechien JR, Chiesa‐Estomba CM, Place S, Van Laethem Y, Cabaraux P, Mat Q, et al. Clinical and epidemiological characteristics of 1420 European patients with mild‐to‐moderate coronavirus disease 2019. Journal of internal medicine. 2020; 288(3): 335-44.
  6. Korkmaz MÖ, Eğilmez OK, Özçelik MA, Güven M. Otolaryngological manifestations of hospitalised patients with confirmed COVID-19 infection. European Archives of Oto-Rhino-Laryngology. 2021;278(5):1675-85.
  7. Jafari Z, Kolb BE, Mohajerani MH. Hearing loss, tinnitus, and dizziness in COVID-19: a systematic review and meta-analysis. Canadian Journal of Neurological Sciences. 2021:1-33.
  8. Neuhauser HK, Radtke A, Von Brevern M, Lezius F, Feldmann M, Lempert T. Burden of dizziness and vertigo in the community. Archives of internal medicine. 2008;168(19):2118-24.
  9. Malakouti SK, Mahmoudian MNS, Alifattahi N, Salehi M. Comorbidity of chronic tinnitus and mental disorders. The international tinnitus journal. 2011;16(2):118-22.
  10. Kovacs E, Wang X, Grill E. Economic burden of vertigo: a systematic review. Health economics review. 2019;9(1):1-14.
  11. Haile LM, Kamenov K, Briant PS, Orji AU, Steinmetz JD, Abdoli A, et al. Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019. The Lancet. 2021;397(10278):996-1009.
  12. Hampton T, Crunkhorn R, Lowe N, Bhat J, Hogg E, Afifi W, et al. The negative impact of wearing personal protective equipment on communication during coronavirus disease 2019. The Journal of Laryngology & Otology. 2020;134(7):577-81.
  13. Saunders GH, Jackson IR, Visram AS. Impacts of face coverings on communication: an indirect impact of COVID-19. International Journal of Audiology. 2021;60(7):495-506.
  14. Beukes EW, Baguley DM, Jacquemin L, Lourenco MP, Allen PM, Onozuka J, et al. Changes in tinnitus experiences during the COVID-19 pandemic. Frontiers in public health. 2020;8:681.
  15. Schlee W, Hølleland S, Bulla J, Simoes J, Neff P, Schoisswohl S, et al. The effect of environmental stressors on tinnitus: a prospective longitudinal study on the impact of the COVID-19 pandemic. Journal of clinical medicine. 2020;9(9):2756.
  16. Knollman-Porter K, Burshnic VL. Optimizing effective communication while wearing a mask during the COVID-19 pandemic. Journal of Gerontological Nursing. 2020;46(11):7-11.
  17. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS medicine. 2009;6(7):e1000097.
  18. Greenhalgh T, Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. Bmj. 2005;331(7524):1064-5.
  19. National Heart, Lung, and Blood Institute. 2014. Study Quality Assessment Tools. https:// nhlbi. nih. gov/health-topics/ study-quality- assessmenttools.
  20. Chern A, Famuyide AO, Moonis G, Lalwani AK. Bilateral sudden Sensorineural hearing loss and Intralabyrinthine hemorrhage in a patient with COVID-19.Otology & Neurotology.2021;42(1): e10.
  21. Koumpa FS, Forde CT, Manjaly JG. Sudden irreversible hearing loss post COVID-19. BMJ Case Reports CP. 2020;13(11):e238419.
  22. Lamounier P, Gonçalves VF, Ramos HVL, Gobbo DA, Teixeira RP, Dos Reis PC, et al. A 67-year-old woman with sudden hearing loss associated with SARS-CoV-2 infection. The American Journal of Case Reports. 2020;21:e927519-1.
  23. Raad N, Ghorbani J, Mikaniki N, Haseli S, Karimi-Galougahi M. Otitis media in coronavirus disease 2019: a case series. The Journal of Laryngology & Otology. 2021;135(1):10-3.
  24. Kilic O, Kalcioglu MT, Cag Y, Tuysuz O, Pektas E, Caskurlu H, et al. Could sudden sensorineural hearing loss be the sole manifestation of COVID-19? An investigation into SARS-COV-2 in the etiology of sudden sensorineural hearing loss. International Journal of Infectious Diseases. 2020;97:208-11.
  25. Cohen BE, Durstenfeld A, Roehm PC. Viral Causes of Hearing Loss: A Review for Hearing Health Professionals. Trends in Hearing. 2014; 18:2331216514541361.
  26. Almufarrij I, Munro KJ. One year on: an updated systematic review of SARS-CoV-2, COVID-19 and audio-vestibular symptoms. International Journal of Audiology. 2021:1-11.
  27. Sriwijitalai W, Wiwanitkit V. Hearing loss and COVID-19: A note. American journal of otolaryngology. 2020;41(3):102473-.
  28. McGonagle D, Bridgewood C, Ramanan AV, Meaney JFM, Watad A. COVID-19 vasculitis and novel vasculitis mimics. The Lancet Rheumatology. 2021;3(3):e224-e33.
  29. Lang B, Hintze J, Conlon B. Coronavirus disease 2019 and sudden sensorineural hearing loss. The Journal of Laryngology & Otology. 2020; 134(11): 1026-8.
  30. Chen X, Fu Y-y, Zhang T-y. Role of viral infection in sudden hearing loss. Journal of International Medical Research. 2019;47(7):
    2865-72.
  31. Ibekwe TS, Fasunla AJ, Orimadegun AE. Systematic Review and Meta-analysis of Smell and Taste Disorders in COVID-19. OTO Open. 2020;4(3):2473974X20957975.
  32. Kuhn M, Heman-Ackah SE, Shaikh JA, Roehm PC. Sudden sensorineural hearing loss: a review of diagnosis, treatment, and prognosis. Trends in amplification. 2011;15(3):91-105.
  33. Munro KJ, Uus K, Almufarrij I, Chaudhuri N, Yioe V. Persistent self-reported changes in hearing and tinnitus in post-hospitalisation COVID-19 cases. International Journal of Audiology. 2020; 59(12): 889-90.
  34. Makar SK, Biswas A, Shatapathy P. The impact of tinnitus on sufferers in Indian population. Indian Journal of Otolaryngology and Head & Neck Surgery. 2014;66(1):37-51.
  35. Chari DA, Limb CJ. Tinnitus. Medical Clinics. 2018;102(6):1081-93.
  36. Viola P, Ralli M, Pisani D, Malanga D, Sculco D, Messina L, et al. Tinnitus and equilibrium disorders in COVID-19 patients: preliminary results. European Archives of Oto-Rhino-Laryngology. 2020.
  37. Elibol E. Otolaryngological symptoms in COVID-19. European Archives of Oto-Rhino-Laryngology. 2021;278(4):1233-6.
  38. Liang Y, Xu J, Chu M, Mai J, Lai N, Tang W, et al. Neurosensory dysfunction: a diagnostic marker of early COVID-19. International Journal of Infectious Diseases. 2020;98:347-52.
  39. Micarelli A, Granito I, Carlino P, Micarelli B, Alessandrini M. Self-perceived general and ear-nose-throat symptoms related to the COVID-19 outbreak: a survey study during quarantine in Italy. Journal of International Medical Research. 2020; 48(10): 0300060520961276.
  40. Xia L, He G, Feng Y, Yu X, Zhao X, Yin S, et al. COVID-19 associated anxiety enhances tinnitus. Plos one. 2021;16(2):e0246328.
  41. Murphy C, Reinhardt C, Linehan D, Katiri R, O’Connor A. A review of primary care referrals for patients with dizziness and vertigo: prevalence and demographics. Irish Journal of Medical Science (1971-). 2021:1-5.
  42. Mukherjee A, Chatterjee S, Chakravarty A. Vertigo and dizziness--a clinical approach. The Journal of the Association of Physicians of India. 2003;51:1095-101.
  43. Saccomano SJ. Dizziness, vertigo, and presyncope: What's the difference? The Nurse Practitioner. 2012;37(12):46-52.
  44. Murdin L, Schilder AG. Epidemiology of balance symptoms and disorders in the community: a systematic review. Otology & Neurotology. 2015; 36(3): 387-92.
  45. Tusa RJ. Dizziness. Medical Clinics of North America. 2009;93(2):263-71.
  46. Malayala SV, Raza A. A case of COVID-19-induced vestibular neuritis. Cureus. 2020;12(6).
  47. Vanaparthy R, Malayala SV, Balla M. COVID-19-induced vestibular neuritis, hemi-facial spasms and Raynaud's phenomenon: a case report. Cureus. 2020;12(11).
  48. Lee H, Sohn S-I, Cho Y-W, Lee S-R, Ahn B-H, Park B-R, et al. Cerebellar infarction presenting isolated vertigo: frequency and vascular topo- graphical patterns. Neurology. 2006; 67(7): 1178-83.
  49. Chetty R, Batitang S, Nair R. Large artery vasculopathy in HIV-positive patients: another vasculitic enigma. Human pathology. 2000; 31(3): 374-9.
  50. Gilden D, Kleinschmidt-DeMasters B, Wellish M, Hedley-Whyte E, Rentier B, Mahalingam R. Varicella zoster virus, a cause of waxing and waning vasculitis: the New England Journal of Medicine case 5-1995 revisited. Neurology. 1996;47(6): 1441-6.
  51. Ralli M, Campo F, Angeletti D, Minni A, Artico M, Greco A, et al. Pathophysiology and therapy of systemic vasculitides. EXCLI Journal. 2020;19:817.
  52. Ralli M, Di Stadio A, De Virgilio A, Croce A, de Vincentiis M. Autoimmunity and otolaryngology diseases. Hindawi; 2018.
  53. Maslovara S, Košec A. Post-COVID-19 Benign Paroxysmal Positional Vertigo. Case Reports in Medicine. 2021;2021.
  54. You P, Instrum R, Parnes L. Benign paroxysmal positional vertigo. Laryngoscope investigative otolaryngology. 2019;4(1):116-23.
  55. Wang L, Liu J, Fan Q, Fan Z, Xu X, Li Z, et al. Benign paroxysmal positional vertigo as a complication of 90-day head-down bed rest. European Archives of Oto-Rhino-Laryngology. 2021;278(3):683-8.
  56. Luth C, Bartell D, Bish M, Yudd A, Palaima M, Cleland JA. The effectiveness of vestibular rehabilitation therapy vs conservative treatment on dizziness: a systematic review and meta-analysis. Physical Therapy Reviews. 2019;24(5):229-38.
  57. Yamamoto R, Naito Y, Tona R, Moroto S, Tamaya R, Fujiwara K, et al. Audio-visual speech perception in prelingually deafened Japanese children following sequential bilateral cochlear implantation. International journal of pediatric otorhinolaryngology. 2017;102:160-8.
  58. McGurk H, MacDonald J. Hearing lips and seeing voices. Nature. 1976;264(5588):746-8.
  59. Magee M, Lewis C, Noffs G, Reece H, Chan JC, Zaga CJ, et al. Effects of face masks on acoustic analysis and speech perception: Implications for peri-pandemic protocols. The Journal of the Acoustical Society of America. 2020;148(6): 3562-8.
  60. Rahne T, Fröhlich L, Plontke S, Wagner L. Influence of face surgical and N95 face masks on speech perception and listening effort in noise. 2021.
  61. Amos NE, Humes LE. Contribution of high frequencies to speech recognition in quiet and noise in listeners with varying degrees of high-frequency sensorineural hearing loss. 2007.
  62. Bosker HR, Peeters D, Holler J. How visual cues to speech rate influence speech perception. Quarterly Journal of Experimental Psychology. 2020; 73(10): 1523-36.
  63. Tona R, Naito Y, Moroto S, Yamamoto R, Fujiwara K, Yamazaki H, et al. Audio–visual integration during speech perception in prelingually deafened Japanese children revealed by the McGurk effect. International journal of pediatric otorhino- laryngology. 2015;79(12):2072-8.
  64. Heyes C. Where do mirror neurons come from? Neuroscience & Biobehavioral Reviews. 2010; 34(4): 575-83.
  65. Chatterjee A. Reflections on mirror neurons and rehabilitation. Cognitive and Behavioral Neurology. 2018;31(4):243-4.
  66. Zult T, Howatson G, Kádár EE, Farthing JP, Hortobágyi T. Role of the mirror-neuron system in cross-education. Sports Medicine. 2014;44(2):
    159-78.
  67. Ariapooran S, Khezeli M. Symptoms of anxiety disorders in Iranian adolescents with hearing loss during the COVID-19 pandemic. BMC psychiatry. 2021;21(1):1-5.
  68. Yang Y, Xiao Y, Liu Y, Li Q, Shan C, Chang S, et al. Mental Health and Psychological Impact on Students with or without Hearing Loss during the Recurrence of the COVID-19 Pandemic in China. International Journal of Environmental Research and Public Health. 2021;18(4):1421.
  69. Dunn CC, Stangl E, Oleson J, Smith M, Chipara O, Wu Y-H. The Influence of Forced Social Isolation on the Auditory Ecology and Psychosocial Functions of Listeners With Cochlear Implants During COVID-

 

19 Mitigation Efforts. Ear and Hearing. 2021; 42(1):20-8.

  1. Clouden TA. Persistent hallucinations in a 46-year-old woman after COVID-19 infection: a case report. Cureus. 2020;12(12).
  2. Elkhaled W, Abid FB, Akhtar N, Abukamar MR, Ibrahim WH. A 23-year-old man with SARS-CoV-2 infection who presented with auditory hallucinations and imaging findings of cytotoxic lesions of the corpus callosum (CLOCC). The American journal of case reports. 2020;21: e928798-1.
  3. Fidan V. New type of corona virus induced acute otitis media in adult. American journal of otolaryngology. 2020;41(3):102487.
  4. Freni F, Meduri A, Gazia F, Nicastro V, Galletti C, Aragona P, et al. Symptomatology in head and neck district in coronavirus disease (COVID-19): a possible neuroinvasive action of SARS-CoV-2. American journal of otolaryngology. 2020; 41(5): 102612.
  5. Miri SM, Ajalloueyan M. Critical alert for otolaryngologists: Earache may be the early signs of COVID-19. Iranian Red Crescent Medical Journal. 2020;22(5).
  6. Mustafa M. Audiological profile of asymptomatic Covid-19 PCR-positive cases. American Journal of Otolaryngology. 2020;41(3):102483.
  7. Alqudah S, Zaitoun M, Alqudah O, Alqudah S, Alqudah Z. Challenges facing users of hearing aids during the COVID-19 pandemic. International Journal of Audiology. 2021:1-7.
  8. Alsadoon E, Turkestani M. Virtual Classrooms for Hearing-impaired Students during the COVID-19 Pandemic. Romanian Journal for Multidimensional Education/Revista Romaneasca pentru Educatie Multidimensionala. 2020;12.