Prevalence of Ear-Related Problems in Individuals Recovered From COVID-19

Document Type : Original

Authors

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

2 School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

3 Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

4 Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis, London, UK.

Abstract

Introduction:
The aim was to assess prevalence of tinnitus, hyperacusis, hearing and balance problems among patients recovered from COVID-19 infection. Self-reported ear and hearing symptoms were compared in three groups comprising: confirmed COVID-19, possible COVID-19, and non-COVID-19.

Materials and Methods:
1649 participants completed the survey in this cross-sectional study. The mean age was 34 years and 65% were female. Participants with confirmed and possible COVID-19 were asked if after their infection (compared to the past) they experienced hearing loss, ringing or whistling noises, fullness or blockage in their ears, loudness of the sounds that are normal to other people bother them more (an indication of hyperacusis), dizziness, giddiness, or imbalance. 

Results:
Among participants with confirmed COVID-19, 16% reported that compared to the past their hearing has decreased, 21.5% noticed tinnitus, 22.5% aural fullness, 26.1% hyperacusis and 17.3% balance problems. Regression models showed that compared to the non-COVID-19 group, participants with confirmed COVID-19 had odds ratios (ORs) of significantly greater than 1 in predicting presence of self-reported symptoms of hearing loss, tinnitus, aural fullness, hyperacusis and balance problems, OR=1.96 (p=0.001), OR=1.63 (p=0.003), OR=1.8 (p<0.001), OR=2.2 (p<0.001), and OR=2.99 (p<0.001), respectively.

Conclusions:
There seem to be higher prevalence of self-report symptoms of ear-related problems among individuals with confirmed COVID-19 infection compared to a non-COVID-19 group during the pandemic.

Keywords

Main Subjects


  1. 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.
  2. 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).
  3. Aazh H, Danesh A, Moore BCJ. Self-Reported Tinnitus Severity Prior to and During the COVID-19 Lockdown in the United Kingdom. Journal of American Academy of Audiology. 2021;32(9):562-6.
  4. Fioretti A, Natalini E, Triggianese G, Eibenstein R, Angelone AM, Lauriello M, et al. Impact of the COVID-19 Lockdown on Patients with Chronic Tinnitus-Preliminary Results. Audiol Res. 2022; 12(3):327-36.
  5. Newman CW, Sandridge SA, Jacobson GP. Psychometric adequacy of the Tinnitus Handicap Inventory (THI) for evaluating treatment outcome. Journal of the American Academy of Audiology. 1998; 9(2):153-60.
  6. Thrane JF, Britze A, Fjaeldstad AW. Incidence and duration of self-reported hearing loss and tinnitus in a cohort of COVID-19 patients with sudden chemosensory loss: A STROBE observational study. European annals of otorhinolaryngology, head and neck diseases. 2022; 139(3):125-8.
  7. Kartal A, Kılıç M. Tinnitus in patients recovering after COVID-19: observational and cross-sectional study. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2022.
  8. Verma H, Shah J, Akhilesh K, Shukla B. Patients' perspective about speech, swallowing and hearing status post-SARS-CoV-2 (COVID-19) recovery: E-survey. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2022; 279(5):2523-32.
  9. Alves de Sousa F, Pinto Costa R, Xará S, Nóbrega Pinto A, Almeida ESC. SARS-CoV-2 and hearing: An audiometric analysis of COVID-19 hospitalized patients. J Otol. 2021;16(3):158-64.
  10. Bowling A, Ebrahim S. Handbook of health research methods: investigation, measurement and analysis: McGraw-Hill International; 2005.
  11. Stratton SJ. Population Research: Convenience Sampling Strategies. Prehosp Disaster Med. 2021; 36(4):373-4.
  12. Kruskal WH, Wallis WA. Use of Ranks in One-Criterion Variance Analysis. Journal of the American Statistical Association. 1952; 47(260): 583-621.
  13. Khalagi K, Gharibzadeh S, Khalili D, Mansournia MA, Mirab Samiee S, Aghamohamadi S, et al. Prevalence of COVID-19 in Iran: results of the first survey of the Iranian COVID-19 Serological Surveillance programme. Clin Microbiol Infect. 2021; 27(11):1666-71.
  14. Nazemipour M, Shakiba M, Mansournia MA. Estimates of anti-SARS-CoV-2 antibody seroprevalence in Iran. The Lancet Infectious Diseases. 2021.
  15. Ghafari M, Kadivar A, Katzourakis A. Estimates of anti-SARS-CoV-2 antibody seroprevalence in Iran. The Lancet Infectious Diseases. 2021; 21(5): 602-3.
  16. IBM SPSS Statistics for Windows. 23 ed. Armonk, NY: IBM Corp.; 2016.
  17. Danno K, Cognet-Dementhon B, Thevenard G, Duru G, Allaert FA, Bordet MF. Management of the early symptoms of influenza-like illnesses and ear, nose and throat (ENT) disorders by pharmacists. Homeopathy. 2014;103(4):239-49.
  18. Czubak J, Stolarczyk K, Orzeł A, Frączek M, Zatoński T. Comparison of the clinical differences between COVID-19, SARS, influenza, and the common cold: A systematic literature review. Adv Clin Exp Med. 2021;30(1):109-14.
  19. Samocha-Bonet D, Wu B, Ryugo DK. Diabetes mellitus and hearing loss: A review. Ageing Res Rev. 2021;71:101423.
  20. Dillard LK, Martinez RX, Perez LL, Fullerton AM, Chadha S, McMahon CM. Prevalence of aminoglycoside-induced hearing loss in drug-resistant tuberculosis patients: A systematic review. J Infect. 2021;83(1):27-36.
  21. Yang P, Ma W, Zheng Y, Yang H, Lin H. A Systematic Review and Meta-Analysis on the Association between Hypertension and Tinnitus. Int J Hypertens. 2015;2015:583493.
  22. Oron Y, Elgart K, Marom T, Roth Y. Cardiovascular risk factors as causes for hearing impairment. Audiology & neuro-otology. 2014; 19(4): 256-60.
  23. Kim JY, Lee S, Cha J, Son G, Kim DK. Chronic kidney disease is associated with increased risk of sudden sensorineural hearing loss and Ménière's disease: a nationwide cohort study. Scientific reports. 2021;11(1):20194.
  24. 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.
  25. Beeching NJ, Fletcher TE, Beadsworth MBJ. Covid-19: testing times. BMJ. 2020;369:m1403.
  26. Mercer TR, Salit M. Testing at scale during the COVID-19 pandemic. Nature Reviews Genetics. 2021;22(7):415-26.
  27. Cozzi D, Albanesi M, Cavigli E, Moroni C, Bindi A, Luvarà S, et al. Chest X-ray in new Coronavirus Disease 2019 (COVID-19) infection: findings and correlation with clinical outcome. La radiologia medica. 2020;125(8):730-7.
  28. Yang W, Sirajuddin A, Zhang X, Liu G, Teng Z, Zhao S, et al. The role of imaging in 2019 novel coronavirus pneumonia (COVID-19). European radiology. 2020;30(9):4874-82.
  29. Zhou S, Wang Y, Zhu T, Xia L. CT features of coronavirus disease 2019 (COVID-19) pneumonia in 62 patients in Wuhan, China. Ajr Am J Roentgenol. 2020;214(6):1287-94.
  30. Neri E, Miele V, Coppola F, Grassi R. Use of CT and artificial intelligence in suspected or COVID-19 positive patients: statement of the Italian Society of Medical and Interventional Radiology. La radiologia medica. 2020;125(5):505-8.
  31. Choi BCK, Pak AWP. A catalog of biases in questionnaires. Prev Chronic Dis. 2005;2(1):A13.
  32. Raphael K. Recall bias: a proposal for assessment and control. International journal of epidemiology. 1987;16(2):167-70.
  33. 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? Frontiers in public health. 2022;10:837513.