The association between COVID-19 vaccination and idiopathic sudden sensorineural hearing loss, clinical manifestation and outcomes.

PURPOSE: Previous data demonstrated an increased incidence of Idiopathic Sensorineural Hearing Loss (ISSNHL) in 2021 compared to 2019-2020, suggesting an association with the anti-COVID-19 vaccine. We aimed to assess our center's incidence and compare the clinical manifestations and outcomes of vaccinated vs. unvaccinated patients. METHODS: A retrospective chart review of all patients diagnosed with ISSNHL during 2021 was conducted and compared to patients who presented in 2018-2020. Patient demographics, audiometry features, vaccination status, and prognosis were evaluated. RESULTS: Throughout 2021, 51 patients were diagnosed with ISSNHL, compared with 31 during 2020, 38 in 2019, and 41 in 2018, demonstrating a 64%, 34%, and 24% increase, respectively. Among patients who presented in 2021, 13 (25.4%) received the anti-COVID-19 vaccine within 30 days before their presentation, and 4 received it within 96 h. Most presented after receiving the second or third dose. Patient characteristics, audiometry features, and prognosis did not significantly differ between vaccinated and unvaccinated patients. CONCLUSIONS: A marked incline was seen in the 2021 ISSNHL incidence at our medical center, of which 25% of cases were within a month post-anti-COVID-19 vaccination. No significant difference was found in clinical manifestations and outcomes between vaccinated and nonvaccinated patients. While other justifications could be sought, an association cannot be ruled out, and further research is needed.

Changes in Smoking Behavior, Stress, and Sleep Duration among Israeli Hospital Workers during the COVID-19 pandemic: A Cross-Sectional Study.

BACKGROUND: Being on the COVID-19 frontline could negatively impact healthcare workers mental health. We examined smoking behavior changes and the association with changes in stress levels and sleeping patterns among hospital workers during the pandemic. METHODS: An online survey was conducted among employees of a large tertiary medical center in Israel. Data collected included socio-demographic characteristics, smoking status, changes in smoking behavior (for smokers only), stress levels, and sleeping duration during the pandemic, perceptions of risk for COVID-19 infection and disease severity, presence of a chronic illness, COVID-19 exposure and infection status, and involvement in treating COVID-19 patients, Multi-nominal logistic regression modeling assessed the effects of covariates on smoking behavior change. RESULTS: Overall, 920 healthcare workers participated. More than half (59%) reported an increase in stress and 28% reported changes in sleep duration. Thirty-five percent of current smokers (n=132), reported smoking more. Increased stress was associated with an increase in smoking (OR=3.45; 95% CI 1.2-9.4, p=0.016), and an increase in sleeping hours was significantly associated with a decrease in smoking (OR=6.62, 95% CI 1.2-32. p=0.02). Among smokers who reported perceived levels of stress to be the same or slightly higher than pre-pandemic, a strong inverse association was observed between sleep and smoking. CONCLUSIONS: The mental health consequences of the pandemic, specifically for health workers, could lead to negative changes in smoking behaviors. Together with offering stress-management skills and coping strategies, mental health support should target smoking behaviors and sleep disturbances. IMPLICATIONS: A high proportion of healthcare employees working in a large tertiary medical centre in Israel reported increased stress levels during the COVID-19 pandemic. Among smokers, increased stress levels were associated with increased smoking, suggesting that smoking may be a coping mechanism for COVID-19 related stress. Offering stress-management skills and coping strategies can mitigate the negative impact on health workers' smoking behaviour, and reduce stress-related increases in smoking behaviour.