Long COVID, audiovestibular symptoms and persistent chemosensory dysfunction: a systematic review of the current evidence.

Objective: The persistence of auditory, vestibular, olfactory, and gustatory dysfunction for an extended time after COVID-19 has been documented, which represents an emerging challenge of which ENT specialists must be aware. This systematic review aims to evaluate the prevalence of persistent audiovestibolar and olfactory/gustatory symptoms in patients with "long-COVID". Methods: The literature was systematically reviewed according to PRISMA guidelines; PubMed, Scopus and Google Scholar were screened by searching articles on audiovestibular symptoms and olfactory/gustatory dysfunction after SARS-CoV-2 infection. The keywords used were hearing loss, tinnitus, vertigo, smell disorders, parosmia, anosmia, hyposmia, dysgeusia combined with COVID-19 or SARS-CoV-2. Results: 1100 articles were identified. After removal of duplicates (382), 702 articles were excluded, and 16 were included in the systematic review. All articles included identified an association between SARS-CoV-2 infection and persistent hearing or chemosensory impairment. The studies were published over a period of 2 years, between 2019 and 2021. Conclusions: The likelihood of patients with persistent audiovestibular symptoms related to COVID-19 was different among the articles; however, olfactory and gustatory disturbances were more consistently reported. Studies with longer follow-up are required to fully evaluate the long-term impact of these conditions.

The effect of coronavirus disease 2019 on the hearing system.

OBJECTIVE: This study aimed to evaluate different auditory regions with audiological tests, based on the presumption that there may be damage to the structures in the hearing system after coronavirus disease 2019. METHODS: Twenty individuals with no history of coronavirus disease 2019 and 27 individuals diagnosed with coronavirus disease 2019 were compared. Pure tone, speech and extended high-frequency audiometry, acoustic immitansmetry, transient evoked and distortion product otoacoustic emissions testing, and auditory brainstem response testing were conducted. RESULTS: The pure tone audiometry and extended high-frequency mean threshold values were higher in the coronavirus disease 2019 group. The transient evoked otoacoustic emissions signal-to-noise ratios were bilaterally lower at 4 kHz in individuals with a coronavirus disease 2019 history. In the auditory brainstem response test, only the interpeak latencies of waves III-V were significantly different between groups. CONCLUSION: Coronavirus disease 2019 may cause damage to the hearing system. Patients should be followed up in the long term with advanced audiological evaluation methods in order to determine the extent and level of damage.

Hearing screening outcomes in neonates of SARS-CoV-2 positive pregnant women.

OBJECTIVE: The current study aimed to investigate possible association of maternal SARS-CoV-2 with newborn hearing loss. We compared hearing screening outcomes in neonates born to women with positive SARS-CoV-2 PCR test results during pregnancy with healthy controls. METHODS: Neonates born between April and December 2020 in our hospital to mothers with positive SARS-CoV-2 PCR test results during pregnancy were included in this study. Neonates with risk factors for universal newborn hearing screening (NHS) were excluded. Neonates born to mothers with positive SARS-CoV-2 PCR test results during pregnancy were compared with healthy controls in terms of newborn hearing screening results and independent variables. RESULTS: Neonates in the COVID-19 group were more likely to have a "refer" result in auditory brainstem responses (ABR) compared with the control group (53/118 and 28/118, respectively; p = 0.001). The second ABR test results did not differ significantly between the groups (p = 0.618). Logistic regression revealed that birth week and type of birth were not associated with the "refer" result. PCR positivity in the second trimester was more likely to produce the "refer" result in the first ABR test (p = 0.014). CONCLUSION: SARS-CoV-2 PCR positivity in pregnancy is significantly associated with an increased risk of abnormal NHS results. Also, the timing of PCR positivity in pregnancy (trimester) may be related to abnormal NHS results.

Impacts of face coverings on communication: an indirect impact of COVID-19.

OBJECTIVE: To understand the impact of face coverings on hearing and communication. DESIGN: An online survey consisting of closed-set and open-ended questions distributed within the UK to gain insights into experiences of interactions involving face coverings, and of the impact of face coverings on communication. SAMPLE: Four hundred and sixty members of the general public were recruited via snowball sampling. People with hearing loss were intentionally oversampled to more thoroughly assess the effect of face coverings in this group. RESULTS: With few exceptions, participants reported that face coverings negatively impacted hearing, understanding, engagement, and feelings of connection with the speaker. Impacts were greatest when communicating in medical situations. People with hearing loss were significantly more impacted than those without hearing loss. Face coverings impacted communication content, interpersonal connectedness, and willingness to engage in conversation; they increased anxiety and stress, and made communication fatiguing, frustrating and embarrassing - both as a speaker wearing a face covering, and when listening to someone else who is wearing one. CONCLUSIONS: Face coverings have far-reaching impacts on communication for everyone, but especially for people with hearing loss. These findings illustrate the need for communication-friendly face-coverings, and emphasise the need to be communication-aware when wearing a face covering.

Telemedicine in Audiology. Best practice recommendations from the French Society of Audiology (SFA) and the French Society of Otorhinolaryngology-Head and Neck Surgery (SFORL).

OBJECTIVES: Access to diagnosis and treatments for auditory disorders and related pathologies has regressed in France during the COVID-19 pandemic, posing a risk to the patient's chance of recovery. This best practice recommendations guide aims to list the existing technological solutions for the remote examination of a patient with hearing complaint, and to outline their benefits and, where applicable, their limitations. METHODS: The recommendations were developed both from the clinical experience of the medical experts who drafted the guide, and from an extensive review of the literature dealing with clinical practice recommendations for tele-audiology. Tele-audiometry solutions were identified on the basis of a search engine query carried out in April 2020, prior to verification of their availability on the European market. RESULTS: Video otoscopy solutions allow for the teletransmission of images compatible with a high-quality diagnosis, either by connecting via internet to a tele-health platform or using a smartphone or a tablet with an iOS or Android operating system. Using the same telecommunication methods, it is possible to remotely conduct a pure-tone audiometry test in accordance with standard practice, a speech-in-quiet or a speech-in-noise audiometry test, as well as objective measures of hearing. Clinical and paraclinical examinations can be accessed by the physician to be interpreted on a deferred basis (asynchronous tele-audiology). Examinations can also be conducted in real time in a patient, at any age of life, as long as a caregiver can be present during the installation of the transducers or the acoumetry. Tele-audiology solutions also find application in the remote training of future healthcare professionals involved in the management of deafness and hearing impairment. CONCLUSION: Under French law, tele-otoscopy is a medical procedure that is either a tele-expertise (asynchronous adive) or a teleconsultation act (synchronous advice). Subjective and objective evaluation of the patient's hearing functions can be done remotely provided that the listed precautions are respected.