Hearing loss and COVID-19: an umbrella review.

INTRODUCTION: COVID-19 can result in an extensive range of extrapulmonary, and neurological signs and symptoms such as olfactory and/or taste dysfunction, and otologic symptoms. The aim of this study was to investigate the hearing loss manifestation from COVID-19. METHODS: The goal of this umbrella review was to examine hearing loss associated with COVID-19 disease. English literature published until October 15, 2022 in online databases including PubMed, Scopus, Web of Science, and Embase was considered for this purpose. Eligibility of the articles for subsequent data extraction was evaluated in a two-step selection process with consideration to an inclusion/exclusion criterion. This review followed the PRISMA protocol and the Amstar-2 checklist for quality assessment. RESULTS: A total of four treatment strategies were used by different studies which included oral corticosteroids, intratympanic corticosteroids, combined oral and intratympanic corticosteroids, and hyperbaric oxygen therapy. Five studies investigated corticosteroid use in the forms of oral or intratympanic injection; four studies reported (complete or partial) hearing improvements after steroid treatment, while one study stated no significant improvement in hearing function. One study reported that oral corticosteroid monotherapy alone was not effective, while vestibular symptoms were ameliorated by a combination of oral prednisone, intratympanic dexamethasone injection, and hydroxychloroquine. CONCLUSION: The findings suggest that despite being one of the rare complications of COVID-19, hearing loss can impact a patient's quality of life. The most common type reported was sensorineural hearing loss, which can be diagnosed with variable techniques.

Pathology and Immunity After SARS-CoV-2 Infection in Male Ferrets Is Affected by Age and Inoculation Route.

Improving COVID-19 intervention strategies partly relies on animal models to study SARS-CoV-2 disease and immunity. In our pursuit to establish a model for severe COVID-19, we inoculated young and adult male ferrets intranasally or intratracheally with SARS-CoV-2. Intranasal inoculation established an infection in all ferrets, with viral dissemination into the brain and gut. Upon intratracheal inoculation only adult ferrets became infected. However, neither inoculation route induced observable COVID-19 symptoms. Despite this, a persistent inflammation in the nasal turbinates was prominent in especially young ferrets and follicular hyperplasia in the bronchi developed 21 days post infection. These effects -if sustained- might resemble long-COVID. Respiratory and systemic cellular responses and antibody responses were induced only in animals with an established infection. We conclude that intranasally-infected ferrets resemble asymptomatic COVID-19 and possibly aspects of long-COVID. Combined with the increasing portfolio to measure adaptive immunity, ferrets are a relevant model for SARS-CoV-2 vaccine research.

Sudden hearing loss and coronavirus disease 2019: the role of corticosteroid intra-tympanic injection in hearing improvement.

BACKGROUND: Coronavirus disease 2019 was first seen in December 2019. Due to the insidious and complex nature of the disease, the list of symptoms is rapidly expanding. So far, few studies have reported sudden sensorineural hearing loss as a possible symptom of coronavirus disease 2019. CASE REPORT: A 60-year-old woman with a complaint of sudden sensorineural hearing loss and subjective severe tinnitus presented to the ENT clinic. Coronavirus disease 2019 was subsequently confirmed with a polymerase chain reaction test. At the time of presentation, she was treated with intra-tympanic dexamethasone. Improvements in hearing threshold and speech perception, and a subjective reduction in tinnitus, were observed after treatment. CONCLUSION: This case report supports evidence from other case reports of a possible association between coronavirus disease 2019 and sudden sensorineural hearing loss. Sudden sensorineural hearing loss may be a symptom of this disease that behaves as an underlying aggravating factor. Intra-tympanic injection of corticosteroids is recommended for managing these patients during the pandemic.

Bilateral Sudden Sensorineural Hearing Loss and Intralabyrinthine Hemorrhage in a Patient With COVID-19.

OBJECTIVE: To describe a case of bilateral sudden sensorineural hearing loss (SSNHL) and intralabyrinthine hemorrhage in a patient with COVID-19. STUDY DESIGN: Clinical capsule report. SETTING: Tertiary academic referral center. PATIENT: An adult woman with bilateral SSNHL, aural fullness, and vertigo with documented SARS-CoV-2 infection (IgG serology testing). INTERVENTIONS: High-dose oral prednisone with taper, intratympanic dexamethasone. MAIN OUTCOME MEASURES: Audiometric testing, MRI of the internal auditory canal with and without contrast. RESULTS: A patient presented with bilateral SSNHL, bilateral aural fullness, and vertigo. Serology testing performed several weeks after onset of symptoms was positive for IgG COVID-19 antibodies. MRI showed bilateral intralabyrinthine hemorrhage (left worse than right) and no tumor. The patient was treated with two courses of high-dose oral prednisone with taper and a left intratympanic dexamethasone injection, resulting in near-resolution of vestibular symptoms, a fluctuating sensorineural hearing loss in the right ear, and a severe to profound mixed hearing loss in the left ear. CONCLUSIONS: COVID-19 may have otologic manifestations including sudden SSNHL, aural fullness, vertigo, and intralabyrinthine hemorrhage.

Proficiency of virtual follow-up amongst tinnitus patients who underwent intratympanic steroid therapy amidst COVID 19 pandemic.

AIM: The aim of this study was to assess the efficacy and feasibility of virtual follow-up in patients who have undergone intratympanic steroid injection for treatment of tinnitus during COVID-19 pandemic. MATERIALS & METHODS: Twenty-five patients having long-term tinnitus undergoing intratympanic steroid course, were followed up virtually via video calling & telephonic methods and evaluated using Tinnitus handicap inventory scoring over the period of 68 days. RESULTS: 20 out of 25 patients expressed improvement from symptoms (80%) and 5 of the remaining (20%) showed no improvement. However, most of them were inarguably satisfied with this virtual method of follow up and had no reservation in following the similar method of observation in future. CONCLUSION: Virtual follow-up using video calling applications and telephonic call is an efficacious, cost effective and user-friendly method, which can provide accurate post procedural observation while keeping in account the nationwide lockdown during COVID 19 pandemic.