Review Article

Impact of COVID-19 on the auditory and vestibular system


Background and Aim: The COVID-19 has affected sensory organs in a different manner. This paper aimed to review the auditory-vestibular symptoms associated with COVID-19 and it also investigated the impacts of this pandemic on hearing-impaired community.
Recent Findings: The existing studies related to the effects of COVID-19 on the auditory-vestibular system were reviewed and discussed in order to achieve the overall image of COVID-19 on this system. Moreover, due to the adverse effects of using a mask on the communication function of hearing-impaired people, the effects of the mask on the communication process of hearing-impaired people were also reviewed.
Conclusion: COVID-19 may be accompanying with some auditory and vestibular dysfunctions. Although there are few findings in this area, they showed that the induced hearing loss is often sudden in nature and it is unclear that this situation is because of the ototoxicity of virus treated drugs or not. The vertigo induced by COVID-19 can be a direct invasion of the virus or an invasion by the immune system and its association with hearing loss and tinnitus must be identified, and appropriate referrals should be considered. On the other hand, due to the adverse effects of using personal protective equipment such as masks on the communication performance of hearing-impaired people, the necessary advice and guidance in this field are provided to the medical staff.

1. Almufarrij I, Uus K, Munro KJ. Does coronavirus affect the audio-vestibular system? A rapid systematic review. Int J Audiol. 2020;59(7):487-491. doi: 10.1080/14992027.2020.1776406
2. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. doi: 10.1056/NEJMoa2002032
3. Menni C, Valdes AM, Freidin MB, Sudre CH, Nguyen LH, Drew DA, et al. Real-time tracking of self-reported symptoms to predict potential COVID-19. Nat Med. 2020;26(7):1037-40. doi: 10.1038/s41591-020-0916-2
4. Wenting A, Gruters A, van Os Y, Verstraeten S, Valentijn S, Ponds R, et al. COVID-19 neurological manifestations and underlying mechanisms: a scoping review. Front Psychiatry. 2020;11:860. doi: 10.3389/fpsyt.2020.00860
5. Pinna P, Grewal P, Hall JP, Tavarez T, Dafer RM, Garg R, et al. Neurological manifestations and COVID-19: experiences from a tertiary care center at the frontline. J Neurol Sci. 2020;415:116969. doi: 10.1016/j.jns.2020.116969
6. Zhou Y, Li W, Wang D, Mao L, Jin H, Li Y, et al. Clinical time course of COVID-19, its neurological manifestation and some thoughts on its management. Stroke Vasc Neurol. 2020;5(2):177-179. doi: 10.1136/svn-2020-000398
7. Viola P, Ralli M, Pisani D, Malanga D, Sculco D, Messina L, et al. Tinnitus and equilibrium disorders in COVID-19 patients: preliminary results. Eur Arch Otorhinolaryngol. 2020;1-6. doi: 10.1007/s00405-020-06440-7
8. Panigada M, Bottino N, Tagliabue P, Grasselli G, Novembrino C, Chantarangkul V, et al. Hypercoagulability of COVID‐19 patients in intensive care unit: a report of thromboelastography findings and other para¬meters of hemostasis. J Thromb Haemost. 2020;18(7):1738-42. doi: 10.1111/jth.14850
9. Wilson WR, Veltri RW, Laird N, Sprinkle PM. Viral and epidemiologic studies of idiopathic sudden hearing loss. Otolaryngol Head Neck Surg. 1983;91(6):653-8. doi: 10.1177/019459988309100612
10. Cohen BE, Durstenfeld A, Roehm PC. Viral causes of hearing loss: a review for hearing health professionals. Trends Hear. 2014;18:2331216514541361. doi: 10.1177/2331216514541361
11. Merchant SN, Adams JC, Nadol Jr JB. Pathology and pathophysiology of idiopathic sudden sensorineural hearing loss. Otol Neurotol. 2005;26(2):151-60. doi: 10.1097/00129492-200503000-00004
12. de Jong MA, Luder A, Gross M. Main Aspects of Peripheral and Central Hearing System Involvement in Unexplained HIV-Related Hearing Complaints. Front Neurol. 2019;10:845. doi: 10.3389/fneur.2019.00845
13. 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. Am J Otolaryngol. 2020;41(5):102612. doi: 10.1016/j.amjoto.2020.102612
14. Munro KJ, Uus K, Almufarrij I, Chaudhuri N, Yioe V. Persistent self-reported changes in hearing and tinnitus in post-hospitalisation COVID-19 cases. Int J Audiol. 2020;59(12):889-890. doi: 10.1080/14992027.2020.1798519
15. Fidan V. New type of corona virus induced acute otitis media in adult. Am J Otolaryngol. 2020;41(3):102487. doi: 10.1016/j.amjoto.2020.102487
16. Abdel Rhman S, Abdel Wahid A. COVID -19 and sudden sensorineural hearing loss, a case report. Otolaryngology Case Reports. 2020;16:100198. doi: 10.1016/j.xocr.2020.100198
17. Sriwijitalai W, Wiwanitkit V. Hearing loss and COVID-19: a note. Am J Otolaryngol. 2020;41(3):102473. doi: 10.1016/j.amjoto.2020.102473
18. Mustafa MWM. Audiological profile of asymptomatic Covid-19 PCR-positive cases. Am J Otolaryngol. 2020;41(3):102483. doi: 10.1016/j.amjoto.2020.102483
19. Karimi-Galougahi M, Safavi Naeini A, Raad N, Mikaniki N, Ghorbani J. Vertigo and hearing loss during the COVID-19 pandemic-is there an association? Acta Otorhinolaryngol Ital. 2020;40(6):463-465. doi: 10.14639/0392-100X-N0820
20. Kilic O, Tayyaar Kalcioglu M, Cag Y, Tuysuz O, Pektas E, Caskurlu H, et al. Could sudden sensorineural hearing loss be the sole manifestation of COVID-19? An inves¬tigation into SARS-COV-2 in the etiology of sudden sensorineural hearing loss. Int J Infect Dis. 2020;97:208-11. doi: 10.1016/j.ijid.2020.06.023
21. Nayak N, Ghosh A, Bhatta DR, Magar DG. COVID-19: a brief review. J Pathol Nepal. 2020;10(1):1659-62. doi: 10.3126/jpn.v10i1.28946
22. Ciorba A, Corazzi V, Skarżyński PH, Skarżyńska MB, Bianchini C, Pelucchi S, et al. Don’t forget ototoxicity during the SARS-CoV-2 (Covid-19) pandemic! Int J Immunopathol Pharmacol. 2020;34:2058738420941754. doi: 10.1177/2058738420941754
23. Cianfrone G, Pentangelo D, Cianfrone F, Mazzei F, Turchetta R, Orlando MP, et al. Pharmacological drugs inducing ototoxicity, vestibular symptoms and tinnitus: a reasoned and updated guide. Eur Rev Med Pharmacol Sci. 2011;15(6):601-36.
24. Prayuenyong P, Kasbekar AV, Baguley DM. Clinical Implications of Chloroquine and Hydroxychloroquine Ototoxicity for COVID-19 Treatment: A Mini-Review. Front Public Health. 2020;8:252. doi: 10.3389/fpubh.2020.00252
25. Elfiky AA. Ribavirin, Remdesivir, Sofosbuvir, Galidesivir, and Tenofovir against SARS-CoV-2 RNA dependent RNA polymerase (RdRp): A molecular docking study. Life Sci. 2020;253:117592. doi: 10.1016/j.lfs.2020.117592
26. Formann E, Stauber R, Denk D-M, Jessner W, Zollner G, Munda-Steindl P, et al. Sudden hearing loss in patients with chronic hepatitis C treated with pegylated interferon/ribavirin. Am J Gastroenterol. 2004;99(5):873-7. doi: 10.1111/j.1572-0241.2004.30372.x
27. Skarzynska MB, Krol B, Czajka N, Czajka Ł. Ototoxicity of drugs used in the treatment of COVID-19. J Hear Sci. 2020;10(1):9-20. doi: 10.17430/JHS.2020.10.1.1
28. Saniasiaya J, Kulasegarah J. Dizziness and COVID-19. Ear Nose Throat. 2021;100(1):29-30. doi: 10.1177/0145561320959573
29. 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 Neurol. 2020;77(6):683-90. doi: 10.1001/jamaneurol.2020.1127
30. 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 mecha¬nisms. ACS Chem Neurosci. 2020;11(7):995-998. doi: 10.1021/acschemneuro.0c00122
31. Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020;87:18-22. doi: 10.1016/j.bbi.2020.03.031
32. Ralli M, Campo F, Angeletti D, Minni A, Artico M, Greco A, et al. Pathophysiology and therapy of systemic vasculitides. EXCLI J. 2020;19:817-854. doi: 10.17179/excli2020-1512
33. Roncati L, Ligabue G, Fabbiani L, Malagoli C, Gallo G, Lusenti B, et al. Type 3 hypersensitivity in COVID-19 vasculitis. Clin Immunol. 2020;217:108487. doi: 10.1016/j.clim.2020.108487
34. Malayala SV, Raza A. A case of COVID-19-induced vestibular neuritis. Cureus. 2020;12(6):e8918. doi: 10.7759/cureus.8918
35. Trecca EMC, Geraldi M, Cassano M. COVID-19 and hearing difficulties. Am J Otolaryngol. 2020;41(4):102496. doi: 10.1016/j.amjoto.2020.102496
36. Ten Hulzen RD, Fabry D. Impact of hearing loss and universal face masking in the COVID-19 era. Mayo Clin Proc. 2020;95(10):2069-72. doi: 10.1016/j.mayocp.2020.07.027
37. West JS, Franck KH, Welling DB. Providing health care to patients with hearing loss during COVID-19 and physical distancing. Laryngoscope Investig Otolaryngol. 2020;5(3):396-398. doi: 10.1002/lio2.382
38. Goldin A, Weinstein BE, Shiman N. How do medical masks degrade speech perception? Hearing Review. 2020;27(5):8-9.
39. Tavanai E, Rouhbakhsh N, Roghani Z. A review of the challenges facing people with hearing loss during the COVID-19 outbreak: toward the understanding the helpful solutions. Aud Vestib Res. 2021;30(2):62-73. doi: 10.18502/avr.v30i2.6091
IssueVol 30 No 3 (2021) QRcode
SectionReview Article(s)
COVID-19 hearing loss hearing-impaired vestibular dysfunction mask

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How to Cite
Amiri M, Hasanalifard M, Delphi M. Impact of COVID-19 on the auditory and vestibular system. Aud Vestib Res. 2021;30(3):152-159.