Sudden Sensorineural Hearing Loss and COVID-19. Systematic Review
Abstract Introduction: Cases of sudden deafness, tinnitus and vestibular neuritis related to SARS-CoV-2 infection have increased. Objective: Systematic review of published cases of sudden hearing loss in the context of SARS-CoV-2 infection and discuss the potential association of infection as a possible etiological agent. Material and method: We conducted a systematic search of PubMed, EMBASE, Cochrane Library and Scielo, without language restriction, including all articles published from March 2020 to 31 January 2022. Results: A total of 16 articles met the inclusion criteria, obtaining 30 patients with sudden deafness and COVID-19. 53% were women and 47% men with a mean age of 46.75 years. 4 patients had cardiovascular risk factors, one asthma, another rheumatoid arthritis and 10 had no history. 25 had unilateral deafness and in 5 cases it was bilateral. All degrees of hearing loss were found, from mild to cophosis. Tinnitus was the most associated symptom in half of the patients, accompanied by vertigo in 10%. 14 patients required ICU admission, 9 received no treatment for infection, one patient received hydroxychloroquine, 2 favipavir and enoxaparin and 2 azithromycin and prednisone. The cochlear implant was the treatment of hearing loss in 2 cases, one was treated with hydroxychloroquine and 23 with intravenous and/or oral and/or intratympanic corticosteroids. Conclusions: Sudden hearing loss is a symptom recently associated with SARS-CoV-2 infection and of uncertain prevalence. The presence of hearing loss should be considered as part of the clinical evaluation of these patients to ensure early diagnosis and treatment.
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Doweck I, Yanir Y, Najjar-Debbiny R, Shibli R, Saliba W. Sudden Sensorineural Hearing Loss During the COVID-19 Pandemic. JAMA Otolaryngol Head Neck Surg. 2022 Apr 1;148(4):373-375.
Chari DA, Parikh A, Kozin ED, Reed M, Jung DH. Impact of COVID-19 on Presentation of Sudden Sensorineural Hearing Loss at a Single Institution. Otolaryngol Head Neck Surg. 2021;165(1):163-65.
Parrino D, Frosolini A, Toninato D, Matarazzo A, Marioni G, de Filippis C. Sudden hearing loss and vestibular disorders during and before COVID-19 pandemic: An audiology tertiary referral centre experience. Am J Otolaryngol. 2022;43(1):103241.
Schreiber BE, Agrup C, Haskard DO, Luxon LM. Sudden sensorineural hearing loss. Lancet. 2010 Apr 3;375(9721):1203-11.
García-Callejo FJ, Balaguer-García R, Lis-Sancerni MD, Ruescas-Gómez L, Murcia-López M. Blood Viscosity in COVID-19 Patients With Sudden Deafness. Acta Otorrinolaringol Esp (Engl Ed). 2022 Mar-Apr;73(2):104-112.
Ricciardiello F, Pisani D, Viola P, Cristiano E, Scarpa A, Giannone A, et al. Sudden Sensorineural Hearing Loss in Mild Covid-19: Case Series and Analysis of the Literature. Audiol. Res. 2021;11:313–26.
Costello F, Dalakas MC. Cranial neuropathies and COVID-19: neurotropism and autoimmunity. Neurology. 2020;4(95):195-96.
Elibol E. Otolaryngological symptoms in COVID-19. Eur Arch Otorhinolaryngol. 2021;278(4):1233-1236.
De Luca P, Scarpa A, Ralli M, et al. Auditory Disturbances and SARS-CoV-2 Infection: Brain Inflammation or Cochlear Affection? Systematic Review and Discussion of Potential Pathogenesis. Front Neurol. 2021;12:707207.
Prince ADP, Stucken EZ. Sudden Sensorineural Hearing Loss: A Diagnostic and Therapeutic Emergency. J. Am. Board Fam. Med. 2021:34,216–23.
Urrútia G, Bonfill X. Declaración PRISMA: una propuesta para mejorar la publicación de revisiones sistemáticas y metaanálisis. Med Clínica. 2010;135:507-11.
Herrera M, García Berrocal JR, García Arumí A, Lavilla MJ, Plaza G, Grupo de Trabajo de la Comisión de Audiología de la SEORL. Actualización del consenso sobre el diagnóstico y tratamiento de la sordera súbita idiopática. Acta Otorrinolaringol Esp. 2019;70:290-300.
Bureau International d’ Audiophonologie (BIAP). CT 02 Clasificación de las deficiencias auditivas. Recomendación biap 02/1. Disponible en: https://www.biap.org/en/recommandations/recomendaciones/ct-02-clasificacio-n-de-las-deficiencias-auditivas/112-rec-02-01-es-clasificacion-audiometrica-de-las-deficiencias-auditivas/file. [Citado el 16/05/2022]
Sahin AR, Erdogan A, Agaoglu PM, et al. 2019 novel coronavirus (COVID-19) outbreak: a review of the current literature. Eur J Med Oncol. 2020;4(1):1–7.
Ozer F, Alkan O. Simultaneous Sudden Hearing Loss and Peripheral Facial Paralysis in a Patient With Covid-19. Ear Nose Throat J. 2021 Jul 5:1455613211028094.
Sriwijitalai W, Wiwanitkit V. Hearing loss and COVID-19: A note. Am J Otolaryngol. 2020 May-Jun;41(3):102473.
Alexander TH, Harris JP. Incidence of sudden sensorineural hearing loss. Otol Neurotol. 2013 Dec;34(9):1586-9.
Whittaker A, Anson M, Harky A. Neurological Manifestations of COVID-19: A Systematic Review and Current Update. Act Neurol Scandinav. 2020.142(1):14–22.
Almufarrij I, Munro KJ. One year on: an updated systematic review of SARS-CoV-2, COVID-19 and audio-vestibular symptoms. Int J Audiol. 2021;22:1–11.
Chandrasekhar SS, Tsai Do BS, Schwartz SR, et al. Clinical practice guideline: sudden hearing loss (Update). Otolaryngol neck Surg. 2019;161:S1-S45.
Chern A, Famuyide AO, Moonis G, Lalwani AK. Bilateral sudden sensorineural hearing loss and intralabyrinthine hemorrhage in a patient with COVID-19. Otol Neurotol 2021; 42:e10–e14.
Edwards M, Muzaffar J, Naik P, Coulson C. Catastrophic bilateral sudden sensorineural hearing loss following COVID-19. BMJ Case Rep. 2021 Jun 24;14(6):e243157.
Gerstacker K, Speck I, Riemann S, Aschendorff A, Knopf A, Arndt S. Ertaubung nach COVID-19? [Deafness after COVID-19? German version]. HNO. 2021;69(8):666-670.
Gunay E, Kozan G, Yuksel E, Mizrakli A, Aslan O, Kavak S, Kaya S, Yilmaz Z. A case of peritoneal dialysis in which SARS-CoV-2 was diagnosed by sudden hearing loss. Ren Fail. 2021 Dec;43(1):325-326.
Cases A, Vera M, López Gómez JM. Riesgo cardiovascular en pacientes con insuficiencia renal crónica. Pacientes en tratamiento sustitutivo renal. Nefrologia. 2002;22 Suppl 1:68-74.
Degen CV, Lenarz T, Willenborf K. Acute profound sensorineural hearing loss after COVID-19 pneumonia. Mayo Clin Proc. 2020;95(8):1801-1803.
Beckers E, Chouvel P, Cassetto V, Mustin V. Sudden sensorineural hearing loss in COVID-19: A case report and literature review. Clin Case Rep. 2021;9(4):2300-04.
Lang B, Hintze J, Conlon B. Coronavirus disease 2019 and sudden sensorineural hearing loss. J Laryngol Otol. 2020 Oct 1:1-3.
Cohen BE, Durstenfeld A, Roehm PC. Viral causes of hearing loss: a review for hearing health professionals. Trends Hear. 2014 Jul 29;18:2331216514541361.
Mateer EJ, Huang C, Shehu NY, Paessler S. Lassa fever-induced sensorineural hearing loss: A neglected public health and social burden. PLoS Negl Trop Dis. 2018 Feb 22;12(2):e0006187.
Mustafa MWM. Audiological profile of asymptomatic Covid-19 PCR-positive cases. Am J Otolaryngol Head Neck Surg. 2020;41(3):102483.
Karimi-Galougahi M, Naeini AS, Raad N, Mikaniki N, Ghorbani J. Vertigo and hearing loss during the COVID-19 pandemic - is there an association? Acta Otorhinolaryngol Ital. 2020 Dec;40(6):463-465.
Suzuki M, Saito K, Min WP, Vladau C, Toida K, Itoh H, et al. Identification of Viruses in Patients With Postviral Olfactory Dysfunction. Laryngoscope. 2007;117:272–77.
Ficenec, S.C.; Schieffelin, J.S.; Emmett, S.D. A Review of Hearing Loss Associated with Zika, Ebola, and Lassa Fever. Am. J. Trop. Med. Hyg. 2019;101:484-90.
Fidan V, Akin O, Koyuncu H. Rised sudden sensorineural hearing loss during COVID-19 widespread. Am J Otolaryngol. 2021 Sep-Oct;42(5):102996.
Mohammed H, Ahmad N, Banerjee A. Prevalence and management of sudden sensorineural hearing loss during the COVID-19 crisis: How do we do it and our experience in twelve patients. Authorea August 10, 2020.
Lamounier P, Franco Gonçalves V, Ramos HVL, Gobbo DA, Teixeira RP, Dos Reis PC, Bahmad F Jr, Cândido Costa C. A 67-Year-Old Woman with Sudden Hearing Loss Associated with SARS-CoV-2 Infection. Am J Case Rep. 2020 Nov 3;21:e927519.
Perret M, Bernard A, Rahmani A, Manckoundia P, Putot A. Acute labyrinthitis revealing COVID-19. Diagnostics. 2021;11:482.
van Rijssen LB, Derks W, Hoffmans R, van Looij MA, van Maanen JP, van Monsjou HS, Nyst HJ, van Rijn PM, Vermeeren L, de Vries N, Ravesloot MJ. No COVID-19 in Patients With Sudden Sensorineural Hearing Loss (SSNHL). Otol Neurotol. 2022;1;43(2):170-173.
Guigou C, Schein AD, Blanchard C, Folia M. Sudden sensorineural hearing loss and SARS-CoV-2: DonâeTMt forget the standard workup!. Eur Ann Otorhinolaryngol Head Neck Dis. 2021;138:219–20.
Kilic O, Kalcioglu MT, Cag Y, Tuysuz O, Pektas E, Caskurlu H, Cet?n F. Could sudden sensorineural hearing loss be the sole manifestation of COVID-19? An investigation into SARS-COV-2 in the etiology of sudden sensorineural hearing loss. Int J Infect Dis. 2020 Aug;97:208-211.
Rahimi V, Asiyabar MK, Rouhbakhsh N. Sudden hearing loss and coronavirus disease 2019: the role of corticosteroid intra-tympanic injection in hearing improvement. J Laryngol Otol 2021;135(5):464-66.
Saki N, Karimi M, Bayat A. Cochlear implant failure following COVID 19: Report of two cases. Am J Otolaryngol. 2021;42(3):102910.
Koumpa FS, Forde CT, Manjaly JG. Sudden irreversible hearing loss post COVID-19. BMJ Case Rep. 2020 Oct 13;13(11):e238419.
Chari DA, Parikh A, Kozin ED, Reed M, Jung DH. Impact of COVID-19 on Presentation of Sudden Sensorineural Hearing Loss at a Single Institution. Otolaryngol Head Neck Surg. 2021;165(1):163-65.
Parrino D, Frosolini A, Toninato D, Matarazzo A, Marioni G, de Filippis C. Sudden hearing loss and vestibular disorders during and before COVID-19 pandemic: An audiology tertiary referral centre experience. Am J Otolaryngol. 2022;43(1):103241.
Schreiber BE, Agrup C, Haskard DO, Luxon LM. Sudden sensorineural hearing loss. Lancet. 2010 Apr 3;375(9721):1203-11.
García-Callejo FJ, Balaguer-García R, Lis-Sancerni MD, Ruescas-Gómez L, Murcia-López M. Blood Viscosity in COVID-19 Patients With Sudden Deafness. Acta Otorrinolaringol Esp (Engl Ed). 2022 Mar-Apr;73(2):104-112.
Ricciardiello F, Pisani D, Viola P, Cristiano E, Scarpa A, Giannone A, et al. Sudden Sensorineural Hearing Loss in Mild Covid-19: Case Series and Analysis of the Literature. Audiol. Res. 2021;11:313–26.
Costello F, Dalakas MC. Cranial neuropathies and COVID-19: neurotropism and autoimmunity. Neurology. 2020;4(95):195-96.
Elibol E. Otolaryngological symptoms in COVID-19. Eur Arch Otorhinolaryngol. 2021;278(4):1233-1236.
De Luca P, Scarpa A, Ralli M, et al. Auditory Disturbances and SARS-CoV-2 Infection: Brain Inflammation or Cochlear Affection? Systematic Review and Discussion of Potential Pathogenesis. Front Neurol. 2021;12:707207.
Prince ADP, Stucken EZ. Sudden Sensorineural Hearing Loss: A Diagnostic and Therapeutic Emergency. J. Am. Board Fam. Med. 2021:34,216–23.
Urrútia G, Bonfill X. Declaración PRISMA: una propuesta para mejorar la publicación de revisiones sistemáticas y metaanálisis. Med Clínica. 2010;135:507-11.
Herrera M, García Berrocal JR, García Arumí A, Lavilla MJ, Plaza G, Grupo de Trabajo de la Comisión de Audiología de la SEORL. Actualización del consenso sobre el diagnóstico y tratamiento de la sordera súbita idiopática. Acta Otorrinolaringol Esp. 2019;70:290-300.
Bureau International d’ Audiophonologie (BIAP). CT 02 Clasificación de las deficiencias auditivas. Recomendación biap 02/1. Disponible en: https://www.biap.org/en/recommandations/recomendaciones/ct-02-clasificacio-n-de-las-deficiencias-auditivas/112-rec-02-01-es-clasificacion-audiometrica-de-las-deficiencias-auditivas/file. [Citado el 16/05/2022]
Sahin AR, Erdogan A, Agaoglu PM, et al. 2019 novel coronavirus (COVID-19) outbreak: a review of the current literature. Eur J Med Oncol. 2020;4(1):1–7.
Ozer F, Alkan O. Simultaneous Sudden Hearing Loss and Peripheral Facial Paralysis in a Patient With Covid-19. Ear Nose Throat J. 2021 Jul 5:1455613211028094.
Sriwijitalai W, Wiwanitkit V. Hearing loss and COVID-19: A note. Am J Otolaryngol. 2020 May-Jun;41(3):102473.
Alexander TH, Harris JP. Incidence of sudden sensorineural hearing loss. Otol Neurotol. 2013 Dec;34(9):1586-9.
Whittaker A, Anson M, Harky A. Neurological Manifestations of COVID-19: A Systematic Review and Current Update. Act Neurol Scandinav. 2020.142(1):14–22.
Almufarrij I, Munro KJ. One year on: an updated systematic review of SARS-CoV-2, COVID-19 and audio-vestibular symptoms. Int J Audiol. 2021;22:1–11.
Chandrasekhar SS, Tsai Do BS, Schwartz SR, et al. Clinical practice guideline: sudden hearing loss (Update). Otolaryngol neck Surg. 2019;161:S1-S45.
Chern A, Famuyide AO, Moonis G, Lalwani AK. Bilateral sudden sensorineural hearing loss and intralabyrinthine hemorrhage in a patient with COVID-19. Otol Neurotol 2021; 42:e10–e14.
Edwards M, Muzaffar J, Naik P, Coulson C. Catastrophic bilateral sudden sensorineural hearing loss following COVID-19. BMJ Case Rep. 2021 Jun 24;14(6):e243157.
Gerstacker K, Speck I, Riemann S, Aschendorff A, Knopf A, Arndt S. Ertaubung nach COVID-19? [Deafness after COVID-19? German version]. HNO. 2021;69(8):666-670.
Gunay E, Kozan G, Yuksel E, Mizrakli A, Aslan O, Kavak S, Kaya S, Yilmaz Z. A case of peritoneal dialysis in which SARS-CoV-2 was diagnosed by sudden hearing loss. Ren Fail. 2021 Dec;43(1):325-326.
Cases A, Vera M, López Gómez JM. Riesgo cardiovascular en pacientes con insuficiencia renal crónica. Pacientes en tratamiento sustitutivo renal. Nefrologia. 2002;22 Suppl 1:68-74.
Degen CV, Lenarz T, Willenborf K. Acute profound sensorineural hearing loss after COVID-19 pneumonia. Mayo Clin Proc. 2020;95(8):1801-1803.
Beckers E, Chouvel P, Cassetto V, Mustin V. Sudden sensorineural hearing loss in COVID-19: A case report and literature review. Clin Case Rep. 2021;9(4):2300-04.
Lang B, Hintze J, Conlon B. Coronavirus disease 2019 and sudden sensorineural hearing loss. J Laryngol Otol. 2020 Oct 1:1-3.
Cohen BE, Durstenfeld A, Roehm PC. Viral causes of hearing loss: a review for hearing health professionals. Trends Hear. 2014 Jul 29;18:2331216514541361.
Mateer EJ, Huang C, Shehu NY, Paessler S. Lassa fever-induced sensorineural hearing loss: A neglected public health and social burden. PLoS Negl Trop Dis. 2018 Feb 22;12(2):e0006187.
Mustafa MWM. Audiological profile of asymptomatic Covid-19 PCR-positive cases. Am J Otolaryngol Head Neck Surg. 2020;41(3):102483.
Karimi-Galougahi M, Naeini AS, Raad N, Mikaniki N, Ghorbani J. Vertigo and hearing loss during the COVID-19 pandemic - is there an association? Acta Otorhinolaryngol Ital. 2020 Dec;40(6):463-465.
Suzuki M, Saito K, Min WP, Vladau C, Toida K, Itoh H, et al. Identification of Viruses in Patients With Postviral Olfactory Dysfunction. Laryngoscope. 2007;117:272–77.
Ficenec, S.C.; Schieffelin, J.S.; Emmett, S.D. A Review of Hearing Loss Associated with Zika, Ebola, and Lassa Fever. Am. J. Trop. Med. Hyg. 2019;101:484-90.
Fidan V, Akin O, Koyuncu H. Rised sudden sensorineural hearing loss during COVID-19 widespread. Am J Otolaryngol. 2021 Sep-Oct;42(5):102996.
Mohammed H, Ahmad N, Banerjee A. Prevalence and management of sudden sensorineural hearing loss during the COVID-19 crisis: How do we do it and our experience in twelve patients. Authorea August 10, 2020.
Lamounier P, Franco Gonçalves V, Ramos HVL, Gobbo DA, Teixeira RP, Dos Reis PC, Bahmad F Jr, Cândido Costa C. A 67-Year-Old Woman with Sudden Hearing Loss Associated with SARS-CoV-2 Infection. Am J Case Rep. 2020 Nov 3;21:e927519.
Perret M, Bernard A, Rahmani A, Manckoundia P, Putot A. Acute labyrinthitis revealing COVID-19. Diagnostics. 2021;11:482.
van Rijssen LB, Derks W, Hoffmans R, van Looij MA, van Maanen JP, van Monsjou HS, Nyst HJ, van Rijn PM, Vermeeren L, de Vries N, Ravesloot MJ. No COVID-19 in Patients With Sudden Sensorineural Hearing Loss (SSNHL). Otol Neurotol. 2022;1;43(2):170-173.
Guigou C, Schein AD, Blanchard C, Folia M. Sudden sensorineural hearing loss and SARS-CoV-2: DonâeTMt forget the standard workup!. Eur Ann Otorhinolaryngol Head Neck Dis. 2021;138:219–20.
Kilic O, Kalcioglu MT, Cag Y, Tuysuz O, Pektas E, Caskurlu H, Cet?n F. Could sudden sensorineural hearing loss be the sole manifestation of COVID-19? An investigation into SARS-COV-2 in the etiology of sudden sensorineural hearing loss. Int J Infect Dis. 2020 Aug;97:208-211.
Rahimi V, Asiyabar MK, Rouhbakhsh N. Sudden hearing loss and coronavirus disease 2019: the role of corticosteroid intra-tympanic injection in hearing improvement. J Laryngol Otol 2021;135(5):464-66.
Saki N, Karimi M, Bayat A. Cochlear implant failure following COVID 19: Report of two cases. Am J Otolaryngol. 2021;42(3):102910.
Koumpa FS, Forde CT, Manjaly JG. Sudden irreversible hearing loss post COVID-19. BMJ Case Rep. 2020 Oct 13;13(11):e238419.
Sanz-Sánchez, C. I., Pérez-Arcos, J. A., Verge-González, J. C., & Cazorla-Ramos, Óscar E. (2022). Sudden Sensorineural Hearing Loss and COVID-19. Systematic Review. Revista ORL, 13(4), e29077. https://doi.org/10.14201/orl.29077
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