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COVID-19 hearing loss project

Award: ENT UK Foundation Grant 2021

Title: COVID-19 hearing loss project

Project Lead: Ananth Vijendren

Grant Amount: £500

Status: Interim Report

 

Background

The Coronavirus disease 2019 (COVID-19) has been postulated to affect nerve function as some patients have had altered sense of smell and taste and there have been reports of long standing nervous system involvement.1 Within the Ear, Nose and Throat forums and published literature, there have been several case reports that the hearing and balance may be affected. One study has suggested that part of the hearing organ (the cochlea) is affected in patients who might subjectively be unaware of any hearing loss2. Additionally, two case reports described cases of profound sensorineural hearing loss post-COVID infection, one requiring cochlear implantation.3,4 These anecdotal evidences suggest there may be COVID-19 infections could affect the hearing and balance nerves.

The purpose of this pilot study is to determine if SARS-CoV-2 virus affects hearing, and if so, the degree and nature of it. This will help us garner an impulse if a larger study may be required to determine if positive COVID-19 patients should have their hearing tested as a matter of protocol and subsequently alert primary care practitioners as well as the ENT community about the potential for hearing loss. This will allow early recognition and prompt medical and rehabilitation treatments to be instituted in a timely manner.

The candidate predictors of hearing loss have been postulated to be age, gender, severity of symptoms of COVID-19 (requirements for oxygen or ventilation, type of medication received), presence of vestibular and other otological symptoms present before or at the time of onset of COVID-19.


Aims and objectives

Aims :

To deliver a pilot, case-control study in order to explore if there is a clinical or subclinical effect on hearing in participants who have suffered symptomatic or asymptomatic COVID-19 infection, irrespective of variant, and if so, its nature and possible site of lesion.

 

Objectives:

  • to recruit COVID-19 positive and negative patients who attended the Lister audiology clinic between 1/01/19 and 31/12/19 (pre-COVID) and had a baseline hearing test;
  • to perform hearing assessments on consenting individuals in order to determine any hearing loss after being tested COVID-19 positive/negative, to capture the range of audiovestibular symptoms they complain of, and to determine whether the hearing loss recovers within a 6 month time frame through 3 further testing.

Impact of ENT UK Foundation funding

The ENT-UK funding has provided us with a small grant for single-use audiological testing equipment. It has also enabled the funding requirements for the study to be adopted as a NIHR portfolio study.


Current Status

We have recruited 30 patients in both COVID and non-COVID arms. Our aim is 100 patients, which we are hoping we can achieve by the end of the year. Alternatively, we may be looking at incorporating the study as a multisite project through NIHR network.


References

1. Silva Andrade B, Siqueira S, de Assis Soares WR, de Souza Rangel F, Santos NO, Dos Santos Freitas A, Ribeiro da Silveira P, Tiwari S, Alzahrani KJ, Góes-Neto A, Azevedo V, Ghosh P, Barh D. Long-COVID and Post-COVID Health Complications: An Up-to-Date Review on Clinical Conditions and Their Possible Molecular Mechanisms. Viruses. 2021 Apr 18;13(4):700. doi: 10.3390/v13040700. PMID: 33919537; PMCID: PMC8072585.

2. M.W.M. Mustafa, Audiological profile of asymptomatic Covid-19 PCR-positive cases, American Journal of Otolaryngology--Head and Neck Medicine and Surgery(2020),https://doi.org/10.1016/j.amjoto.2020.1024832.

3. Gerstacker K, Speck I, Riemann S, Aschendorff A, Knopf A, Arndt S. Deafness after COVID-19? HNO. 2021 May 21:1–4. doi: 10.1007/s00106-021-01041-0. Epub ahead of print. PMID: 34019138; PMCID: PMC8138955.

4. Koumpa FS, Forde CT, Manjaly JG. Sudden irreversible hearing loss post COVID-19 BMJ Case Reports CP 2020;13:e238419.

 


 

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