Objective: To describe otologic dysfunction in patients with the novel SARS-CoV-2. Review Methods: Search strategies acquired for each database included keywords. The keywords use were-Otologic OR Vestibular OR Audiologic and COVID-19 OR Coronavirus OR SARS-CoV-2. Resulting articles were imported into a systematic review software and screened for appropriateness. To be eligible for inclusion in the analysis, the studies and case reports should have met the following criteria: i. Description of otologic dysfunction in COVID-19 patients ii. peer review Studies were excluded if: i. the description of the specific dysfunction was inadequate ii. there were no original case descriptions Data that met the inclusion criteria was extracted and analyzed. Results: A total of 62 articles were identified and screened, seven articles met the inclusion criteria and were analyzed. The articles were mainly case reports (5) with 2 case series. There were 28 patients in total identified with the largest study comprising 20 patients. All patients presented with hearing loss, 27 of whom had audiometry. Three patients had associated vestibular symptoms (vertigo, otalgia, and tinnitus). Conclusion: SARS-CoV-2 is a probable cause of middle ear infections and sensorineural hearing loss, secondary to spread of the novel virus into the middle ear and related neural structures.

HIV influences the non-traumatic myelopathy spectrum in regions with high HIV prevalence. Empiric treatment of HIV-myelopathy patients with anti-tuberculous medications where resources are severely limited has merit.

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Congenital deformities of the labyrinth of the inner ear may be associated with an increased risk of infection and varying degrees of otologic and vestibular dysfunction. Lateral semicircular canal abnormalities specifically can be associated with either normal hearing or hearing loss (conductive or sensorineural). In our patient, the acute symptoms of vertigo and tinnitus coincided with the diagnosis of COVID-19. It is unlikely that the symptomatology was related to the acute infection, even in the face of the underlying congenital abnormality. It has been shown that there is no correlation between the severity of the radiological abnormality and vestibular symptomatology in patients with isolated abnormalities of the semicircular canals. The abnormality can be asymptomatic.

Toxoplasma seroprevalence was determined in 307 consecutive HIV-infected medical inpatients at the Helen Joseph Hospital, Johannesburg, South Africa, using an enzyme linked immunosorbent assay to detect immunoglobulin G (IgG) and IgM antibodies. The mean age of patients was 36 years, with a female to male ratio of 1.3 to 1. The mean CD4 count was 109 cells/mL. Toxoplasma antibodies were detected in 25 patients (8%). Twenty-two of these patients were IgG positive and IgM negative, i.e. reactivation toxoplasmosis. Only two patients (0.65%) had clinical manifestations of toxoplasmosis (one toxoplasma encephalitis and one retinitis). The risk for toxoplasma encephalitis (TE) was 0.33%. These results indicate that the toxoplasma seroprevalence and the TE risk in this population is low. The implication from this study is that in HIV-infected populations where the toxoplasma seroprevalence is low, the TE risk will be low and empiric treatment of focal brain lesions with anti-toxoplasma therapy may be inappropriate.

The novel coronavirus and accompanying lockdown measures have resulted in the disruption of specialist clinic services. There have been reports of a decrease in the number of clinic attendees and surgical procedures performed in clinics throughout the worldThe study period was from the 2 January 2020 until 19 June 2020 which was divided by the lockdown date of the 26 March 2020, into two periods of 85 days for comparative review.During the pre-lockdown phase (2 January 2020 to 25 March 2020), 2160 patients were booked for the outpatient clinics and 1911 attended in this period (88.5%). In contrast during the post-lockdown period (26 March 2020 to 19 June 2020), 1220 visits were scheduled. Of these, 937 (76.8%) visits were completed. The number of patient visits booked (p=0.01) and completed (0.0001) after lockdown declined significantly. The total number of outpatient procedures performed pre-lockdown was 1892 (0.99/ patient) compared to 937 (1.04/ patient) post-lockdown. This represents an approximate decrease of 50% in the number of procedures completed post-lockdown but the change in the number of procedures/ patient was not significant (p=0.4).During the pre-lockdown phase 228 theatre cases were completed, including 66 emergencies and post-lockdown there were 188 cases together with 48 emergencies. There were no elective cases post-lockdown. The study illustrates that even during a stringent lockdown period there is an ongoing need for specialist ENT services and health care systems need to be tailored to manage all patients such that care is not shifted away from vulnerable groups and solely focused on Covid19 patients.

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