The Impact of COVID-19 and the Pandemic on Tinnitus: A Systematic Review

Beukes, Eldré W.; Ulep, Alyssa Jade; Eubank, Taylor; Manchaiah, Vinaya

doi:10.3390/jcm10132763

Cited by 39 publications

(50 citation statements)

References 67 publications

(305 reference statements)

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“…Jafari, Kolb, and Mohajerani (2021) included two studies with low tinnitus prevalence in their tinnitus meta-analysis that we excluded as "measured a pre-existing symptom" (Elibol 2021: 1%;Lechien et al 2020: 0.3%) and one study not identified by Almufarrij and Munro (2% in Karadaş, € Ozt€ urk, and Sonkaya 2020). Our revised tinnitus prevalence estimate is close to the 8% (CI: 5-13%) reported in the recent tinnitus meta-analysis by Beukes et al (2021). The biggest difference between the two prevalence estimates is for vertigo/ dizziness, although this is perhaps unsurprising given the difference in foci.…”

Section: Discussionsupporting

confidence: 76%

Revised meta-analysis and pooled estimate of audio-vestibular symptoms associated with COVID-19

Lough

Almufarrij

Whiston

et al. 2021

International Journal of Audiology

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A rapid review of audio-vestibular symptoms relating to SARS-CoV-2 and COVID-19 appeared in IJA in 2020 (Almufarrij, Uus, and Munro 2020), but the first systematic review and meta-analysis appeared in 2021 (Almufarrij and Munro 2021). Their pooled prevalence estimates of hearing loss, tinnitus and rotatory vertigo, based primarily on retrospective recall of symptoms, were 7.6% (CI: 2.5-15.1), 14.8% (CI: 6.3-26.1) and 7.2% (CI: 0.01-26.4), respectively. Almufarrij and Munro urged caution when interpreting these data because it was not always clear within each study if the symptom associated with SARS-CoV-2 and COVID-19 was new or a change (i.e. the prevalence may have been over-estimated if the symptoms were present before, and unchanged by, . With this in mind, we reviewed the 28 studies in their metaanalysis and attempted to contact authors of individual studies

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Section: Discussionsupporting

confidence: 76%

Revised meta-analysis and pooled estimate of audio-vestibular symptoms associated with COVID-19

Lough

Almufarrij

Whiston

et al. 2021

International Journal of Audiology

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“…Evidence for the association of audiovestibular symptoms relating to confirmed cases of COVID-19 has been evaluated in several systematic reviews and meta-analyses (6)(7)(8)(9)(10). These meta-analyses report pooled prevalence estimates of between 3.1% [95% confidence interval (CI): 1.0-9.0] to 7.6% (95% CI: 2.5-15) for new hearing loss, and between 4.5% (95% CI: 1.2-15.0) and 14.8% (CI: 6.3-26.1) for new tinnitus following COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Shedding Light on SARS-CoV-2, COVID-19, COVID-19 Vaccination, and Auditory Symptoms: Causality or Spurious Conjunction?

Saunders¹,

Beukes²,

Uus³

et al. 2022

Front. Public Health

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There are reports of associations between SARS-CoV2, COVID-19, COVID-19 vaccines, and auditory symptoms (hearing difficulty, tinnitus). However, most studies have relied on self-report and lack baseline and/or non-COVID control groups. This makes it problematic to differentiate if symptoms are associated with SARS-CoV2, COVID-19, the vaccine, psychosocial factors or recall bias. In this study, we differentiate these by comparing hearing and tinnitus survey data collected pre- and during the pandemic. The survey conducted during the pandemic asked about the onset and change in three types of symptom. Type One—known association (loss of smell, memory/concentration issues, persistent fatigue), Type Two—indeterminate association (auditory symptoms), and Type Three—no established association with COVID-19 (toothache). We hypothesized that if auditory symptoms are directly associated with COVID-19, their onset and change would be similar to Type One symptoms, but if indirectly associated (reflecting psychosocial factors and/or recall bias) would be more similar to Type Three symptoms. Of the 6,881 individuals who responded, 6% reported confirmed COVID-19 (positive test), 11% probably had COVID-19, and 83% reported no COVID-19. Those with confirmed or probable COVID-19 more commonly reported new and/or worsened auditory symptoms than those not reporting COVID-19. However, this does not imply causality because: (1) new auditory symptoms coincided with COVID-19 illness among just 1/3 of those with confirmed or probable COVID-19, and another 1/3 said their symptoms started before the pandemic—despite reporting no symptoms in the pre-pandemic survey. (2) >60% of individuals who had COVID-19 said it had affected their Type 3 symptoms, despite a lack of evidence linking the two. (3) Those with confirmed COVID-19 reported more Type 1 symptoms, but reporting of Type 2 and Type 3 symptoms did not differ between those with confirmed COVID-19 and those without COVID-19, while those who probably had COVID-19 most commonly reported these symptom types. Despite more reports of auditory symptoms in confirmed or probable COVID-19, there is inconsistent reporting, recall bias, and possible nocebo effects. Studies that include appropriate control groups and use audiometric measures in addition to self-report to investigate change in auditory symptoms relative to pre-COVID-19 are urgently needed.

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“…Beukes and colleagues conducted a systematic review to understand the influence of the COVID-19 pandemic or SARS-CoV-2 infection on tinnitus ( 11 ). Although this systematic review included 33 studies, many of the research questions remained unanswered.…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19 Confinement on Tinnitus and Hearing Loss in Older Adults: Data From the LOST in Lombardia Study

et al. 2022

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BackgroundAlthough a direct relationship between tinnitus or hearing difficulties and COVID-19 has been suggested, current literature provides inconsistent results, and no research has been undertaken in older adults.MethodsIn November 2020, we conducted the LOST in Lombardia survey, a telephone-based cross-sectional study on a sample of 4,400 individuals representative of the general population aged ≥65 years from Lombardy region, Northern Italy. Individuals with diagnosed tinnitus and/or hearing loss were asked whether their conditions had improved or deteriorated in 2020 compared to 2019.ResultsOverall, 8.1% of older adults reported a diagnosis of tinnitus and 10.5% of hearing loss. In 2020 compared to 2019, among individuals with tinnitus, those with increasing severity (5.0%) were similar to those decreasing it (5.3%). Among individuals with hearing loss, more people reported an increase (13.6%) than a decrease (3.2%) in their disease severity. No individual with a diagnosis in 2020 of tinnitus (n = 6) or hearing loss (n = 13) had COVID-19. The incidence of tinnitus was lower in 2020 (rate: 14.8 per 10,000 person-years) than in previous years (rate in 1990–2019: 36.0 per 10,000 person-years; p = 0.026). There was no change in the incidence of hearing loss (p = 0.134).ConclusionsIn this large representative sample of older adults, on average neither COVID-19 confinement nor SARS-CoV-2 infection appeared to increase the severity or incidence of tinnitus. The increased severity of hearing difficulties may totally or partially be explained by physiologic deterioration of the condition, or by a misperception due to the use of face-masks.

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The Impact of COVID-19 and the Pandemic on Tinnitus: A Systematic Review

Cited by 39 publications

References 67 publications

Revised meta-analysis and pooled estimate of audio-vestibular symptoms associated with COVID-19

Revised meta-analysis and pooled estimate of audio-vestibular symptoms associated with COVID-19

Shedding Light on SARS-CoV-2, COVID-19, COVID-19 Vaccination, and Auditory Symptoms: Causality or Spurious Conjunction?

The Impact of COVID-19 Confinement on Tinnitus and Hearing Loss in Older Adults: Data From the LOST in Lombardia Study

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