Abstract: Following the global pandemic caused by the coronavirus 2019 (Covid-19), significant research has identified long-term health impacts following infection. Recent research has suggested that audio-vestibular symptoms are present in both symptomatic and asymptomatic cases. The aim of this study was to understand how Covid-19 impacted peripheral and central auditory functions in patients with chronic Covid related symptoms. Participants filled out questionnaires and completed standard tests including pure tone audiometry, otoacoustic emissions, speech in noise testing, and dichotic digits. A total of 10 of 34 adults stated having hearing difficulties during or after experiencing Covid-19. Conclusions are indicating a minimal impact.
Summary: Objective The recent global pandemic led to a rapid increase of research attempting to understand the various symptoms of coronavirus 2019 (Covid-19). Recent research found a relationship between audio-vestibular symptoms and Covid-19 infection. However, literature has limited knowledge on the full impact that Covid-19 may have on multiple auditory structures; most studies have focused on pure tone thresholds and/or otoacoustic emissions (OAEs). The present study focused on how chronic Covid-19 symptoms impacted auditory structures. It attempted to answer if people with hearing difficulty concerns after Covid-19 performed poorer on auditory tests than those without concerns and normed research data. The study tested a) those with hearing difficulty after Covid-19 do perform poorer than those without complaints and normed group and b) those who had Covid-19 do have reduced TEOAS compared to the normed group.
Design Data was from the November 2023-August 2024 data collection period of a larger ongoing research study that assessed multi-sensory function in patients with chronic (i.e., >6 month) Covid symptoms. Participants completed: symptom surveys (including the Hearing Handicap Inventory [HHI]), an in-person interview, tympanometry, OAEs, pure tone audiometry (normal threshold ≤ 15 dB HL), words-in-noise (WIN) testing, and dichotic digits testing. Participants also completed the Self-Administered Gerocognitve Exam (SAGE) to screen for mild cognitive impairment (normal score ≥17).
Results A total of 52 participants were enrolled in the larger project during the data collection period. However, 17 participants have missing data as some dropped out of the study (n=7), no showed/canceled their appointment (n=8) or declined the hearing/balance testing (n= 2). Among the final 34 participants, 11 participants confirmed experiencing “hearing loss’ in their life. Only 1 participant confirmed having hearing loss prior to Covid-19 thus included in the non-impacted group. The 10 participants who reported hearing difficulties was a combination of groups based on onset of hearing loss symptoms, as during their infectious period (n= 2) and after having Covid-19 (n= 8). In the non-impacted group, mean age was 49.6 years (SD= 12.9 years), right ear pure tone average (PTA) was 15.6 dB HL with a WIN threshold of 6.2, and left ear PTA was 17.4 dB HL and a left WIN threshold of 6.0 dB SNR. This group reported no “hearing loss” in the skip-questionnaire symptom survey, therefor they did not fill out the HHI. For the impacted group, the mean HHI was 13.6, right ear PTA was 16.8 dB HL with a 5.7 WIN threshold and left ear PTA was 15.0dB HL with a 7.0 dB SNR WIN threshold. SAGE scores for both groups were within normal range.
Conclusion These results indicated a small portion of people complained of hearing difficulties during or after having Covid-19 which aligned with current findings in the literature. Results indicated a minimal difference between the two Covid groups based on the ear specific PTA and WIN average thresholds.
Instructional Level Reasoning new information regarding how the viral infection, Covid-19, impacts the auditory system, information presented requires background knowledge of multiple standard auditory measures
Brief Summary of Clinical Takeaways: The clinical takeaway from this session is Covid-19 may have impacted a patient’s sense of hearing. Another clinical takeaway is that clinicians should consider performing otoacoustic emissions testing for this population.
Assumptions Attendees should have a basic knowledge of administering and interpretating audiometric tests.
Learning Objectives:
Upon completion of this session, the participant will be able to describe how Covid-19 impacts peripheral and central auditory function in the adult population.
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