Exploring Severity of SARS-CoV-2 Infection Impact on Audio-Vestibular Function

Introduction: The purpose of this study is to investigate the otologic effects of SARS-CoV-2 infection.

Methods: In this cohort study, surveys were administered to adult (>18 years old) patients who tested positive for SARS-CoV-2 infection between January and September of 2022 at a single-institution academic hospital. Pearson’s Chi square tests were conducted to compare rates of otologic symptom occurrence (including dizziness, hearing loss, aural fullness, tinnitus, and otalgia) following SARS-CoV-2 infection between demographic groups, with p <0.05 considered statistically significant.

Results: Of 1,499 patients, the mean age was 55, 63.2% were female, and 85.7% self-identified as white. Among this cohort, 19.9% reported dizziness, 9.6% reported hearing loss, 17.5% reported aural fullness, 16.3% reported tinnitus, and 9.1% reported otalgia. When stratified by decade-long age groups, there were significant differences in rates of dizziness (p < 0.001), aural fullness (p < 0.001), tinnitus (p < 0.001), and ear pain (p = 0.001). Females reported higher rates of aural fullness (22% vs 10%, p< 0.001) and otalgia (12% vs 5%, p < 0.001) compared to males. Patients hospitalized due to SARS-CoV-2 infection reported higher rates of dizziness (40% vs 19%, p< 0.001) and hearing loss (27% vs 9%, p< 0.001). Patients reporting two SARS-CoV-2 infection occurrences (N=266, 18%) reported higher rates of tinnitus (22% vs. 14%, p = 0.004) and dizziness (24% vs. 18%, p=0.026) when compared to those infected once (N = 1,172, 79%).

Conclusions: The inner ear manifestations of SARS-CoV-2 infection continue to be poorly understood. These findings add to a body of literature seeking to quantify patient risk factors for post-infection ototoxicity and include age, female sex, severity of infection, and number of infections experienced by an individual.