Clinical Characteristics of Corona Virus Disease 2019-Related Hearing Loss

HOU Qing; ZHANG Yufei; YIN Zedeng

doi:10.3969/j.issn.1672-2922.2025.01.016

Abstract：Objective To summarize the classification,mechanisms and treatment of corona virus disease 2019-related hearing loss(COVID-19-RHL),as well as the possibility of COVID-19 prediction.Methods The PubMed,EMBASE and CNKI were searched for published literature on COVID-19 and hearing,with a focus on the classification,mechanisms and treatment of COVID-19-RHL as well as the possibility of COVID-19 prediction.Results The number of literatures on COVID-19-RHL is limited and most of them are case reports.Hearing issues include sudden sensorineural hearing loss(SSNHL),sensorineural hearing loss(SNHL)and otitis media(OM,with or without mixed SSNHL or SNHL).SSNHL seems to be the most common type of COVID-19-RHL.Mechanisms of COVID-19-RHL may include direct damage of inner ear structures by the virus,immune-mediated inflammatory reactions,microcirculatory disturbance such as thrombosis,etc.Oral and combined intratympanic glucocorticoids can improve hearing in most patients with COVID-19-RHL.Furthermore,otitis media can resolve with outpatient treatment or home observation.High-frequency(4,6 and 8 kHz)threshold shifts and decreased transient evoked otoacoustic emission(TEOAE)amplitudes can be seen in asymptomatic cases.Hearing loss can be used to predict positive COVID-19 in endemic areas.Conclusion SSNHL is the most common type of COVID-19 RHL.Glucocorticoids can improve hearing in most patients with SSNHL.Clinicians should be on high alert for the possibility of virus infection in patients with hearing loss and atypical respiratory symptoms in COVID-19 pandemic areas.High-frequency audiometry and TEOAE may pick up hearing impairment in asymptomatic COVID-19.