Researchers Say One Potential Long-Term Health Implication Of COVID-19 Could Be Hearing Loss
COVID-19 Long-Term Health Implications
: Researchers in a collaborative international study are warning that hearing loss could be one of the long-term health side-effects from COVID-19.
Their research review was published in the International Journal of Audiology. https://www.tandfonline.com/doi/full/10.1080/14992027.2020.1776406
Though the pace of research on the SARS-CoV-2 coronavirus has been impressively rapid, there remains a lot we still do not know about the anomalous pathogen. One of those unknowns is the potential long-term health implications for people who have had the COVID-19 disease.
Despite an avalanche of research on the virus, most are focusing on the immediate priority of epidemiology, diagnosis, treatment, vaccines and antibody tests. However, there is already growing evidence that COVID-19 is not a simple lung infection. Why, for example, is asthma not a major risk factor for COVID-19 when it is a major risk factor for influenza?
Emerging studies are showing that there may well be long-term health consequences for a variety of organ systems that extend beyond the respiratory system, including the cardiovascular, immune and nervous systems. And there may be implications for health disciplines that are seemingly unrelated to COVID-19. For example, there are reports of headaches, blood clots, digestive problems and the chilblain appearance of "COVID toe.”
Past studies have shown that viruses such as measles, mumps and meningitis can cause hearing loss. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4222184/#:~:text=Viral%20infections%2C%20in%20particular%20cytomegalovirus,has%20been%20proposed%20for%20otosclerosis.
Also coronaviruses can cause peripheral neuropathy, damage to the nerves that carry information to and from the brain. It is possible, in theory that COVID-19 could cause auditory neuropathy, a hearing disorder where the cochlea is functioning but transmission along the auditory nerve to the brain is impaired. People with auditory neuropathy have difficulty hearing when there is background noise, such as in a pub. https://pubmed.ncbi.nlm.nih.gov/28748673/?otool=igbumllib
It has also been observed that auditory neuropathy has been linked with Guillain-Barré syndrome, an acute immune disease that affects central and peripheral nerves. Importantly, COVID-19 is also associated with Guillain-Barré syndrome. https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(20)30109-5/fulltext
The published review in the International Journal of Audiology, found reports of hearing loss and tinnitus, but there were only a small number of studies and the quality of evidence was low.
It is important not to diagnose hearing loss where it does not exist, or where it is coincidental given the high rates of COVID-19 in the population. On the other hand, the findings of the review might simply reflect the start of the understanding of this emergent health condition. Physicians need to be prepared to act.
A physician working in Manchester said they have surveyed COVID-19 patients after discharge from hospital and, so far, three out of 25 have reported problems with their hearing. Until that data have been published in a peer-reviewed journal, there is a need to treat it cautiously, but it does provide a possible early indication of what might be to come.
As a result of the need to provide timely evidence for decision-makers on this urgent and emergent health issue, the researchers are planning to repeat the review of COVID-19 and hearing loss at regular intervals over the coming year. It is likely that other health disciplines will follow suit. Health conditions may emerge over time that has clear clinical relevance. Following up with COVID-19 patients will probably teach researchers a lot about the long-term consequences of this destructive disease.
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