Does coronavirus affect the audio-vestibular system? A rapid systematic review

Abstract

Objective: This rapid systematic review investigated audio-vestibular symptoms associated with coronavirus.

Design: The protocol for the rapid review was registered in the International Prospective Register of Systematic Reviews and the review methods were developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias was assessed using the National Institute of Heath quality assessment tools.

Study sample: After rejecting more than 2300 records, there were five case reports and two cross-sectional studies that met the inclusion criteria.

Results: No records of audio-vestibular symptoms were reported with the earlier types of coronavirus (i.e. severe acute respiratory syndrome [SARS] and Middle East respiratory syndrome [MERS]). Reports of hearing loss, tinnitus, and vertigo have rarely been reported in individuals who tested positive for the SARS-CoV-2.

Conclusion: Reports of audio-vestibular symptoms in confirmed COVID-19 cases are few, with mostly minor symptoms, and the studies are of poor quality. Emphasis over time is likely to shift from life-threatening concerns to longer-term health-related consequences such as audio-vestibular dysfunction. High-quality studies are needed to investigate the acute effects of COVID-19, as well as for understanding long-term risks, on the audio-vestibular system.

Review registration: Prospective Register of Systematic Reviews (PROSPERO; registration number CRD42020184932)

Keywords:

• Hearing loss
• coronavirus
• COVID-19
• SARS-CoV2
• tinnitus
• vertigo

Acknowledgements

The authors thank Jun Xia for her constructive comments on the protocol of this review. We also thank Becky Skidmore, the information specialist, for developing the search strategy for this rapid systematic review. Sincere thanks to the three anonymous reviewers who provided very helpful comments in a very timely manner.

Disclosure statement

The authors declare no conflict of interest.

Additional information

Funding

IA is partially funded, and KJM and KU are supported, by the NIHR Manchester Biomedical Research Centre [under Grant number IS-BRC-1215-20007]. IA is also supported by the Deanship of Scientific Research at the College of Applied Medical Sciences Research Centre at King Saud University.