Sudden Onset Hearing Loss and COVID-19

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A recently published report in the journal BMJ Case Reports describes the case of a 45-year-old who developed sudden hearing loss after contracting COVID-19. Thus, the first case reported in the UK.

Sudden Onset Sensorineural Hearing Loss (SSNHL) is a common complaint in the Otolaryngology department. It has a worldwide incidence of 5-160 cases per 100,000 people annually. The exact cause of the disease is still unknown but, it can develop as a result of infection with viruses such as CMV (cytomegalovirus) and the herpes virus. 

Hearing loss and tinnitus are symptoms that have been seen in patients with both COVID-19 and influenza virus, but have not been highlighted.

study authors

Although uncommon, it can develop following COVID-19 infection. A few cases from across Turkey, Germany, and Egypt have linked the condition to COVID-19.

First Case of Sudden Hearing Loss in the UK

Ten days after contracting COVID-19, a 45-year-old in the UK developed breathing problems. As a result, he was immediately hospitalized and shifted to the intensive care unit (ICU). Due to difficulty breathing, he remained intubated for 30 days.

At the hospital, he received a combination of steroids, remdesivir, and plasma exchange. He soon recovered and shifted out of the ICU. A week after extubation and transfer out of the ICU, the patient noticed a ringing sound in his left ear along with a sudden hearing loss. 

The 45-year-old had no health problems other than asthma. Nor did he have a history of hearing-related problems. Physical examination and imaging studies excluded any other causes of hearing loss in the patient. 

Steroids – The standard of Treatment 

Sudden hearing loss can reverse with early identification and immediate treatment with steroids.

The patient received oral steroids along with intratympanic steroid injections. He reported the most improvement following a course of oral steroids. While his hearing loss improved partially, it did not restore to normal. 

SARS-CoV-2 causes an inflammatory response that results in an increase in inflammatory cytokines. Inflammatory cytokines are known to cause hearing loss.

In conclusion, the authors of the study suggest COVID-19 patients with acute hearing loss are immediately referred to the otolaryngology department.

Additionally, patients hospitalized due to COVID-19 should be screened for hearing loss to decrease hearing loss-associated morbidities. 

Reference:

Koumpa FS, Forde CT, Manjaly JG. Sudden irreversible hearing loss post COVID-19. BMJ Case Reports CP 2020;13:e238419. http://dx.doi.org/10.1136/bcr-2020-238419

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