Narrative Review of Sudden Sensory Neural Hearing Loss as Atypical Presentation of COVID 19 Infection

Candice  Que-Ansorge,; Diane  D. Diamante,

Narrative Review of Sudden Sensory Neural Hearing Loss as Atypical Presentation of COVID 19 Infection

Abstract:

Introduction Severe Acute Respiratory Syndrome Corona virus type 2 (nSARS-CoV-2) or COVID-19 is a global pandemic that started last 2019 in Wuhan China. It affects different organs which results to a variety of clinical presentation. The most common presentation includes headache, fever, diarrhea, anosmia with or without dysgeusia, upper and lower respiratory tract infection. It can lead to dyspnea and death. A few patients have atypical presentation such as sudden sensory neural hearing loss (SSNHL) which is often not investigated for COVID-19 infection due to its low incidence. Currently, an observable rise in the incidence of SSNHL in COVID-19 survivors worldwide is noted. This leads to an increased number of survivors with hearing impairment. Objectives The goal of this study is to report updates in sudden sensory neural hearing loss caused by COVID-19 infection. This will give a broader perspective in the clinical presentation, pathophysiology, management and disease outcome of COVID-19 infected patients with SSNHL. This will aid medical practitioners to consider hearing loss as an atypical COVID-19 presentation and manage the patients accordingly. Methodology This is a narrative review that includes 5 case reports and 1 case series which are chosen using PRISMA guidelines. The total number of patients included is 10. They were all rt-PCR and audiometry confirmed covid-19 patients with SSNHL. The timing, degree of severity, treatment and outcome were all documented and tabulated. Conclusion Sensory Neural Hearing loss is an increasing cause of hearing impairment. Direct correlation is still unknown due to undocumented SSNHL patients with no routine rt-PCR. There are several proposed possible pathophysiology of SSNHL in COVID-19. One of which is the ototoxic side effects of some covid-19 drugs, hence treatment regimen should include otological examination to watch out for signs of toxicity. Although various pathophysiology is being considered, all can be managed by steroid therapy. The most effective is a combination of oral and intratympanic injection of corticosteroid.

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