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Cited by 54Long-Term Effects of COVID-19COVID-19 Clinical Research StudiesVestibular and auditory disorders

Auditory Disturbances and SARS-CoV-2 Infection: Brain Inflammation or Cochlear Affection? Systematic Review and Discussion of Potential Pathogenesis

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De Luca, Pietro, Scarpa, Alfonso, Ralli, Massimo, Tassone, Domenico, Simone, Matteo, De Campora, Luca, Cassandro, Claudia, Di Stadio, Arianna·2021·Frontiers in Neurology
DOI 10.3389/fneur.2021.707207PMC PMC8373381
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Abstract

Patients affected by COVID-19 present a series of different symptoms; despite some of these are common, other less likely appear. Auditory symptoms seem to be less frequent, maybe because rarer or, alternatively, because they are underestimated during the clinical investigation. The hearing impairment might be related to the central or peripheral involvement of the auditory pathways; in particular, the likelihood of thrombosis might be one of the causes. To date, the prevalence of auditory symptoms such as sudden or progressive sensorineural hearing loss and tinnitus is unclear in COVID-19 patients. However, their presence might be an early sign of thrombosis or spread of the infection into the brain. In this systematic review of the literature we investigated the presence of auditory symptoms in COVID-19 patients and discussed their potential origin and causal relationship with SARS-CoV-2. Results showed that, despite rarely, auditory impairment can appear in patients with COVID-19 and should always be investigated for an early treatment and potential indicator of involvement of the central nervous system.

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  • Large-scale epidemiological data on the association between acute RTIs and SSNHL are lacking.

    “These studies generally suggest an increased risk of SSNHL following viral infections, but their findings are inconsistent, and large-scale epidemiological data are lacking [8].”

    From Acute Respiratory Tract Infection and Sudden Sensorineural Hearing Loss: A Multinational Cohort Study (2025) · cites this paper as [8]

    The Results (Study Characteristics; page unavailable) identify only 11 case reports and one case series concerning SSNHL in patients with SARS-CoV-2 infection. The Results (Limits of the Study; page unavailable) call the overall sample of 204 patients small and note weaknesses in the study designs. This supports a lack of large-scale evidence for SARS-CoV-2, but the review does not establish that epidemiological data are lacking for acute respiratory tract infections generally. (LLM, conf=0.84)

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  • Previous investigations into the association between acute RTIs and SSNHL have largely been limited to case reports, small cohort studies, or single-center experiences, often without adequate control for confounding factors.

    “Previous investigations into the association between acute RTIs and SSNHL have largely been limited to case reports, small cohort studies, or single-center experiences, often without adequate control for confounding factors.”

    From Acute Respiratory Tract Infection and Sudden Sensorineural Hearing Loss: A Multinational Cohort Study (2025) · cites this paper as [8]

    The Results (Study Characteristics; page unavailable) identify 11 case reports and one case series on SSNHL in patients with SARS-CoV-2 infection. The Limits of the Study section (page unavailable) also notes small samples, uncontrolled designs, and insufficient detail about control groups. The review does not establish that these limitations characterize investigations of acute respiratory tract infections generally, or that the studies were predominantly single-center. (LLM, conf=0.87)

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Authors
De Luca, P., Scarpa, A., Ralli, M., Tassone, D., Simone, M., De Campora, L., Cassandro, C., & Di Stadio, A.
Affiliations
  • University of Salerno (IT)
  • Sapienza University of Rome (IT)
  • Azienda Ospedaliera San Giovanni Addolorata (IT)
  • University of Turin (IT)
ORCID
Venue
Frontiers in Neurology
Publisher
Frontiers Media SA
Published
2021-08-04
Volume
12
Pages
707207-707207
ISSN
1664-2295 (ISSN-L)
DOI
10.3389/fneur.2021.707207
PMC
PMC8373381
OpenAlex
W3192105634
Cited by
54
References
2
Citations by year
2026: 1 · 2025: 12 · 2024: 7 · 2023: 16 · 2022: 18
FWCI
1.31
Type
journal article
Language
en
Update notices
corrigendum (2023-06-26)
Open access
Licence
Locations
  • Frontiers in Neurology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
Keywords
COVID-19 pandemic, SARS-CoV-2, auditory disturbances, hearing loss, tinnitus, sensorineural hearing loss, thrombosis, neuroinflammation, central nervous system involvement, pathogenesis

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