Can Covid-19 side effects include hearing loss?
A rather funny Bruce Y. Lee wrote an article for Forbes titled: Can Covid-19 Coronavirus Cause Hearing Problems Even With No Other Symptoms? If you do not believe us that he is funny, then just read his impressive bio at the end of this blog.
Amongst the humour are very valid points made about the potential that COVID-19 has shown to cause hearing damage, whether it be the virus attacking the hearing system or ototoxic medications being the root cause of the hearing loss. This has sparked conversations as to why it is so important for healthcare providers to monitor hearing loss during and after COVID-19 treatments.
The SARS-CoV2 virus has shown cases where it not only targeted the respiratory system but also the nervous system, and as previously posted on our blog, a research letter was published in JAMA Otolaryngology Head and Neck Surgery, where a team from the Johns Hopkins School of Medicine described how they had detected the corona virus in the middle ear or mastoid of three patients. So if the virus can be found there, what damage is it causing at that site, if any?
Ototoxicity monitoring is not a new phenomenon, and as the title states in a published letter in the International Journal of Immunopathology and Pharmacology written by Andrea Ciorba, and colleagues, Don’t forget ototoxicity during the SARS-CoV-2 (Covid-19) pandemic! Other viruses such as the herpes simplex virus type 1 (HSV-1), the herpes zoster virus (HZV), the cytomegalovirus, the measles virus, and the human immunodeficiency virus (HIV) are known to affect the ear and cause ear-related symptoms. In the cases where certain ototoxic medications (such as chloroquine, hydroxychloroquine, azithromycin, remdesivir, favipiravir and lopinavir) have been chosen to treat the symptoms of a virus it seems only necessary to ensure that ototoxic monitoring is included in any patient’s consultation.
We reiterated these thoughts in a blog published in November; Ototoxic medications in modern medicine.
With the current pandemic, COVID-19, antivirals and anti-inflammatory drugs have been used to help manage patients’ symptoms as there is no vaccine nor treatment for the condition as yet. Antimalarial drugs such as chloroquine (CQ) are widely used to treat COVID-19 symptoms and complications. Other drugs, antibiotics, such as azithromycin are administered in COVID-19 patients, and at times in combination with hydroxychloroquine (HCQ). Aminoglycosides have also been introduced in COVID-19 patients to treat secondary infections such as pneumonia.
The above mentioned drugs have been extensively reported to be ototoxic.
Ramatsoma, Ramma, and Koekemoer (2020) have outlined the role of audiologists in the management of COVID-19 patients. Although this article was focused on audiologists’ role, it also outlines ototoxic treatments that are currently used in COVID-19 patients extensively. What the article brings to light is that, clinicians, other health workers, and patients themselves should always be on guard and aware of the of treatment prescribed in order to ensure appropriate informational and emotional counselling, and appropriate referral and management to prevent or mitigate the effects of ototoxic medications on the auditory and vestibular system.
The KUDUwave audiometer models now all come with extended high frequencies so that it is possible to conduct ototoxicity monitoring easily with your standard screening or diagnostic audiometer. The KUDUwave Pro TMP is a fully comprehensible diagnostic audiometer, including extended high frequencies, speech testing, tympanometry and acoustic reflexes – All in one compact, light weight, and portable device.