Evaluation of cochlear and auditory brainstem functions in COVID-19 patients; a case control study

Adel Abdel-Maksoud Nassar, Rasha Hamdy El-Kabarity, Nourhan Nour El-Din Hassan, Abeer Mohamed El-Gendy
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Abstract

Many viral infections can cause hearing loss due to affection of cochlear hair cells or neurogenic pathway. Although, the damage secondary to viral infections is mainly cochlear affection; auditory brainstem can be affected as well. It was predicted that SARS-COV-2 infection can similarly affect the auditory system. This study aimed to detect affection in auditory system and if present investigate the possible site of lesion (up to the level of the brain stem) in relation to COVID-19 infection. This is a case control study, where the study group constituted of thirty adults, diagnosed with COVID-19 at least 2 weeks prior to testing and up to 6 months, without previous auditory complaints pre-COVID-19 or other risk factors that could affect the auditory pathway. Fifteen adult participants that were age and gender matched to the study group with no previous history of covid-19 infection constituted the control group. Audiological evaluations done to all participants were pure-tone and speech audiometry, tympanometry, transient-evoked otoacoustic emission with and without contralateral suppression and auditory brainstem response measurements. The study group showed significantly worse pure tone thresholds at high frequencies 4 and 8 kHz (p < 0.01), significantly worse transient-evoked otoacoustic emission signal to noise ratio at 2800 Hz and 4000 Hz (p < 0.05) and significantly lower total suppression index (p<0.05). On the other hand, there was no significant difference between both groups in auditory brainstem response wave latencies (p > 0.05). COVID-19 had subtle effect on cochlear basal turn, and it is shown that the auditory efferent system may also be affected, while the auditory nerve and afferent brainstem pathways seems to be spared. Moreover, the absence of the symptoms of auditory dysfunction postcovid-19 does not guarantee normal auditory functions.
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评估 COVID-19 患者的耳蜗和听觉脑干功能;病例对照研究
许多病毒感染都会导致听力损失,原因是耳蜗毛细胞或神经源通路受到感染。虽然病毒感染造成的损害主要是耳蜗损伤,但听觉脑干也会受到影响。据预测,SARS-COV-2 感染同样会影响听觉系统。本研究旨在检测听觉系统的病变,如果存在,则调查与 COVID-19 感染有关的可能病变部位(直至脑干水平)。这是一项病例对照研究,研究组由 30 名成年人组成,他们在检测前至少 2 周和 6 个月内被诊断出感染了 COVID-19,在感染 COVID-19 前没有听觉症状,也没有其他可能影响听觉通路的风险因素。对照组由 15 名年龄和性别与研究组相匹配、既往无 COVID-19 感染史的成人组成。对所有参与者进行的听力评估包括纯音和言语测听、鼓室测听、瞬态诱发耳声发射(带或不带对侧抑制)和听性脑干反应测量。研究组在高频 4 和 8 kHz 的纯音阈值明显降低(p < 0.01),在 2800 Hz 和 4000 Hz 的瞬态诱发耳声发射信噪比明显降低(p < 0.05),总抑制指数明显降低(p 0.05)。COVID-19 对耳蜗基转有微妙的影响,表明听觉传出系统也可能受到影响,而听觉神经和传入脑干通路似乎不受影响。此外,没有听觉功能障碍的症状并不能保证 Covid-19 后听觉功能正常。
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