Neurotological Manifestations of Patients with COVID-19

ABS TRACT Objective: To evaluate the frequency, discomfort level, duration, and laboratory tests of neurotological symptoms (hearing loss, hyperacusis and vertigo) and their association with eustachian tube dysfunction (ETD), smell and taste impairment in hospitalized patients with coronavirus disease-2019 (COVID-19). Material and Methods: The study prospectively enrolled a consecutive series of patients with COVID-19, who were hospitalized and followed up for the first 3 months. In addition to demographic data and laboratory test (the highest value for D-dimer, ferritin, C-reactive protein and neutrophil; the lowest value for fibrinogen, lymphocyte and platelet during hospitalization) results, a record was made of visual analogue scale scores of symptoms that present. The results were evaluated in three separate categories according to the presence or absence of neurotologic symptoms, according to gender and according to age as >60 years and <60 years. Results: A total of 141 patients completed the study. The frequency of all neurotological symptoms in the whole study population was determined as approximately 10%. The laboratory test results were seen to be similar in patients who experienced or did not experience at least one neurotological symptom (p=0.181). Most neurotological symptoms were seen along with smell and/or taste impairment; 61% of the patients with vertigo, 81% with hyperacusis, and 91% with hearing loss. All patients who experience ETD were detected to also experienced at least one neurotological symptom. Regarding age groups, 93% of the patients with hyperacusis, and 86% of patients with taste and smell impairment were in the <60 years age category (p=0.032). Conclusion: Neurotological symptoms are present in patients with COVID-19 and should be questioned. The vast majority of these symptoms are associated with smell and taste impairments. It should be kept in mind that patients with ETD symptom may experience additional neurotological symptoms.