One year on: an updated systematic review of SARS-CoV-2, COVID-19 and audio-vestibular symptoms.

Almufarrij, Ibrahim; Munro, Kevin J

OBJECTIVE The aim was to systematically review the literature to December 2020, in order to provide a timely summary of evidence on SARS-CoV-2, COVID-19 and audio-vestibular symptoms. DESIGN The protocol was registered in the International Prospective Register of Systematic Reviews. The methods were developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Risk of bias was assessed using the National Institutes of Heath quality assessment tools. STUDY SAMPLE After rejecting 850 records, 28 case reports/series and 28 cross-sectional studies met the inclusion criteria. RESULTS There are multiple reports of hearing loss (e.g. sudden sensorineural), tinnitus and rotatory vertigo in adults having a wide range of COVID-19 symptom severity. The pooled estimate of prevalence based primarily on retrospective recall of symptoms, was 7.6% (CI: 2.5-15.1), 14.8% (CI: 6.3-26.1) and 7.2% (CI: 0.01-26.4), for hearing loss, tinnitus and rotatory vertigo, respectively. However, these could be an over-estimate because it was not always clear that studies report a change in symptom. CONCLUSION There are multiple reports of audio-vestibular symptoms associated with COVID-19. However, there is a dearth of high-quality studies comparing COVID-19 cases and controls. REVIEW REGISTRATION Prospective Register of Systematic Reviews (PROSPERO); registration number CRD42020227038).