Exacerbation of Preexisting Otologic Conditions After COVID-19 Infection.

Abstract

Background: Since the height of the COVID-19 pandemic, there have been an increasing number of reports of incidence of otologic conditions after infection. We aim to investigate whether a history of otologic conditions was associated with elevated risk of similar or exacerbated symptoms after COVID-19 infection.

Methods: Surveys were administered to patients 18 years or older who had tested positive via PCR testing for COVID-19 infection between January 2020 and September 2022. Incidence of otologic symptoms within the 10-day period after COVID-19 infection was compared between participants with a preexisting otologic condition and control participants.

Results: Of 1,499 patients who tested positive for COVID-19, 63.2% were female, 87.5% were White, and the mean age was 58 years. Of these, 721 (48%) reported a preexisting otologic condition, with loss of hearing (25.5%) and history of dizziness (18.8%) being most highly represented among this subcohort. Of patients with a preexisting condition, 35.5% subjectively reported that they believed COVID-19 infection had worsened otologic symptoms of their condition. Univariable analysis revealed that individuals were more likely to report dizziness post-COVID-19 infection if they had a preexisting history of dizziness (29.1% versus 17.8%, p < 0.001) or preexisting history of vestibular neuritis (58.8% versus 19.5%, p < 0.001) than those who did not. Similarly, individuals with a history of vestibular migraine were more likely to report migraine symptoms after infection than those who did not (27.9% versus 7.2%, p < 0.001). Multivariable analysis revealed that preexisting history of dizziness, vestibular neuritis, vestibular migraine, and autoimmune conditions increased the odds of several otologic symptoms, although an exception was observed with decreased odds for changes in hearing in patients with preexisting history of dizziness. Younger age and female gender were associated with higher odds for various otologic symptoms after COVID-19 infection.

Conclusions: These findings indicate that certain preexisting otologic conditions may be associated with a greater likelihood of exacerbation after COVID-19 infection and may help guide screening protocols for those at greatest risk.

Level of evidence: III.

Irb: UCSD IRB #801971.