Insights into perceived listening difficulties post COVID-19 infection: no measurable hearing difficulty on clinical tests despite increased self-reported listening effort

Abstract

Objective: The aim was to use a battery of clinic-based auditory assessment procedures to compare participants with and without self-reported hearing difficulties following a confirmed COVID-19 infection. A further aim was to compare the groups on self-reported measures of listening effort and fatigue.

Methods: There were 25 participants in each group (age range 20-59 years, 80% females). Participants were recruited after a minimum of 4 weeks of testing positive. Hearing assessment involved tympanometry, acoustic reflex thresholds, pure-tone audiometry (PTA; 0.25-14 kHz), and distortion product otoacoustic emissions (DPOAEs; 0.5-10 kHz). Listening effort was assessed using the Arabic version of the Effort Assessment Scale (EAS-A) and fatigue was assessed using the Arabic version of the Fatigue Assessment Scale (FAS-A).

Results: There was no difference between groups on any measure except for greater self-reported listening effort in the perceived hearing difficulty group (p = 0.01).

Conclusion: The only difference between groups was self-reported listening effort. This could be due to a subclinical auditory deficit following COVID-19, increased listening effort due to the impact of COVID-19 on cognitive processes, or a psychosomatic response/health anxiety.

Keywords: COVID-19; cognition; fatigue; listening effort; psychology; sub-clinical hearing loss.

Figure 1

(A) Mean ART data (ipsilateral, left panel; contralateral, right panel) for the PD and the no-PD groups. (B) Mean hearing threshold across the standard frequency range (left panel) and at the high frequency range (right panel) for the PD and the no-PD groups. (C) Mean DPOAEs SNRs across the frequencies 0.5–8 kHz (left panel) and DPOAE SNR at 10 kHz (right panel) for the PD and the no-PD groups. (D) Self-reported listening effort (Left panel) and self-reported fatigue (right panel) for the PD and the no-PD groups. The solid horizontal line in the middle of each box plot represents the median score. Each box represents the upper and the lower quartiles of the data (the middle 50%). The distance between the upper quartile and the top whisker is the range of the top 25% scores. The distance between the lower quartile and the bottom whisker is the range of the bottom 25% scores. Circles represent outliers that are more than 1.5 times the interquartile range (the range between the upper and the lower quartile). Stars represent outliers that are more than 3 times the interquartile range.