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. 2024 Nov 26:12:1508607.
doi: 10.3389/fpubh.2024.1508607. eCollection 2024.

Tinnitus and COVID-19: effect of infection, vaccination, and the pandemic

Yihsin Tai  1 , Namitha Jain  2   3 , Gibbeum Kim  2   3 , Fatima T Husain  2   3   4
Affiliations

Tinnitus and COVID-19: effect of infection, vaccination, and the pandemic

Yihsin Tai et al. Front Public Health. .

Abstract

Introduction: The COVID-19 pandemic, which began worldwide around March 2020, has had an impact on hearing health, specifically tinnitus and hearing loss. Physiologically, COVID-19 infection, or medication used to treat the infection, has been reported to be a potential risk factor for tinnitus onset. In addition, tinnitus was reported to be a long COVID symptom or to occur after a COVID-19 vaccination in some cases. With most reports focused on the clinical population, this study aimed to investigate how the onset of tinnitus is associated with COVID-19 infection, long COVID, and COVID-19 vaccination in the general population based on self-report, while accounting for otologic and psychological symptoms.

Methods: In this study, a cross-sectional online survey that included general demographic questions, questions about tinnitus, hearing loss, hyperacusis, emotional status, and the Tinnitus Functional Index (TFI) was conducted.

Results: Completed survey data of 1,511 respondents who reported having tinnitus or believed to have COVID-associated tinnitus were included in the analysis. Participants were categorized into four groups based on their judgment regarding the etiology of their tinnitus: (1) COVID infection group, (2) long COVID group, (3) COVID vaccination group, and (4) pre-existing tinnitus group. The results suggest that tinnitus severity (estimated using TFI scores) was significantly lower in the pre-existing tinnitus group than in any of the COVID-associated tinnitus groups. While varying factors were found to contribute to tinnitus severity among the COVID-associated groups, overall, depression and/or anxiety accounted for the most variance in predicting tinnitus severity.

Discussion: The findings highlight the need to evaluate the impact of varying otologic and psychological symptoms in individuals with COVID-associated tinnitus for better patient-centered care.

Keywords: COVID infection; COVID vaccination; hearing loss; long COVID; survey; tinnitus.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Forest plot showing the relationship between COVID-associated tinnitus and different otologic or psychological symptoms. Age- and gender-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using multivariate logistic regressions in each COVID-associated tinnitus group. The red dashed line denotes the reference line of no association between two examined factors (when ORs = 1). Significant associations were found between COVID infection-associated tinnitus and hyperacusis, as well as between COVID vaccination-associated tinnitus and hearing loss or anxiety. *p < 0.05.
Figure 2
Figure 2
Boxplot showing the Tinnitus Functional Index (TFI) score in each group. The thick horizontal line within each box denotes the median value, and the box denotes the interquartile range. The error bars represent the maximum and minimum values of the TFI. The pre-existing tinnitus group showed a significantly lower median TFI score than any COVID-associated tinnitus group. **p < 0.01; ***p < 0.001.
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