Trajectory of COVID-related tinnitus over the pandemic timeline

OBJECTIVES: COVID-19 is a respiratory disease caused by the coronavirus SARS-CoV-2. Previous studies reported cases of tinnitus following COVID infection, most of them mild and with similar characteristics to other forms of tinnitus. Our aim is to further explore the relationship between COVID-19 and tinnitus. For this purpose, we analyzed people in our city after a COVID-19 infection. METHOD: 233 patients over 18-years old and previously confirmed diagnosis of COVID-19 confirmed by either a RT-PCR, antibodies or antigens test were included. Patients were subdivided in three groups: No Tinnitus (NT), tinnitus that already existed before COVID-19 (Chronic Tinnitus, CT) and tinnitus that arose during or after COVID-19 (Post-COVID-19 Tinnitus, PCT). Data concerning COVID-19 symptoms, drugs prescribed for COVID-19, tinnitus characteristics, comorbidities and other otological symptoms were collected. Tinnitus assessment included pure tone audiograms, the Tinnitus Handicap Inventory, visual-analog scales for loudness and distress as well as the hospital anxiety and depression scale. Patients with CT were additionally asked whether their tinnitus worsened after their COVID-19 infection. RESULTS: No statistical difference was found between CT and PCT concerning hearing, tinnitus characteristics and tinnitus distress. There was also no statistically significant difference between PCT and NT with respect to COVID-19 symptoms and pharmacological COVID-19 treatment. Only 7% of the patients with CT reported worsening of their tinnitus after COVID-19. There was a decrease on post-COVID cases along the pandemic's timeline: 9.8% in 2020, 6.7% in 2021, 4.4% in 2022 and 0% in 2023 and 2024 (p = 0.058). CONCLUSION: Our data demonstrated that PCT tinnitus is very similar to other forms of tinnitus and generally mild. Also, PCT cases decreased along the pandemic's timeline, possibly due to the onset of vaccination, emergence of omicron as the dominant variant and improvement on the psychological aspects related to the pandemics. EVIDENCE LEVEL: 3b.