key: cord-259837-5tbdqzxr
authors: Kalcioglu, Mahmut Tayyar; Cag, Yasemin; Kilic, Osman; Tuysuz, Ozan
title: May COVID-19 cause sudden sensorineural hearing loss?
date: 2020-09-29
journal: Int J Infect Dis
DOI: 10.1016/j.ijid.2020.09.1468
sha: 
doc_id: 259837
cord_uid: 5tbdqzxr

nan

We thank to Pietro D L et al for their comments on our recently published article (Kilic et al., 2020) . In previous studies, viral infections have been reported to have an important role in the etiology of sudden sensorineural hearing loss (SSNHL) (Cohen et al., 2014) . Therefore, it is not unreasonable to think that COVID-19, as a viral infection, may also cause SSNHL.

Moreover, recently, studies on the effects of SARS-CoV-2 virus on central and peripheral nervous systems have been published. Some of these studies have reported Guillain -Barré syndrome (Toscano et al., 2020) and impaired olfactory function (Eliezer et al., 2020) to be related to SARS-CoV-2. Another recently published study reported neurologic changes in 58 of 64 patients with COVID-19 (Helms et al., 2020) .

When we observed an unexpected increase in SSNHL cases with no other symptoms in our ENT outpatient clinics during the COVID-19 pandemic, we thought that it might be related to COVID-19. Therefore, we investigated the possibility of SARS-CoV-2 infection in these J o u r n a l P r e -p r o o f patients. By using RT-PCR method, we detected the presence of SARS-CoV-2 in one of our 5 patients (Kilic et al., 2020) . Our study is the first in the literature to show that there may be a relationship between SSNHL and COVID-19.

The results of a recent study on the effect of COVID-19 on hearing functions supports our hypothesis (Mustafa, 2020) . The author reported that both transient evoked otoacoustic emissions and high frequency pure-tone thresholds amplitudes were significantly worse in the asymptomatic COVID-19 PCR-positive patients group.

Undoubtedly, routine healthcare services are disrupted during the pandemic, so the association of SSNHL cases with COVID-19 may have been gone unnoticed in healthcare institutions due to the increased workload. Of course, in order to make a definitive diagnosis, studies that would demonstrate the presence of the virus in the relevant tissues, such as postmortem studies, are required. However, in the ongoing pandemic, we believe that every symptom should be taken into consideration and shared with the medical community. We believe that our article will increase awareness on this issue. Thus, will encourage the design of large studies, in the regions with high prevalence of COVID-19, as also suggested by Pietro et al.

Viral causes of hearing loss: a review for hearing health professionals

Sudden and Complete Olfactory Loss Function as a Possible Symptom of COVID-19

Neurologic Features in Severe SARS-CoV-2 Infection

Could sudden sensorineural hearing loss be the sole manifestation of COVID-19? An investigation into SARS-COV-2 in the etiology of sudden sensorineural hearing loss

Audiological profile of asymptomatic Covid-19 PCR-positive cases

Barré Syndrome Associated with SARS-CoV-2

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.