{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T06:44:04Z","timestamp":1793169844355,"version":"4.5.0"},"reference-count":105,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>ABSTRACT:<\/jats:title>\n                  <jats:sec id=\"S0317167121000639_as1\">\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Extensive studies indicate that severe acute respiratory syndrome coronavirus (SARS-CoV-2) involves human sensory systems. A lack of discussion, however, exists given the auditory\u2013vestibular system involvement in CoV disease 2019 (COVID-19). The present systematic review and meta-analysis were performed to determine the event rate (ER) of hearing loss, tinnitus, and dizziness caused by SARS-CoV-2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167121000639_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Databases (PubMed, ScienceDirect, Wiley) and World Health Organization updates were searched using combined keywords: \u2018COVID-19,\u2019 \u2018SARS-CoV-2,\u2019 \u2018pandemic,\u2019 \u2018auditory dysfunction,\u2019 \u2018hearing loss,\u2019 \u2018tinnitus,\u2019 \u2018vestibular dysfunction,\u2019 \u2018dizziness,\u2019 \u2018vertigo,\u2019 and \u2018otologic symptoms.\u2019<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167121000639_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Twelve papers met the eligibility criteria and were included in the study. These papers were single group prospective, cross-sectional, or retrospective studies on otolaryngologic, neurologic, or general clinical symptoms of COVID-19 and had used subjective assessments for data collection (case histories\/medical records). The results of the meta-analysis demonstrate that the ER of hearing loss (3.1%, CIs: 0.01\u20130.09), tinnitus (4.5%, CIs: 0.012\u20130.153), and dizziness (12.2%, CIs: 0.070\u20130.204) is statistically significant in patients with COVID-19 (\n                      <jats:italic>Z<\/jats:italic>\n                      \u2264 \u22124.469,\n                      <jats:italic>p<\/jats:italic>\n                      \u2264 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167121000639_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>COVID-19 can cause hearing loss, tinnitus, and dizziness. These findings, however, should be interpreted with caution given insufficient evidence and heterogeneity among studies. Well-designed studies and follow-up assessments on otologic symptoms of SARS-CoV-2 using standard objective tests are recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/cjn.2021.63","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T08:27:13Z","timestamp":1618216033000},"page":"184-195","source":"Crossref","is-referenced-by-count":140,"title":["Hearing Loss, Tinnitus, and Dizziness in COVID-19: A Systematic Review and Meta-Analysis"],"prefix":"10.1017","volume":"49","author":[{"given":"Zahra","family":"Jafari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan E.","family":"Kolb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0964-2977","authenticated-orcid":false,"given":"Majid H.","family":"Mohajerani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"key":"S0317167121000639_ref39","doi-asserted-by":"publisher","DOI":"10.1007\/s12311-020-01177-9"},{"key":"S0317167121000639_ref105","doi-asserted-by":"publisher","DOI":"10.1515\/REVEH.2003.18.1.19"},{"key":"S0317167121000639_ref91","doi-asserted-by":"publisher","DOI":"10.1016\/j.cub.2014.03.034"},{"key":"S0317167121000639_ref1","volume-title":"Features, Evaluation, and Treatment of Coronavirus (COVID-19)","author":"Cascella","year":"2020"},{"key":"S0317167121000639_ref2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13091"},{"key":"S0317167121000639_ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102487"},{"key":"S0317167121000639_ref92","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcmed.2020.04.019"},{"key":"S0317167121000639_ref27","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-020-01432-5"},{"key":"S0317167121000639_ref66","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318219c171"},{"key":"S0317167121000639_ref14","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820926473"},{"key":"S0317167121000639_ref70","article-title":"Expression of ACE2, TMPRSS2, and furin in mouse ear tissue","author":"Uranaka","year":"2020","journal-title":"bioRxiv"},{"key":"S0317167121000639_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2020.05.030"},{"key":"S0317167121000639_ref75","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9092756"},{"key":"S0317167121000639_ref72","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002002"},{"key":"S0317167121000639_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2020.108427"},{"key":"S0317167121000639_ref34","doi-asserted-by":"publisher","DOI":"10.1177\/0003489419842577"},{"key":"S0317167121000639_ref32","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.45357"},{"key":"S0317167121000639_ref81","doi-asserted-by":"publisher","DOI":"10.7874\/jao.2016.20.3.174"},{"key":"S0317167121000639_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.05.193"},{"key":"S0317167121000639_ref36","first-page":"645","article-title":"Case report: need for vigilance in recognizing neurologic presentations of COVID-19","volume":"102","author":"Avener","year":"2020","journal-title":"Am Fam Phys."},{"key":"S0317167121000639_ref55","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2020.0180"},{"key":"S0317167121000639_ref99","doi-asserted-by":"publisher","DOI":"10.1002\/path.1570"},{"key":"S0317167121000639_ref69","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102483"},{"key":"S0317167121000639_ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-020-04547-7"},{"key":"S0317167121000639_ref29","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-020-04525-z"},{"key":"S0317167121000639_ref19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"S0317167121000639_ref59","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002860"},{"key":"S0317167121000639_ref100","doi-asserted-by":"publisher","DOI":"10.1021\/acschemneuro.0c00122"},{"key":"S0317167121000639_ref87","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28000"},{"key":"S0317167121000639_ref68","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022440"},{"key":"S0317167121000639_ref88","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainresrev.2010.12.002"},{"key":"S0317167121000639_ref77","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000642"},{"key":"S0317167121000639_ref61","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2021.1882493"},{"key":"S0317167121000639_ref89","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-019-2718-9"},{"key":"S0317167121000639_ref44","doi-asserted-by":"publisher","DOI":"10.14639\/0392-100X-N0820"},{"key":"S0317167121000639_ref50","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0000000000003068"},{"key":"S0317167121000639_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2011.06.004"},{"key":"S0317167121000639_ref64","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.08.006"},{"key":"S0317167121000639_ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2020.05.034"},{"key":"S0317167121000639_ref28","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1091"},{"key":"S0317167121000639_ref17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjophth-2020-000563"},{"key":"S0317167121000639_ref84","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001396"},{"key":"S0317167121000639_ref13","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1585"},{"key":"S0317167121000639_ref98","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0092547"},{"key":"S0317167121000639_ref52","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16526"},{"key":"S0317167121000639_ref9","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.498"},{"key":"S0317167121000639_ref96","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbih.2020.100081"},{"key":"S0317167121000639_ref93","doi-asserted-by":"publisher","DOI":"10.1080\/10715760600623825"},{"key":"S0317167121000639_ref18","doi-asserted-by":"publisher","DOI":"10.1177\/0145561320946902"},{"key":"S0317167121000639_ref97","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.00737-08"},{"key":"S0317167121000639_ref51","first-page":"e8918","article-title":"A case of COVID-19-induced vestibular neuritis","volume":"12","author":"Malayala","year":"2020","journal-title":"Cureus."},{"key":"S0317167121000639_ref54","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102473"},{"key":"S0317167121000639_ref46","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2020.03.89"},{"key":"S0317167121000639_ref53","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.12185"},{"key":"S0317167121000639_ref71","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002848"},{"key":"S0317167121000639_ref73","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2019.100963"},{"key":"S0317167121000639_ref85","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-014-3937-6"},{"key":"S0317167121000639_ref78","first-page":"361","article-title":"Dizziness: a diagnostic approach","volume":"82","author":"Post","year":"2010","journal-title":"Am Fam Physician."},{"key":"S0317167121000639_ref31","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820926144"},{"key":"S0317167121000639_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102612"},{"key":"S0317167121000639_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.xocr.2020.100198"},{"key":"S0317167121000639_ref86","first-page":"1","article-title":"One year on: an updated systematic review of SARS-CoV-2, COVID-19 and audio-vestibular symptoms","author":"Almufarrij","year":"2021","journal-title":"Int J Audiol."},{"key":"S0317167121000639_ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-06319-7"},{"key":"S0317167121000639_ref58","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2008-3"},{"key":"S0317167121000639_ref57","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.598531"},{"key":"S0317167121000639_ref16","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.61.10.29"},{"key":"S0317167121000639_ref26","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13089"},{"key":"S0317167121000639_ref45","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.06.023"},{"key":"S0317167121000639_ref83","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2020.108487"},{"key":"S0317167121000639_ref94","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3182635417"},{"key":"S0317167121000639_ref6","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13620"},{"key":"S0317167121000639_ref37","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000021240"},{"key":"S0317167121000639_ref41","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.25711"},{"key":"S0317167121000639_ref80","doi-asserted-by":"publisher","DOI":"10.1055\/b-006-161125"},{"key":"S0317167121000639_ref104","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.00252"},{"key":"S0317167121000639_ref103","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1056\/NEJMoa2023184","article-title":"Repurposed antiviral drugs for covid-19 - interim WHO solidarity trial results","volume":"384","author":"Pan","year":"2021","journal-title":"N Engl J Med"},{"key":"S0317167121000639_ref11","first-page":"1","article-title":"Otolaryngological manifestations of hospitalised patients with confirmed COVID-19 infection","author":"\u00d6z\u00e7elik Korkmaz","year":"2020","journal-title":"Eur Arch Otorhinolaryngol."},{"key":"S0317167121000639_ref76","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-06147-9"},{"key":"S0317167121000639_ref90","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/7432797"},{"key":"S0317167121000639_ref47","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-238419"},{"key":"S0317167121000639_ref12","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.1127"},{"key":"S0317167121000639_ref56","doi-asserted-by":"publisher","DOI":"10.1007\/s10047-020-01183-y"},{"key":"S0317167121000639_ref30","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa272"},{"key":"S0317167121000639_ref74","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.592878"},{"key":"S0317167121000639_ref101","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102513"},{"key":"S0317167121000639_ref79","first-page":"154","article-title":"Dizziness: approach to evaluation and management","volume":"95","author":"Muncie","year":"2017","journal-title":"Am Fam Phys."},{"key":"S0317167121000639_ref95","doi-asserted-by":"publisher","DOI":"10.1159\/000453066"},{"key":"S0317167121000639_ref63","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2011.06.004"},{"key":"S0317167121000639_ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"S0317167121000639_ref24","first-page":"1","article-title":"Tinnitus and equilibrium disorders in COVID-19 patients: preliminary results","author":"Viola","year":"2020","journal-title":"Eur Arch Otorhinolaryngol."},{"key":"S0317167121000639_ref8","doi-asserted-by":"publisher","DOI":"10.1177\/0145561320947255"},{"key":"S0317167121000639_ref82","volume-title":"Clinical Methods: The History, Physical, and Laboratory Examinations","author":"Reilly","year":"1990"},{"key":"S0317167121000639_ref7","doi-asserted-by":"publisher","DOI":"10.1080\/14992027.2020.1776406"},{"key":"S0317167121000639_ref33","doi-asserted-by":"publisher","DOI":"10.3233\/VES-201505"},{"key":"S0317167121000639_ref49","first-page":"1","article-title":"Coronavirus disease 2019 and sudden sensorineural hearing loss","author":"Lang","year":"2020","journal-title":"J Laryngol Otol."},{"key":"S0317167121000639_ref60","doi-asserted-by":"publisher","DOI":"10.1177\/0145561320974849"},{"key":"S0317167121000639_ref42","doi-asserted-by":"publisher","DOI":"10.1111\/imj.14880"},{"key":"S0317167121000639_ref65","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7300.1479"},{"key":"S0317167121000639_ref43","doi-asserted-by":"publisher","DOI":"10.19102\/icrm.2020.111102"},{"key":"S0317167121000639_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.08.006"},{"key":"S0317167121000639_ref62","doi-asserted-by":"publisher","DOI":"10.1016\/j.vacun.2020.11.001"},{"key":"S0317167121000639_ref67","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182718"},{"key":"S0317167121000639_ref102","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.04.012"},{"key":"S0317167121000639_ref48","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.927519"},{"key":"S0317167121000639_ref15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241661"}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167121000639","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T04:08:51Z","timestamp":1647230931000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167121000639\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,12]]},"references-count":105,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["S0317167121000639"],"URL":"https:\/\/doi.org\/10.1017\/cjn.2021.63","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,12]]}}}