{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T05:08:02Z","timestamp":1755839282845,"version":"3.41.2"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T00:00:00Z","timestamp":1645488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>There are reports of associations between SARS-CoV2, COVID-19, COVID-19 vaccines, and auditory symptoms (hearing difficulty, tinnitus). However, most studies have relied on self-report and lack baseline and\/or non-COVID control groups. This makes it problematic to differentiate if symptoms are associated with SARS-CoV2, COVID-19, the vaccine, psychosocial factors or recall bias. In this study, we differentiate these by comparing hearing and tinnitus survey data collected pre- and during the pandemic. The survey conducted during the pandemic asked about the onset and change in three types of symptom. Type One\u2014known association (loss of smell, memory\/concentration issues, persistent fatigue), Type Two\u2014indeterminate association (auditory symptoms), and Type Three\u2014no established association with COVID-19 (toothache). We hypothesized that if auditory symptoms are directly associated with COVID-19, their onset and change would be similar to Type One symptoms, but if indirectly associated (reflecting psychosocial factors and\/or recall bias) would be more similar to Type Three symptoms. Of the 6,881 individuals who responded, 6% reported confirmed COVID-19 (positive test), 11% probably had COVID-19, and 83% reported no COVID-19. Those with confirmed or probable COVID-19 more commonly reported new and\/or worsened auditory symptoms than those not reporting COVID-19. However, this does not imply causality because: (1) new auditory symptoms coincided with COVID-19 illness among just 1\/3 of those with confirmed or probable COVID-19, and another 1\/3 said their symptoms started before the pandemic\u2014despite reporting no symptoms in the pre-pandemic survey. (2) &amp;gt;60% of individuals who had COVID-19 said it had affected their Type 3 symptoms, despite a lack of evidence linking the two. (3) Those with confirmed COVID-19 reported more Type 1 symptoms, but reporting of Type 2 and Type 3 symptoms did not differ between those with confirmed COVID-19 and those without COVID-19, while those who probably had COVID-19 most commonly reported these symptom types. Despite more reports of auditory symptoms in confirmed or probable COVID-19, there is inconsistent reporting, recall bias, and possible nocebo effects. Studies that include appropriate control groups and use audiometric measures in addition to self-report to investigate change in auditory symptoms relative to pre-COVID-19 are urgently needed.<\/jats:p>","DOI":"10.3389\/fpubh.2022.837513","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T07:37:21Z","timestamp":1645515441000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Shedding Light on SARS-CoV-2, COVID-19, COVID-19 Vaccination, and Auditory Symptoms: Causality or Spurious Conjunction?"],"prefix":"10.3389","volume":"10","author":[{"given":"Gabrielle H.","family":"Saunders","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eldre","family":"Beukes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Uus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J.","family":"Armitage","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin J.","family":"Munro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,22]]},"reference":[{"key":"B1","unstructured":"WHO Director-General's Opening Remarks at the Media Briefing on COVID-19 - 11 March 20202020"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical characteristics of coronavirus disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N Engl J Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2331216514541361","DOI":"10.1177\/2331216514541361","article-title":"Viral causes of hearing loss: A review for hearing health professionals","volume":"18","author":"Cohen","year":"2014","journal-title":"Trends Hear."},{"key":"B4","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1038\/s43856-021-00044-w","article-title":"Direct SARS-CoV-2 infection of the human inner ear may underlie COVID-19-associated audiovestibular dysfunction","volume":"1","author":"Jeong","year":"2021","journal-title":"Commun Med."},{"volume-title":"COVID-19 Rapid Guideline: Managing the Long-Term Effects of COVID-19","year":"2020","key":"B5"},{"key":"B6","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1080\/14992027.2021.1896793","article-title":"One year on: an updated systematic review of SARS-CoV-2, COVID-19 and audio-vestibular symptoms","volume":"60","author":"Almufarrij","year":"2021","journal-title":"Int J Audiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1080\/14992027.2020.1776406","article-title":"Does coronavirus affect the audio-vestibular system? 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