Perfil clínico de pacientes com perda auditiva sensorioneural súbita em vigência da pandemia de COVID-19
Data
2024-02-02
Autores
Peron, Kelly Abdo 
Orientadores
Penido, Norma de Oliveira
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Descrever as principais características clínicas e auditivas dos pacientes com PASNS em vigência da pandemia da COVID-19, assim como correlacionar a recuperação auditiva em subgrupos de indivíduos infectados e não infectados pelo SARS-CoV-2. Métodos: Coorte de pacientes com PASNS unilateral e bilateral, subdivididos em grupos com histórico positivo e negativo para SARS-CoV-2, em vigência da pandemia da COVID-19 entre 2020 e 2022. Foi realizada uma avaliação demográfica e exame audiológico seriado com seguimento de 120 dias. A evolução auditiva foi analisada por meio da média do PTA e dos critérios de recuperação auditiva, com a posterior comparação entre os subgrupos. Resultados: Foram avaliados 52 pacientes com acometimento unilateral (76,9%) e bilateral (23,1%), com predomínio de casos simultâneos, e com 100% da amostra com zumbido em associação. Indivíduos unilaterais e bilaterais apresentaram recuperação auditiva distinta, com pior prognóstico sinalizado pelos indivíduos bilaterais. Em relação a COVID-19, 28,8% dos indivíduos tinham histórico positivo (9 casos unilaterais e 6 bilaterais). Pacientes com COVID-19 grave contraíram a doença no período pré- vacinal e evoluíram com PASNS bilateral simultânea sem recuperação auditiva ao longo do seguimento, evidenciando uma discrepância na recuperação auditiva em relação aos demais grupos estudados, assim como tendência a estabilização auditiva precoce. Conclusão: Observamos uma recuperação auditiva distinta e significativa nos indivíduos com acometimento unilateral e bilateral, em relação a média de seguimento do PTA, apesar de não ter sido vislumbrada uma diferença no acometimento auditivo inicial. Encontramos uma maior incidência de PASNS bilateral simultânea em pacientes com COVID-19 grave e não vacinados. Nos pacientes com COVID-19, os indivíduos com acometimento unilateral e bilateral evoluíram de forma significativamente distinta, denotando uma tendência de recuperação auditiva completa na PASNS unilateral, fato oposto ao encontrado nos indivíduos bilaterais, com propensão para pior prognóstico. Não identificamos impacto auditivo nos indivíduos sem histórico da COVID-19.
Objective: To describe the main clinical and auditory characteristics of patients with sudden sensorineural hearing loss (SSNHL) during the COVID-19 pandemic, as well as to correlate hearing recovery in subgroups of individuals infected and not infected by SARS-CoV-2. Methods: Cohort of patients with unilateral and bilateral SSNHL, subdivided into groups with positive and negative history for SARS-CoV-2, during the COVID-19 pandemic between 2020 and 2022. A demographic assessment and serial audiological examination with follow-up were performed 120 days. Hearing evolution was analyzed using the mean PTA and hearing recovery criteria, followed by a comparison between the subgroups. Results: 52 patients with unilateral (76.9%) and bilateral (23.1%) involvement were, evaluated predominantly presenting simultaneous cases, and 100% of the sample reporting associated tinnitus. Unilateral and bilateral cases presented distinct hearing recovery, with a worse prognosis indicated by bilateral cases. Regarding COVID-19, 28.8% of individuals had a positive history (9 unilateral and 6 bilateral cases). Patients with severe COVID-19 contracted the disease in the pre-vaccination period and developed simultaneous bilateral SSNHL without hearing recovery throughout the follow-up, showing a discrepancy in hearing recovery in relation to the other groups studied, as well as a tendency towards early hearing stabilization. Conclusion: We observed a distinct and significant hearing recovery in individuals with unilateral and bilateral involvement, in relation to the PTA average follow-up, although no difference was seen in the initial hearing impairment. We found a higher incidence of simultaneous bilateral SSNHL in patients with severe COVID-19 and they were not vaccinated. Among patients with COVID-19, individuals with unilateral and bilateral involvement progressed significantly differently, indicating a tendency to a complete hearing recovery in unilateral SSNHL, contrary to findings in bilateral individuals, with a propensity for a worse prognosis. We did not identify hearing impact in individuals without COVID-19 positivity.
Objective: To describe the main clinical and auditory characteristics of patients with sudden sensorineural hearing loss (SSNHL) during the COVID-19 pandemic, as well as to correlate hearing recovery in subgroups of individuals infected and not infected by SARS-CoV-2. Methods: Cohort of patients with unilateral and bilateral SSNHL, subdivided into groups with positive and negative history for SARS-CoV-2, during the COVID-19 pandemic between 2020 and 2022. A demographic assessment and serial audiological examination with follow-up were performed 120 days. Hearing evolution was analyzed using the mean PTA and hearing recovery criteria, followed by a comparison between the subgroups. Results: 52 patients with unilateral (76.9%) and bilateral (23.1%) involvement were, evaluated predominantly presenting simultaneous cases, and 100% of the sample reporting associated tinnitus. Unilateral and bilateral cases presented distinct hearing recovery, with a worse prognosis indicated by bilateral cases. Regarding COVID-19, 28.8% of individuals had a positive history (9 unilateral and 6 bilateral cases). Patients with severe COVID-19 contracted the disease in the pre-vaccination period and developed simultaneous bilateral SSNHL without hearing recovery throughout the follow-up, showing a discrepancy in hearing recovery in relation to the other groups studied, as well as a tendency towards early hearing stabilization. Conclusion: We observed a distinct and significant hearing recovery in individuals with unilateral and bilateral involvement, in relation to the PTA average follow-up, although no difference was seen in the initial hearing impairment. We found a higher incidence of simultaneous bilateral SSNHL in patients with severe COVID-19 and they were not vaccinated. Among patients with COVID-19, individuals with unilateral and bilateral involvement progressed significantly differently, indicating a tendency to a complete hearing recovery in unilateral SSNHL, contrary to findings in bilateral individuals, with a propensity for a worse prognosis. We did not identify hearing impact in individuals without COVID-19 positivity.