Sudden sensorineural hearing loss and COVID-19
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Sudden sensorineural hearing loss (SSNHL) could be a nonspecific symptom of a SARS-CoV-2.

In their study, the authors enrolled 5 male patients with unilateral SSNHL and evaluated them for SARS-CoV-2 using real-time polymerase chain reaction (RT-PCR) testing; the authors reported that only one subject was positive for RT PCR testing and, therefore, they noted a positive response to COVID-19 specific treatment in this positive patient.

SNNHL has multiple etiologies, such as vascular, viral and autoimmune, and its incidence is increasing yearly. Viral infections are considered one of the most common etiologies of this disease. High serum levels of antiviral antibodies, such as antibodies against cytomegalovirus, herpes zoster, herpes simplex type 1, influenza B, enterovirus, and rubeola have been isolated from the serum of patients with SSNHL.

However, the precise etiopathogenesis of viral infections in SSNHL is still unclear. The main hypothesis on how viral infections could lead to SSNHL is the invasion of cochlear nerve or of the soft tissues of the cochlea. Most SSNHL recovery occur within the first 2 weeks after onset; even without treatment a significant percentage of patients may experience complete or partial recovery.

By searching in scientific literature, even in the largest analyses of hospitalized COVID-19 patients, SSNHL is not mentioned as a possible consequence of SARS-CoV-2 infection.

Conclusively, the authors’ statements that “it should be kept in mind that non-specific symptoms such as SSNHL could be the only sign to recognize COVID-19 cases” is very interesting but should be supported by larger case series.