PURPOSE: This umbrella review synthesizes and discusses systematic reviews (SRs) and meta-analyses (MAs) on auditory outcomes associated with COVID-19 infection and vaccination side effects. It is innovative in offering a comprehensive synthesis of evidence across adults and infants while summarizing vaccine-related auditory side effects. METHOD(S): This literature search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, with no restrictions on population age or symptom severity. Four electronic databases were searched from their inception to October 2024. The Assessment of Multiple Systematic Reviews 2 checklist and Risk of Bias in Systematic Reviews tool were used to assess the quality of evidence and the risk of bias. RESULT(S): The systematic search identified 534 articles, narrowed down to 14 SRs following a full-text review: Nine focused on auditory outcomes of COVID-19; two, on outcomes in infants born to mothers infected during pregnancy; and three, on the auditory side effects of vaccination. A random-effects model revealed significantly high pooled estimates of hearing loss (5.0%, 95% CI [1.0, 9.0], p < .012, three MAs, N = 21,932) and tinnitus (13.5%, 95% CI [5.9, 21.1], p <= .001, four MAs, N = 36,236) in adults. However, current evidence in nonhospitalized patients indicates that auditory symptoms often improve after recovery. Studies also show a low rate of hearing loss in infants whose mothers contracted COVID-19 during pregnancy. Similarly, whereas COVID-19 vaccination has been linked to hearing loss and tinnitus, these effects are rare, and most patients experience improvement within weeks to months. CONCLUSION(S): Evidence suggests a significantly high rate of hearing loss and tinnitus associated with COVID-19 in adults, although auditory symptoms remain rare in newborns and following vaccination. However, caution is warranted due to limitations and variability across the studies.
Abstract
All age groups
Pregnant women
COVID-19
Safety
