Abstract
Tinnitus is a symptom that can significantly affect the quality of life of every patient. In patients with tinnitus, one of the most important diagnostic element is medical history data. Patients classify the pitch and loudness of tinnitus graphically using the visual analog scale (VAS). Visual analog scale and similar questionnaires constitute a valuable addendum of the clinical picture in patients with tinnitus. It seems essential, especially in the light of the information presented in the case report on the probability of correlation between tinnitus and stress and depression associated with social isolation infection avoidance. The knowledge about the patient’s hearing condition before contracting COVID-19, the early symptoms of SARS-CoV-2 infection, the method of diagnosis of the infection, the time and method of isolation of the patient, and the time from the diagnosis of COVID-19 to the appearance of otolaryngological symptoms might enable the reader to gain more knowledge on the correlation between COVID-19 and tinnitus. New research reveals that tinnitus is being exacerbated by COVID-19.
We have read the case study presented by Chirakkal et al “COVID-19 and tinnitus” with great interest. 1 Since we feel unsatisfied with the information provided, we present our questions and doubts in this letter.
Tinnitus is a symptom that can significantly affect the quality of life of every patient. The authors performed the only audiometric assessment of the frequency and intensity of tinnitus in the patient post-COVID-19. They assessed the frequency and intensity of the tinnitus 4 kHz and 10 dB, respectively. In the Department of Otolaryngology, Medical University of Gdansk, Poland, as in most centers that manage patients with tinnitus, one of the most important diagnostic element is medical history data. Patients classify the pitch and loudness of tinnitus graphically using the visual analog scale (VAS). Our patients receive questionnaires that assess how troublesome their tinnitus is and its influence on their daily activity and ability to function. We compare the VAS results and questionnaires before and after treatment, which assesses therapy results objectively. 2,3 Visual analog scale and similar questionnaires constitute a valuable addendum of the clinical picture in patients with tinnitus. It seems essential, especially in the light of the information presented in the case report on the probability of correlation between tinnitus and stress and depression associated with social isolation infection avoidance.
The authors’ opinion about the low-frequency hearing loss (0.25, 0.5, 1 kHz) as attributed to COVID-19 seems interesting, though premature. So far, the opinions of other researchers are different. Mustafa compared the results of audiometric tests in 20 asymptomatic patients infected with SARS-CoV-2 and a control group of 20 healthy people. In the first group, he showed hearing impairment in the high-frequency range (4, 6, 8 kHz). 4 We agree with the authors on the need of further tests and larger sample size, which would enable to form an appropriate opinion on the subject.
In the case study, it is noticeable that there is no information provided on the following: patient’s hearing condition before contracting COVID-19; the early symptoms of SARS-CoV-2 infection; the method of diagnosis of the infection; the time and method of isolation of the patient; and the time from the diagnosis of COVID-19 to the appearance of otolaryngological symptoms. Answering these might enable the reader to gain more knowledge on the correlation between COVID-19 and tinnitus. New research reveals that tinnitus is being exacerbated by COVID-19. 5 Knowledge on this subject is expanding but remains insufficient. 6 -10
