Evaluation of the Peripheral and Central Auditory Systems in Children and Adolescents Before and After COVID-19 Infection.

Unlabelled: COVID-19 is an infectious disease caused by the SARS-CoV-2 virus. During and after COVID-19, audiovestibular symptoms and impairments have been reported.

Objectives: This study aimed to investigate the impacts of COVID-19 on the peripheral and central auditory systems of children and adolescents following the acute COVID-19 phase based on behavioral, electroacoustic, and electrophysiological audiological assessments.

Methods: This is a primary, prospective, observational, and cross-sectional study of 23 children aged 8 to 15 years who acquired confirmed COVID-19 and who, before infection, had not had any auditory complaints or school complications. The results were compared with pre-pandemic data collected from a similar group of 23 children who had normal peripheral and central hearing and good school performance. Each participant answered a questionnaire about child development, school, and health history and underwent tests including pure-tone audiometry and high-frequency audiometry, imitanciometry, transient evoked otoacoustic emissions, and distortion product otoacoustic emissions. They also received tests of Brainstem Auditory Evoked Potentials, Long Latency Auditory Evoked Potentials, Dichotic Digits Test, Sentence Identification Test, Dichotic Consonant-Vowel Test, Frequency Pattern Test, and Gaps-In-Noise Test.

Results: Significant differences were observed between the groups, with the study group showing worse thresholds compared to the control group at both standard audiometric frequencies and at higher frequencies, although both groups were still within normal limits ( ≤ 0.05). In addition, the study group had a higher prevalence of absent responses, as identified by otoacoustic emissions and acoustic reflexes. In terms of central auditory performance, the study group showed ABRs with significantly longer latencies of waves I, III, and V compared to the control group. The study group also performed less well on the Dichotic Digits and Pediatric Speech Identification tests.

Conclusions: COVID-19 appears to alter the auditory system, both peripherally at the level of the outer hair cells and more centrally.