Kim Hye Jun, Jeong Seogsong, Kim Kyuwoong, Lee Joon Don, Oh Yun Hwan, Suh Michelle J
Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.
Department of Biomedical Informatics, Korea University College of Medicine, Seoul, South Korea.
EClinicalMedicine. 2024 Jul 29;75:102759. doi: 10.1016/j.eclinm.2024.102759. eCollection 2024 Sep.
The association of COVID-19 with hearing loss (HL) is unclear among young adults and needs to be investigated. This study was conducted to determine the association of COVID-19 with HL and sudden sensorineural hearing loss (SSNHL) in young adults.
This nationwide population-based cohort study used data from the Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service. The study population consisted of young adult citizens aged 20-39 years without a history of HL. All participants were followed up from July 1, 2022 until HL, death, or December 31, 2022. A positive diagnosis of SARS-CoV-2 infection was determined through laboratory testing employing real-time reverse transcription polymerase chain reaction assays using nasopharyngeal or oropharyngeal swabs. The primary and secondary outcomes were HL and SSNHL, respectively. Age, sex, household income, Charlson comorbidity index, COVID-19 vaccination, hypertension, diabetes, and dyslipidemia-adjusted subdistribution hazard ratios (aSHRs) and 95% confidence intervals (CIs) were evaluated using the Fine-Gray subdistribution hazard regression model, considering overall death as a competing event to compare the aSHRs between COVID-19 positive and negative groups.
A total of 6,716,879 young adults were eligible for the analyses. During 40,260,757 person-months (PMs) of follow-up, 38,269 cases of HL and 5908 cases of SSNHL were identified. The risk of HL (incidence: 11.9 versus 3.4/10,000 PMs; SHR, 3.51; 95% CI, 3.39-3.63; aSHR, 3.44; 95% CI, 3.33-3.56; < 0.0001) and SSNHL (incidence: 1.8 versus 0.5/10,000 PMs; SHR, 3.58; 95% CI, 3.29-3.90; aSHR, 3.52; 95% CI, 3.23-3.83; < 0.0001) was higher in COVID-19 group as compared to no COVID-19 group. In the sensitivity analyses that evaluated HL and SSNHL risks after adopting multiple imputations, utilizing inverse probability of treatment weighting, limiting study population to the cohort with a health screening examination, the results were consistent to the primary analysis.
Our findings suggest a heightened risk of HL and SSNHL following COVID-19 in young adults. Due to study limitations, including the lack of objective audiological data, issues with generalizability to other populations, and the retrospective design, careful interpretation is necessary. Further studies with objective audiological data and a longer follow-up period are warranted.
IITP (Institute for Information & Communications Technology Planning & Evaluation; IITP-2024- RS-00156439) and Jeju National University Hospital Research Fund (2023).
新型冠状病毒肺炎（COVID-19）与年轻人听力损失（HL）之间的关联尚不清楚，需要进行调查。本研究旨在确定COVID-19与年轻人HL及突发性感音神经性听力损失（SSNHL）之间的关联。
这项基于全国人群的队列研究使用了韩国疾病控制与预防机构-COVID-19-国民健康保险服务的数据。研究人群包括20至39岁无HL病史的年轻成年公民。所有参与者从2022年7月1日起随访至发生HL、死亡或2022年12月31日。通过使用鼻咽或口咽拭子的实时逆转录聚合酶链反应检测进行实验室检测来确定SARS-CoV-2感染的阳性诊断。主要和次要结局分别为HL和SSNHL。使用Fine-Gray子分布风险回归模型评估年龄、性别、家庭收入、Charlson合并症指数、COVID-19疫苗接种、高血压、糖尿病和血脂异常调整后的子分布风险比（aSHRs）及95%置信区间（CIs），将总体死亡视为竞争事件以比较COVID-19阳性和阴性组之间的aSHRs。
共有6716879名年轻人符合分析条件。在40260757人月的随访期间，确定了38269例HL病例和5908例SSNHL病例。与未感染COVID-19的组相比，COVID-19组发生HL（发病率：11.9比3.4/10000人月；标准化风险比（SHR），3.51；95%CI，3.39 - 3.63；aSHR，3.44；95%CI，3.33 - 3.56；P < 0.0001）和SSNHL（发病率：1.8比0.5/10000人月；SHR，3.58；95%CI，3.29 - 3.90；aSHR，3.52；95%CI，3.23 - 3.83；P < 0.0001）的风险更高。在采用多重填补、使用治疗权重逆概率、将研究人群限制在进行健康筛查检查的队列后评估HL和SSNHL风险的敏感性分析中，结果与初步分析一致。
我们的研究结果表明，年轻人感染COVID-19后发生HL和SSNHL的风险增加。由于研究存在局限性，包括缺乏客观听力数据、对其他人群的可推广性问题以及回顾性设计，因此需要谨慎解读。有必要开展进一步的研究，提供客观听力数据并延长随访期。
信息通信技术规划与评估研究所（IITP；IITP - 2024 - RS - 00156439）和济州国立大学医院研究基金（2023）。
