VESTIBULAR AND OTOLOGICAL SYMPTOMS IN COVID-19 PATIENTS

The aim of this study was to assess the prevalence and characteristics of vestibular and otological symptoms among patients with mild-to-moderate COVID-19. The study included all adults patients with mild-to moderate COVID-19 who were assisted by a medical telephone monitoring center following discharge from the main hospital wards and emergency rooms of the Metropolitan City of Milan in the period from October 1, 2020 to March 31, 2021. Each patient was contacted by experienced physicians daily via telephone to ensure constant monitoring of symptoms from the day of diagnosis until the end of the quarantine period. A total of 1512 patients (765 females, 747 males) met the inclusion criteria. The median age was 51 (± 18.4) years (range 18-100). Dizziness was reported by 251 (16.6%) subjects, among whom 110 (43.8%) complained of lightheadedness, 70 (27.9%) of disequilibrium, 41 (16.3%) of presyncope, and 30 (12%) of vertigo. Among the cases of vertigo, 20 (66.7%) were attributable to benign paroxysmal positional vertigo (VPPB), 6 to vestibular migraine (20%), 2 to vestibular neuritis (6.7%), 1 to labyrinthitis (3.3%) and 1 to Menière's disease (3.3%). Compared to males, females had a higher prevalence of dizziness (20.3% vs 12.9%, p< 0.001). The main otological symptoms reported by the patients were aural fulness (n=100, 6.6%), tinnitus (n=99, 6.5%), and otalgia (n=85, 5.6%), followed by hyperacusis (n=46, 3.0%), otorrhea (n=6, 0.4%), and sudden sensorineural hearing loss (n=3, 0.2%). Dizziness has been underestimated thus far; indeed, one-sixth of the patients in this study complained of new-onset dizziness. This finding suggest that dizziness should be included among the main symptoms of COVID-19. Vestibular and otological symptoms due to COVID-19 deserve careful investigation and monitoring during the period of acute infection.