Revised meta-analysis and pooled estimate of audio-vestibular symptoms associated with COVID-19

A rapid review of audio-vestibular symptoms relating to SARS-CoV-2 and COVID-19 appeared in IJA in 2020 (Almufarrij, Uus, and Munro 2020), but the first systematic review and meta-analysis appeared in 2021 (Almufarrij and Munro 2021). Their pooled prevalence estimates of hearing loss, tinnitus and rotatory vertigo, based primarily on retrospective recall of symptoms, were 7.6% (CI: 2.5–15.1), 14.8% (CI: 6.3–26.1) and 7.2% (CI: 0.01–26.4), respectively. Almufarrij and Munro urged caution when interpreting these data because it was not always clear within each study if the symptom associated with SARS-CoV-2 and COVID-19 was new or a change (i.e. the prevalence may have been over-estimated if the symptoms were present before, and unchanged by, COVID-19). With this in mind, we reviewed the 28 studies in their meta-analysis and attempted to contact authors of individual studies where there was uncertainty or missing data. We then conducted a new meta-analysis using more conservative inclusion criteria.