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DOI 10.37219/2528-8253-2025-3-4-16

Shydlovska TA, Bezega MI, Volkova TV  Bezega BM
USE OF A SPECIAL QUESTIONNAIRE
TO DETECT DAMAGE TO SENSORY SYSTEMS IN COVID-19 PATIENTS
Shydlovska Tetiana A
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Med-ical Science of Ukraine”; Kyiv, Ukraine.
Head of the laboratory of voice and hearing
Doctor of Medical Sciences, Professor
E-mail: lorprof3@ukr.net
Orchid ID: https://orcid.org/0000-0002-7894-359X
Bezega Mychailo I
Poltava State Medical University
Department of Otorhinolaryngology with Ophthalmology
Candidate of Medical Sciences
Email: lorbezega@gmail.com
ORCID ID: https://orcid.org/0000-0002-1250-1190
Volkova Tetyana V
State Institution “O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Med-ical Science of Ukraine”; Kyiv, Ukraine
Laboratory for Occupational Voice and Hearing
Junior Researcher
E-mail: amtc@kndio.kiev.ua
Orchid ID: https://orcid.org/0000-0002-7894-359X
Bezeha Bohdan M
Communal enterprise «M.V. Sklifosovsky Poltava Regional Clinical Hospital Poltava Regional Council»
ENT department
Otolaryngologist
Email: bogdanbezegalor@gmail.com
ORCID ID: https://orcid.org/0000-0003-0517-9989

Abstract

From the first strains of the SARS-CoV-2 virus to the present-day mutations, it has been shown that the disease can cause changes in sensory systems – leading to impaired smell, taste, hearing and other sensory disorders. At the same time, the clinical manifestations of the disease have changed somewhat over time. Disruption of the sensory function affects the quality of life of patients and, in the absence of timely treatment, can be persistent and irreversible. Despite a significant number of studies, the various clinical manifestations of the disease are still poorly understood. and early targeted therapy is of great medical and social importance

The purpose of this work is to determine the frequency and severity of disorders of the sensory systems in patients with COVID-19 using a special questionnaire in dynamics, taking into account the observation period.

Materials and methods: The results of the application of a special questionnaire developed by us to identify disorders in the auditory, olfactory and olfactory systems, as well as the voice production system in patients with COVID-19 were analysed. The results of the questionnaire of two groups of patients (100 people each) who had contracted SARS-CoV-2 during different observation periods (the period 2020-2021 – group 1, 2022-2024 – group 2) were analysed, and a comparative analysis was carried out.

Results and discussion: In the first years of the pandemic, in 61% of cases, patients identified some of the olfactory function disorders, mainly in the form of anosmia or decreased olfactory sensitivity (38%), however, in 23% of cases, there was a distortion of the sense of smell or its enhancement. Mostly, the olfactory disorder occurred in the first few days of the disease and the sense was partially or completely restored after recovery. However, in 5%, certain disorders persisted for another 1-3, up to 6 months after the illness, and in 8%, the sense of smell did not fully recover 6 months after recovery. Mostly, persistent olfactory function disorders were identified in moderate-severe and severe COVID-19. Over time, the symptom of olfactory disorder during COVID-19 ceased to be the leading one and patients report such manifestations less and less often during the disease. However, it is still relevant for 39% of patients and cases of persistent long-term anosmia or hyposmia still occur in 6% of cases.

Hearing impairment, according to our observations, increased from 56% to 61%, and the vast majority of them had a prolonged (persistent up to 6 months after recovery) and persistent (persistent for more than 6 months after recovery) nature – 38% in the first period and 51% in the second.

Hearing impairment often occurred sometime after COVID-19, both in the 1st period (23%) and in the 2nd (28%). Some patients had progression of existing SNP, 15% in the first period, and 18% in the second. In such patients, the first signs of damage to the auditory system could be noted within a few days of the onset of the disease, or they appeared somewhat later.

We mainly observed sensorineural hearing loss, from the initial ones in the form of changes in the tone curve in an extended frequency range, to moderate lesions according to the International Classification. Some patients, however, had significant hearing impairment of grade 3-4 and even cases of deafness. Moreover, they developed quite rapidly and in most cases had signs of labyrinth infarction. In 17% of cases, there was a conductive component mainly due to impaired function of the auditory tubes due to oedema of the mucous membrane, secretory otitis media and inflammatory processes of the middle ear.

Vestibular function disorders in the form of dizziness were noted by about a third (33% in the first and 27% in the second period) of the examined. Mostly these were dizzinesses that occurred during the illness. In some patients, the symptom persisted after recovery, mainly in patients with sensorineural hearing loss.

Changes in voice function were indicated by 28% of patients, mainly in the form of voice fatigue (16%) and hoarseness (22%). In 8% of patients, we observed a hypotonic of the larynx or vocal fold paresis, which developed 10-14 days after the onset of the disease and worsened over time. Patients with voice disorders sought help from an otolaryngologist mainly 1-2 months after recovery, when voice disorders became chronic.

The data obtained indicate that the presence and severity of symptoms of sensory system damage in COVID-19 change over time and require further observation.

Conclusions:

  1. COVID-19 disease is often accompanied by damage to the auditory, olfactory and vestibular systems, as well as voice function disorders. Moreover, over time and with virus mutations, the nature of damage to some sensory systems has changed
  2. Olfactory and taste disorders in COVID-19 are usually observed directly during the disease, but in 7% of cases (olfactory disorders) and still persist for a long time after recovery. Compared to the pandemic period, the percentage of damage to the taste and olfactory analysers has significantly decreased.
  3. Hearing and voice function disorders often develop somewhat delayed from the onset of COVID-19 and the manifestations may worsen after the end of the active phase of the disease. Hearing impairments have increased recently from 56 to 61%, mainly due to long-term (increased from 17 to 26%), persistent (increased from 21 to 25%), and delayed (increased from 23 to 28%) impairments. There has also been a slight increase (by 1%) in cases of long-term and persistent voice impairments and delayed voice formation disorders (increased from 8 to 12%).
  4. Vestibular disorders occur mainly during the disease and in the period up to 6 months after recovery, and have slightly decreased in the last observation period. The percentage of complaints from the vestibular system during COVID-19 disease decreased from 16 to 5%, however, complaints of dizziness that lasted up to 6 months after recovery increased slightly from 12 to 18%.
  5. The proposed questionnaire is easy to use, informative and allows for timely detection of disorders of the sensory systems and voice function in patients who have recovered from COVID-19.

Keywords: COVID-19, sensory systems, auditory system, hearing impairment, olfactory function, voice impairment.

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