Ear, nose, and throat manifestations of COVID-19 and its vaccines

Abstract

Coronavirus disease 2019 (COVID-19) is a highly infectious disease and was designated a pandemic by the World Health Organization (WHO) on March 11, 2020. There are no classical manifestations of the disease. The most prevalent symptoms include fever, cough, dyspnea, myalgia and headache. The main route of transmission of the severe acute respiratory syndrome coronavirus-2 is through the upper respiratory tract. Therefore, it is not strange to find different ear, nose and throat (ENT) symptoms in individuals infected with this virus. Olfactory dysfunction is a common feature of COVID-19; either it is the only presenting symptom or it accompanies other manifestations of the disease. Other otolaryngological features such as sudden sensorineural hearing loss (SSNHL), dysphonia, nasal obstruction, sore throat, etc. are less frequent manifestations of COVID-19. These features, in addition, to being presented early in the disease process, certain long-standing symptoms like parosmia, dysphonia, and persistent deafness, are other characteristics of the disease. Geographical variation in otorhinolaryngological prevalence is another problem with this debilitating disease. Local and systemic adverse effects (local site injection pain, fever, myalgia, headache, and others) of the COVID-19 vaccines are more frequent than otolaryngological side effects (anosmia, hyposmia, Bell’s palsy, SSNHL, etc.). We aimed in this review to summarize the early and persistent ENT symptoms of COVID-19 or after the various COVID-19 vaccines.

Keywords: COVID-19; Otorhinolaryngological features; Otological features; Rhinological features; Laryngological features; COVID-19 vaccines

Core Tip: The most common otorhinolaryngological manifestations of coronavirus disease 2019 (COVID-19) are olfactory dysfunctions rather than other symptoms (sore throat, nasal obstruction, deafness, dysphonia, tinnitus, etc.). They might be present alone or associated with other common features of the disease (fever, cough, myalgia, headache and dyspnea). Adverse effects of the COVID-19 vaccines include local injection pain, fever, myalgia, headache, and others. Otorhinolaryngological side effects like Bell’s palsy, anosmia and deafness due to COVID-19 vaccines are reported in the literature as individual cases or small case series. We review the currently available evidence regarding the otorhinolaryngological features of COVID-19 or after vaccination.