Impact of COVID-19 on diagnosis and management of newborn hearing loss

Leona J Tu; Liliya Benchetrit; Cheryl K Glovsky; Michael S Cohen

doi:10.1016/j.ijporl.2023.111598

Impact of COVID-19 on diagnosis and management of newborn hearing loss

Int J Pediatr Otorhinolaryngol. 2023 Jul:170:111598. doi: 10.1016/j.ijporl.2023.111598. Epub 2023 May 13.

Authors

Leona J Tu¹, Liliya Benchetrit², Cheryl K Glovsky³, Michael S Cohen³

Affiliations

¹ Drexel University College of Medicine, Philadelphia, PA, 19129, USA. Electronic address: ljt38@drexel.edu.
² Department of Otolaryngology-Head and Neck Surgery, Boston University Medical Center, Boston, MA, 02118, USA.
³ Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA.

Abstract

Introduction: The COVID-19 pandemic has caused unexpected disruptions in patient care, including adherence to the Early Hearing Detection and Intervention (EHDI) 1-3-6 guidelines. These guidelines mandate newborn hearing screening (NHS) by 1 month of age, diagnosis of hearing loss (HL) by 3 months, and referral to Early Intervention by 6 months. The objective of this study was to investigate the impact of COVID-19 on EHDI benchmarks in a major US city to help clinicians address current needs and prepare for future disruptive events.

Methods: Retrospective review was performed for all patients who did not pass NHS at two tertiary care centers between March 2018 and March 2022. Patients were divided into three cohorts based on the periods of time before, during, and after the COVID-19 Massachusetts State of Emergency (SOE). Demographics, medical history, NHS results, Auditory Brainstem Response results, and hearing aid (HA) intervention data were collected. Two-sampled independent t-tests and analysis of variance were used to compute rate and time outcomes.

Results: 30,773 newborns underwent NHS and 678 failed NHS. There was no difference in 1-month benchmark NHS rates, increased 3-month benchmark HL diagnosis rate post-SOE COVID (91.7%; p = 0.002), and increased 6-month benchmark HA intervention rate post-SOE COVID compared to pre-COVID (88.9% vs. 44.4%; p = 0.027). Mean time to NHS was lower during SOE COVID compared to pre-COVID (1.9 days vs. 2.0 days; p = 0.038) and mean time to HL diagnosis was higher during SOE COVID (47.5 days; p < 0.001). Lost to follow-up (LTF) rate at HL diagnosis decreased post-SOE (4.8%; p = 0.008).

Conclusion: No differences in EHDI 1-3-6 benchmark rates between pre-COVID and SOE COVID patients were observed. However, increased 3-month benchmark HL diagnosis and 6-month benchmark HA intervention rates and a decreased LTF rate at 3-month benchmark HL diagnosis were observed post-SOE COVID.

Keywords: Auditory brainstem response; COVID-19; Hearing loss; Outcomes; Pandemic; SARS-CoV-2.

MeSH terms

COVID-19 Testing
COVID-19*
Deafness*
Hearing Loss* / diagnosis
Hearing Loss* / epidemiology
Hearing Loss* / therapy
Hearing Tests / methods
Humans
Infant
Infant, Newborn
Neonatal Screening / methods
Pandemics