COVID-19 associated anxiety enhances tinnitus

Li Xia; Gang He; Yong Feng; Xiaoxu Yu; Xiaolong Zhao; Shankai Yin; Zhengnong Chen; Jian Wang; Jiangang Fan; Chuan Dong

doi:10.1371/journal.pone.0246328

COVID-19 associated anxiety enhances tinnitus

PLoS One. 2021 Feb 5;16(2):e0246328. doi: 10.1371/journal.pone.0246328. eCollection 2021.

Authors

Li Xia¹, Gang He², Yong Feng², Xiaoxu Yu², Xiaolong Zhao², Shankai Yin³, Zhengnong Chen³, Jian Wang⁴, Jiangang Fan², Chuan Dong²

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Mianyang Central Hospital, Mianyang, Sichuan, China.
² Department of Otolaryngology-Head and Neck Surgery, Sichuan Provincial People's Hospital and Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China.
³ Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
⁴ School of Communication Science and Disorders, Dalhousie University, Halifax, Nova Scotia, Canada.

Abstract

To investigate if the anxiety associated with coronavirus disease 2019 (COVID-19) is a promoting factor to tinnitus. A retrospective research design collected from 188 tinnitus patients, was used to compare the clinical characteristics of tinnitus between the patients in 2020 under pandemic pressure and those from the matching period in 2019. While anxiety was quantified using the Zung's Self-rating Anxiety Scale (SAS), tinnitus severity was evaluated using the Tinnitus Handicap Inventory (THI) questionnaire and the test of tinnitus loudness (TL). The assessments were repeated after the sound therapy plus educational counselling (STEC) for 38 patients in 2020 and 58 patients in 2019 and compared with EC alone therapy for 42 patients in 2020 and 17 patients in 2019. A large increase in anxiety was evident in 2020 in both case rate and SAS. The treatment of both methods was less effective in 2020. SAS, THI and TL were all deteriorated after the EC alone treatment in 2020, while an improvement was seen in 2019. This suggests that EC alone could not counteract the stress by COVID-19 at all, and the stress, if not managed well, can significantly increase the severity of tinnitus and associated anxiety. By using the EC subgroup in virtual control, we conclude that anxiety can serve as a promoting factor to tinnitus. We believe that this is the first study report that confirm the causative/promotive role of anxiety on tinnitus during COVID-19 pandemic.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Anxiety / complications*
COVID-19 / complications*
Female
Humans
Male
Middle Aged
Retrospective Studies
Severity of Illness Index
Sound
Surveys and Questionnaires
Tinnitus / complications*
Tinnitus / diagnosis
Tinnitus / therapy

Grants and funding

This study was funded by Health and Family Planning Commission of Sichuan Province of China [18PJ078] for C.D., the National Natural Science Foundation of China [81770998] for Z.C. and Natural Science & Engineering Research Council of Canada [RGPIN 2017-04493] for J.W. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.