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Principal Investigator: Kelly M. Reavis
Organization: PORTLAND VA MEDICAL CENTER
Fiscal Year: 2022
Funding agency: Veterans Affairs
Project Background/Rationale: The purpose of this proposal is to quantitatively examine and
qualitatively understand the impact of COVID-19 on Veterans' auditory function. Since the
pandemic began, over 230,000 Veterans in the VA health care system have tested or been
presumed positive for COVID-19. It has been hypothesized that COVID-19 may have adverse
effects on the auditory system, although the extent is unknown. Viral induced hearing loss is not
a new phenomenon and several case studies and case series have reported new onset and
progression of hearing loss and tinnitus, sudden hearing loss (sudden occurrence of acute
hearing loss), ear pain, noise sensitivity and otitis media with respect to COVID-19. Moreover,
we are lacking an understanding of the auditory rehabilitation needs of COVID-19 survivors.
This evidence is required to successfully restore and return Veterans' auditory function to
improve their quality of life.
Project Aims: There is a need to understand the short- and long-term consequences of
COVID-19 on the auditory system, especially among Veterans who are already at risk for
underlying auditory complications, and to conceptualize these within a rehabilitation framework.
The specific aims of this research proposal are to (1) Quantify the burden and impact of COVID-
19 on Veterans' auditory function; and (2) Describe Veterans' experiences with auditory
complications following COVID-19 with respect to timing, onset, clinical course, rehabilitation
needs, and quality of life.
Project Methods: This 2-year pilot project will be accomplished through a mixed-methods
approach with a sequential quantitative-qualitative design. Quantitative data regarding COVID-
19 auditory sequelae will be gathered via patient surveys and review of the electronic medical
record (n=1,566). Qualitative data will be gathered via semi-structured interviews with COVID-
19 patients (n=40). By focusing on the personal and lived experiences among Veterans with
COVID-19, the qualitative aim will explore emerging issues and contextual nuances otherwise
unmeasurable using survey methods. Data will be stratified by hospitalization history so that
unique needs of Veterans with more severe disease can be examined.
Anticipated Impact: Completion of the proposed study will provide evidence for the impacts of
COVID-19 on the auditory system. It is our goal to immediately provide clinicians with a better
understanding of this complex patient population, functional limitations, and perceived
rehabilitation needs. Observed hearing loss and tinnitus may very well become chronic, so the
audiological impact of the pandemic may substantially outlast the current phase. Results of this
study will lead to a VA Rehabilitation Research & Development, Merit Award application
exploring the longitudinal effects of COVID-19 on the ear, hearing, and tinnitus using more
robust and audiometric test measures not feasible in this pilot study.
Terms: <2019 novel corona virus><2019 novel coronavirus><2019-nCoV><ACE2><ARDS caused by sepsis><Acute><Adverse effects><Affect><Audiogram><Audiometric Test><Audiometry><Auditory><Auditory system><Award><Bacterial Pneumonia><Biological><Brain><Brain Nervous System><CMV><COVID infected patient><COVID patient><COVID positive patient><COVID survivors><COVID-19><COVID-19 affected><COVID-19 consequence><COVID-19 effect><COVID-19 exposure><COVID-19 impact><COVID-19 impacted><COVID-19 infected patient><COVID-19 infection><COVID-19 infection survivors><COVID-19 patient><COVID-19 positive><COVID-19 positive patient><COVID-19 positivity><COVID-19 related risk><COVID-19 risk><COVID-19 risk factor><COVID-19 survivors><COVID-19 therapy><COVID-19 treatment><COVID-19 virus><COVID19><COVID19 infection><COVID19 patient><COVID19 positive><COVID19 positive patient><COVID19 positivity><COVID19 therapy><COVID19 treatment><COVID19 virus><CV-19><CV19><Cadaver><Caring><Case Series><Case Study><Cell Body><Cells><Chronic><Clinical><Clotting><CoV emergence><CoV-2><CoV2><Coagulation><Coagulation Process><Cochlea><Cochlear Organ><Communicable Diseases><Complex><Computerized Medical Record><Consequentialism><Cytomegalovirus><Data><Development and Research><Disease><Disorder><Dysfunction><Ear><Earache><Electronic Medical Record><Encephalon><Endothelium><Epidemic Parotitis><Epithelial Cells><Functional disorder><Future><German Measles><Goals><HCMV><Health><Health Care Systems><Healthcare Systems><Hearing><Hearing Disorders><Hearing Loss><Hearing Tests><Hearing problem><History><Hospital Admission><Hospitalization><Hyperacusia><Hyperacusis><Hypoacuses><Hypoacusis><Immune system><Infection><Infectious Disease Pathway><Infectious Diseases><Infectious Disorder><Inflammation><Inflammatory><Interview><Ischemia><Life><Life Experience><Literature><Loudness Perception Disturbances><Loudness Recruitment><MOF syndrome><Mastoid><Mastoid process><Measles><Measures><Medical Rehabilitation><Meningitis><Methods><Morbidity><Morbidity - disease rate><Multiple Organ Dysfunction Syndrome><Multiple Organ Failure><Mumps><Nervous System><Nervous system structure><Neurologic Body System><Neurologic Organ System><Otalgia><Otitis Media><Pathway interactions><Patients><Phase><Physiopathology><Pilot Projects><Prevalence><Process Mastoideus><Pulmonary Body System><Pulmonary Organ System><QOL><Quality of life><R & D><R&D><Receptor Cell><Recording of previous events><Rehabilitation><Rehabilitation therapy><Reporting><Research Proposals><Respiratory Signs and Symptoms><Respiratory System><Respiratory Tracts><Respiratory distress><Respiratory tract structure><Ringing-Buzzing-Tinnitus><Risk><Rubella><Rubeola><SARS corona virus 2><SARS-CO-V2><SARS-COVID-2><SARS-CoV-2><SARS-CoV-2 exposure><SARS-CoV-2 infected patient><SARS-CoV-2 infection><SARS-CoV-2 patient><SARS-CoV-2 positive><SARS-CoV-2 positive patient><SARS-CoV-2 positivity><SARS-CoV-2 survivors><SARS-CoV-2 therapy><SARS-CoV-2 treatment><SARS-CoV2><SARS-CoV2 exposure><SARS-CoV2 infection><SARS-associated corona virus 2><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-related corona virus 2><SARS-related coronavirus 2><SARSCoV2><Salivary Gland Viruses><Severe Acute Respiratory Coronavirus 2><Severe Acute Respiratory Distress Syndrome CoV 2><Severe Acute Respiratory Distress Syndrome Corona Virus 2><Severe Acute Respiratory Distress Syndrome Coronavirus 2><Severe Acute Respiratory Syndrome CoV 2><Severe Acute Respiratory Syndrome-associated coronavirus 2><Severe Acute Respiratory Syndrome-related coronavirus 2><Severe acute respiratory syndrome associated corona virus 2><Severe acute respiratory syndrome corona virus 2><Severe acute respiratory syndrome coronavirus 2><Severe acute respiratory syndrome coronavirus 2 exposure><Severe acute respiratory syndrome coronavirus 2 infection><Severe acute respiratory syndrome coronavirus 2 positive><Severe acute respiratory syndrome coronavirus 2 positivity><Severe acute respiratory syndrome related corona virus 2><Structure><Sudden Hearing Loss><Survey Instrument><Survey Method><Survey Methodology><Surveys><Survivors><Systemic infection><Temporal Lobe><Testing><Therapeutic><Time><Tinnitus><Vascular Smooth Muscle><Veterans><Viral><Virus><Work><Wuhan coronavirus><acute respiratory distress syndrome caused by sepsis><adverse consequence><adverse outcome><airway symptom><allergic/immunologic body system><allergic/immunologic organ system><angiotensin converting enzyme 2><angiotensin converting enzyme II><auditory disease><auditory disorder><auditory dysfunction><auditory pathway><auditory problem><auditory rehabilitation><auditory tests><bacteria pneumonia><base><biologic><case report><chronic effect of COVID-19><co-morbid><co-morbidity><comorbidity><corona virus disease 2019><corona virus emergence><coronavirus disease 2019><coronavirus disease 2019 consequence><coronavirus disease 2019 effect><coronavirus disease 2019 exposure><coronavirus disease 2019 impact><coronavirus disease 2019 infected patient><coronavirus disease 2019 infection><coronavirus disease 2019 patient><coronavirus disease 2019 positive><coronavirus disease 2019 positive patient><coronavirus disease 2019 positivity><coronavirus disease 2019 risk><coronavirus disease 2019 risk factor><coronavirus disease 2019 therapy><coronavirus disease 2019 treatment><coronavirus disease 2019 virus><coronavirus disease infected patient><coronavirus disease patient><coronavirus disease positive patient><coronavirus disease-19><coronavirus disease-19 impact><coronavirus disease-19 patient><coronavirus disease-19 virus><coronavirus emergence><coronavirus infectious disease-19><coronavirus patient><cytokine><cytokine release syndrome><cytokine storm><cytomegalovirus group><decreased loudness tolerance><design><designing><drug induced hearing impairment><drug induced hearing loss><dysfunctional hearing><ear ache><ear pain><emergent CoV><emergent corona virus><emergent coronavirus><emerging CoV><emerging corona virus><emerging coronavirus><epidemic parotiditis><experience><exposure to COVID-19><exposure to SARS-CoV-2><exposure to SARS-CoV2><exposure to Severe acute respiratory syndrome coronavirus 2><exposure to coronavirus disease 2019><hCoV19><hearing assessment><hearing defect><hearing deficit><hearing difficulty><hearing disability><hearing disease><hearing dysfunction><hearing impairment><improved><infected with COVID-19><infected with COVID19><infected with SARS-CoV-2><infected with SARS-CoV2><infected with coronavirus disease 2019><infected with severe acute respiratory syndrome coronavirus 2><interest><long term consequences of COVID-19><long term consequences of SARS-CoV-2 infection><long term consequences of coronavirus disease-19><long term effects of COVID-19><long term health consequences of COVID-19><long term health consequences of SARS-CoV2 infection><long term impact of COVID-19><long term impact of SARS-CoV-2 infection><long-term consequence of severe acute respiratory distress syndrome-cov-2 infection><long-term effects of coronavirus disease-19><longterm consequences of COVID-19><longterm consequences of SARS-CoV-2 infection><longterm effects of COVID-19><longterm health consequences of COVID-19><longterm health consequences of SARS-CoV2 infection><longterm impact of COVID-19><longterm impact of SARS-CoV-2 infection><loudness intolerance><male><middle ear><middle ear infection><military veteran><morbilli><mortality><multiorgan failure><multiple organ system failure><nCoV><nCoV2><new CoV><new corona virus><new coronavirus><noise sensitivity><novel CoV><novel corona virus><novel coronavirus><ototoxic><ototoxicity><pandemic><pandemic disease><pathophysiology><pathway><patient infected with COVID><patient infected with COVID-19><patient infected with SARS-CoV-2><patient infected with coronavirus disease><patient infected with coronavirus disease 2019><patient infected with severe acute respiratory syndrome coronavirus 2><patient population><patient with COVID><patient with COVID-19><patient with COVID19><patient with SARS-CoV-2><patient with coronavirus disease><patient with coronavirus disease 2019><patient with severe acute respiratory distress syndrome coronavirus 2><pilot study><rehab research><rehab therapy><rehabilitation care><rehabilitation research><rehabilitation service><rehabilitative><rehabilitative care><rehabilitative therapy><research and development><respiratory symptom><risk associated with COVID-19><risk factor associated with COVID-19><risk factor related to COVID-19><risk related to COVID-19><sepsis ARDS><sepsis acute respiratory distress syndrome><sepsis associated ARDS><sepsis associated acute respiratory distress syndrome><sepsis induced ARDS><sepsis induced acute respiratory distress syndrome><sepsis related ARDS><sepsis related acute respiratory distress syndrome><severe acute respiratory syndrome coronavirus 2 infected patient><severe acute respiratory syndrome coronavirus 2 patient><severe acute respiratory syndrome coronavirus 2 positive patient><severe acute respiratory syndrome coronavirus 2 therapy><severe acute respiratory syndrome coronavirus 2 treatment><sudden onset hearing loss><survive COVID-19><survive SARS-CoV-2><temporal cortex><treat COVID-19><treat COVID19><treat SARS-CoV-2><treat coronavirus disease 2019><treat severe acute respiratory syndrome coronavirus 2><veteran population>