Auditory complications of COVID-19 infection and vaccination: a TriNetX retrospective cohort study
- 1Department of Otolaryngology– Head & Neck Surgery, Medical University of South Carolina, 135 Rutledge Ave, MSC 550, Charleston, SC 29425 USA
- 2Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ USA
Abstract
Purpose: To assess the incidence of new-onset tinnitus and hearing loss following COVID-19 infection or vaccination using a large, real-world electronic health record database.
Methods: A retrospective cohort study utilizing the TriNetX Global Collaborative Network (180 + million records). Adults without prior tinnitus or hearing loss were grouped by exposure: COVID-19 infection, mRNA vaccination, viral vector vaccination, and unexposed controls. Outcomes included tinnitus (ICD-10-CM: H93.1) and hearing loss (ICD-10-CM: H90) within six months post-index. Propensity score matching controlled for confounding and odds ratios (ORs) were calculated.
Results: mRNA vaccination was associated with increased odds of tinnitus (OR 1.220; 95% CI: 1.189–1.252) and hearing loss (OR 1.214; 95% CI: 1.189–1.240), with small absolute risk differences (0.143% and 0.215%, respectively; p < 0.0001). Viral vector vaccination showed increased tinnitus odds (OR 1.269; 95% CI: 1.114–1.447) but not hearing loss. COVID-19 infection was not associated with tinnitus (OR 1.022; 95% CI: 0.997–1.048) and showed modestly reduced odds of hearing loss (OR 0.930; 95% CI: 0.911–0.950) versus controls. Compared directly, infection conferred lower tinnitus odds and higher hearing loss odds than mRNA vaccination ([OR 0.856; 95% CI: 0.833–0.879] and [OR 1.313; 95% CI: 1.285–1.343], respectively).
Conclusion: COVID-19 infection was not associated with tinnitus or hearing loss. mRNA and viral vector vaccines showed small but significant increases in new-onset tinnitus, with mRNA vaccines also associated with hearing loss. While absolute risks remained low, findings support continued surveillance and research to inform counseling and promote understanding of potential otologic effects.
Related
- Vaccination status and its association with complications among the patients admitted with measles in the dedicated measles hospitals, Dhaka, Bangladesh
- Distinct Longitudinal Antibody Responses Following Primary Influenza Infection or Vaccination in Infants: A Prospective Birth Cohort Study
- Assessing the impact of a gender-neutral approach to HPV vaccination on vaccination coverage for nine-year-old girls in Cameroon: A retrospective, cross-sectional study
- Epidemiology of animal bites and post-exposure vaccination coverage in Davao City, Philippines: A five-year retrospective cohort study, 2019–2023
- Age-specific humoral immune response to SARS-CoV-2: A comparative analysis of antibody levels in children and adults after vaccination with primary series or infection
BibTeX
@article{chun2026auditory,
title = {{Auditory complications of COVID-19 infection and vaccination: a TriNetX retrospective cohort study}},
author = {Warren B. Chun and Kaiwen Chen and Shaun A. Nguyen and Robert F. Labadie},
journal = {European Archives of Oto-Rhino-Laryngology},
year = {2026},
month = jul,
doi = {10.1007/s00405-026-10512-5},
url = {https://doi.org/10.1007/s00405-026-10512-5},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Auditory complications of COVID-19 infection and vaccination: a TriNetX retrospective cohort study
AU - Warren B. Chun
AU - Kaiwen Chen
AU - Shaun A. Nguyen
AU - Robert F. Labadie
PY - 2026
DA - 2026/07/27
JO - European Archives of Oto-Rhino-Laryngology
DO - 10.1007/s00405-026-10512-5
UR - https://doi.org/10.1007/s00405-026-10512-5
AB - Purpose: To assess the incidence of new-onset tinnitus and hearing loss following COVID-19 infection or vaccination using a large, real-world electronic health record database. Methods: A retrospective cohort study utilizing the TriNetX Global Collaborative Network (180 + million records). Adults without prior tinnitus or hearing loss were grouped by exposure: COVID-19 infection, mRNA vaccination, viral vector vaccination, and unexposed controls. Outcomes included tinnitus (ICD-10-CM: H93.1) and hearing loss (ICD-10-CM: H90) within six months post-index. Propensity score matching controlled for confounding and odds ratios (ORs) were calculated. Results: mRNA vaccination was associated with increased odds of tinnitus (OR 1.220; 95% CI: 1.189–1.252) and hearing loss (OR 1.214; 95% CI: 1.189–1.240), with small absolute risk differences (0.143% and 0.215%, respectively; p < 0.0001). Viral vector vaccination showed increased tinnitus odds (OR 1.269; 95% CI: 1.114–1.447) but not hearing loss. COVID-19 infection was not associated with tinnitus (OR 1.022; 95% CI: 0.997–1.048) and showed modestly reduced odds of hearing loss (OR 0.930; 95% CI: 0.911–0.950) versus controls. Compared directly, infection conferred lower tinnitus odds and higher hearing loss odds than mRNA vaccination ([OR 0.856; 95% CI: 0.833–0.879] and [OR 1.313; 95% CI: 1.285–1.343], respectively). Conclusion: COVID-19 infection was not associated with tinnitus or hearing loss. mRNA and viral vector vaccines showed small but significant increases in new-onset tinnitus, with mRNA vaccines also associated with hearing loss. While absolute risks remained low, findings support continued surveillance and research to inform counseling and promote understanding of potential otologic effects.
SN - 0937-4477
SN - 1434-4726
ER -