A Narrative Review of Pharmacologic Treatments for COVID‐19: Safety Considerations and Ototoxicity

Abstract

Objective/HypothesisThe purpose of this review is to summarize evidence‐based data regarding the ototoxic effects of potential COVID‐19 therapeutics to treat patients suffering from SARS‐CoV‐2.MethodsMedications under investigation as novel therapeutics to treat COVID‐19 were identified using the search term coronavirus therapeutics, COVID therapeutics, and SARS‐CoV‐2 therapeutics on ClinicalTrials.gov and the PubMed Database. A literature review was performed using the PubMed Database for each proposed COVID‐19 therapeutic to identify relevant articles. Search criteria included Medical Subject Headings (MeSH) and key word search terms for ototoxicity, vestibulotoxicity, hearing disorders, and vertigo.ResultsSix proposed COVID‐19 therapeutics were identified as possessing ototoxic side effects including chloroquine and hydroxychloroquine, azithromycin, lopinavir‐ritonavir, interferon, ribavirin, and ivermectin.ConclusionsAvailable evidence suggests that ototoxic effects may be improved or mitigated by stopping the offending agent. Recognition of hearing loss, tinnitus, or imbalance/vertigo is therefore crucial to facilitate early intervention and prevent long‐term damage. Hospitals should consider the inclusion of audiologic monitoring protocols for patients receiving COVID‐19 therapeutics with known ototoxicity, especially in high‐risk patient groups such as the elderly and hearing impaired. Laryngoscope, 131:1626–1632, 2021