Auditory Rehabilitation Needs in COVID-19 Survivors

项目背景/理由：本提案的目的是定量研究和 定性了解COVID-19对退伍军人听觉功能的影响。以来 大流行开始，超过230，000退伍军人在VA医疗保健系统已经测试或 可能是新型冠状病毒感染据推测，COVID-19可能会对 对听觉系统的影响，尽管程度尚不清楚。病毒性听力损失不是 一些案例研究和案例系列报告了新的发病情况， 听力损失和耳鸣的进展，突发性听力损失（突然发生急性 听力损失）、耳痛、噪音敏感性和中耳炎。此外，委员会认为， 我们对COVID-19幸存者的听力康复需求缺乏了解。 这些证据是成功恢复和恢复退伍军人的听觉功能所必需的。 提高他们的生活质量。 项目目标：有必要了解的短期和长期后果 COVID-19对听觉系统的影响，特别是在已经有风险的退伍军人中 潜在的听觉并发症，并在康复框架内将其概念化。 本研究提案的具体目标是（1）量化COVID的负担和影响- 19对退伍军人的听觉功能;和（2）描述退伍军人的经验， COVID-19后并发症的时间、发病、临床病程、康复 需求和生活质量。 项目方法：这个为期2年的试点项目将通过混合方法完成， 采用序贯定量-定性设计方法。关于COVID的定量数据- 将通过患者调查和电子医疗器械审查收集19例听觉后遗症。 记录（n= 1，566）。定性数据将通过与COVID的半结构化访谈收集- 19例患者（n=40）。通过关注退伍军人的个人和生活经历， COVID-19，定性目标将探讨新出现的问题和背景的细微差别，否则 无法用调查方法来衡量。数据将按住院史分层，以便 可以检查患有更严重疾病的退伍军人的独特需求。 预期影响：完成拟议的研究将提供证据，证明 新冠肺炎对听觉系统的影响我们的目标是立即为临床医生提供更好的 了解这一复杂的患者人群、功能限制和感知 康复需要。听力损失和耳鸣很可能会成为慢性病，因此， 大流行对听力的影响可能远远超过目前的阶段。成果 研究将导致VA康复研究与发展，优异奖申请 探索COVID-19对耳朵、听力和耳鸣的纵向影响， 稳健和听力测试措施在本试点研究中不可行。

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.