February - May 2020

A lot of things have occurred in 2020, one of which is the lock-down policy of the Italian government in order to prevent the spread of the SARS-CoV-2 pandemic.

Despite the fact that the Portal is an on-line entity, the various global lock-downs have impacted significantly our internal update procedures. At this very moment we do not have any estimate of when things will go back to normal and when the Portal contributors will be back on-line !!

I have been following the race to find a cure against the virus, my personal opinion is that this will be rather difficult till we understand exactly what is the SARS-CoV-2 and which  are exactly the targeting tissues. The respiratory complications are ONLY a part of the global infection activity.

In terms of drugs Chloroquine and Hydroxychloroquine have been widely promoted in various clinical setups, but data in the literature have suggested that in many treated cases side effects such as sensorineural hearing loss, tinnitus, and/or persistent imbalance, are  common. Azithromycin,  has been administered often in combination to Hydroxychloroquine, reinforcing its action, in SARS-CoV-2 patients. It has also been reported to cause both reversible and irreversible sensorineural hearing loss and tinnitus. Remdesivir and Favipiravir, are antiviral, adenosine nucleotide analogues, reported as a possible useful treatment against SARS-CoV-2. However, ototoxicity has been included amongst the possible side effects of adenosine nucleotide analogues; specifically, data in the literature report that patients may develop irreversible unilateral or bilateral hearing loss and tinnitus due to the use of these antivirals, usually after few weeks of administration.

The reason I presented the above excursus on the SARS-CoV-2 drug treatment strategies,  is that the fastest and most accurate methods to detect objectively ototoxicity are protocols based on otoacoustic emissions.

I am assuming that around the end of the year we will see the first publications coming out in the literature.