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

Laryngoscope. 2021 Jul;131(7):1626-1632. doi: 10.1002/lary.29424. Epub 2021 Jan 27.


Objective/hypothesis: The 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.

Methods: Medications 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.

Results: Six proposed COVID-19 therapeutics were identified as possessing ototoxic side effects including chloroquine and hydroxychloroquine, azithromycin, lopinavir-ritonavir, interferon, ribavirin, and ivermectin.

Conclusions: Available 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.

Keywords: COVID-19; SSNHL; ototoxicity; tinnitus; vertigo.

Publication types

  • Review

MeSH terms

  • COVID-19 / complications
  • COVID-19 / drug therapy*
  • Humans
  • Ototoxicity / etiology*

Supplementary concepts

  • COVID-19 drug treatment