Neonatal Hearing Screening and Prevalence of Hearing Impairment in the Time Period of COVID-19 Epidemic in the North of Iran

Background and Aim: COVID-19 is an acute respiratory disease, caused by a coronavirus named SARS-CoV-2. Previous reports suggest an association between COVID-19 infection and Hearing Loss (HL). We have investigated the Universal Newborn Hearing Screening (UNHS) results in the time period of COVID-19 epidemic in Guilan Province, north of Iran. 
Methods: We analyzed UNHS results from10 major obstetrics hospitals from 20th Mar 2020 to 19th Mar 2021, and compared the total UNHS positive/“refer” and total neonatal HL reports with the same time periods of recent three years. The prevalence of risk factors for HL were analyzed during the same period. 
Results: The total number of childbirth was decreased significantly from 27735 birth cases  in Mar 2017-2018 to 18216 births in Mar 2020-2021 (p<0.001), but the total “refer” rate was significantly increased from 63.0 per 1,000 births in Mar 2019-2020 to 79.8 in Mar 2020-2021 (OR=1.29, 95% CI: 1.19-1.39, p<0.001), and also increased from 74.7 per 1,000 births in Mar 2017-2020 to 79.8 in Mar 2020-2021 (OR=1.07, 95% CI: 1.01-1.14, p=0.020). The HL rate increased from 10.3 per 10,000 births in Mar 2019-2020 and from 11.4 per 10,000 births in Mar 2017-2020 to 18.7 in Mar 2020-2021 (OR=1.81 and 1.63, 95% CI: 1.06-3.09 and 1.10-2.44, p=0.028 and 0.015, respectively). The prevalence of preterm birth (p=0.039) and neonatal intensive care unit stay (p=0.016) was increased significantly during Mar 2020-2021. 
Conclusion: The chance of “refer” results and neonatal HL, found in the UNHS program, increased during the COVID-19 epidemic in comparison to the past years. 
Keywords: Newborn; hearing screening; hearing loss; COVID-19