*Corresponding author: Adriana Perez Ferreira Neto, Department of Otorhino- laryngology-Head and Neck Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, 821 Botucatu St, Sao Paulo, SP, Brazil, Tel: (+55 11) 5576- 4848; E-mail: dri_neto@msn.com Citation: Neto APF, Costa MB, de Barros Suzuki FA, Onishi ET (2021) Tinnitus Increase during the COVID-19 Pandemic in Brazil. J Otolaryng Head Neck Surg 7: 63. Received: November 07, 2021; Accepted: November 23, 2021; Published: November 30, 2021 Copyright: © 2021 Neto APF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits un- restricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction In December 2019, a new type of corona virus was identifed in a group of adults with pneumonia of unknown etiology in Wuhan, Chi- na. The new virus was named severe acute respiratory syndrome co- rona virus 2 (SARS-CoV-2), and the disease caused by it was termed corona virus disease 2019 (COVID-19) [1]. The World Health Orga- nization, concerned with the severity and quick spread of the virus, characterized COVID-19 as a pandemic in March 2020 [2]. The transmission of COVID-19 occurs mainly from person to person. In order to reduce the spread of the disease, in March 2020, several states in Brazil adopted lockdown, with the closure of non-es- sential services, such as restaurants, movie theaters, stores, schools, outpatient clinics etc [3]. These measures had socioeconomic, psy- chological and health care delivery impacts [4-7]. Tinnitus may be defned as the conscious awareness of a sound in the absence of a corresponding external auditory stimulus [8]. The prevalence of tinnitus is estimated at 11.9% to 30.3% globally [9]. Oiticica and Bittar found a prevalence of 22% in the city of Sao Paulo, and the majority (64%) reported feeling annoyed because of the tin- nitus [10]. Previous studies have shown a close association between tinnitus symptoms and anxiety, depression and insomnia, with signif- icant interference in the quality of life of afected individuals [11,12]. We hypothesized that the impacts resulting from the pandemic could cause an increase in the tinnitus annoyance. Thus, this study aimed to assess whether tinnitus annoyance increased with the pan- demic and to correlate this increase with socioeconomic, psychologi- cal and health care delivery impacts. Methods Patient selection and study design This is a cross-sectional study approved by the Ethics Commit- tee of our institution (protocol 41820820.7.0000.5505), including patients previously followed up at the tinnitus outpatient clinic of a tertiary referral center. The outpatient services were suspended from March to July 2020, due to the lockdown. When outpatient visits were allowed again, patients were invited to participate in the study by an- swering a standard questionnaire on their frst visit, which occurred between August and October of the same year. The inclusion criteria were as follows: patients with a previous diagnosis of tinnitus, regard- less of etiology, and agreement to participate in the study by signing the informed consent form (ICF).The exclusion criteria were patients under 18 years of age. Standard questionnaire applied The following information was collected through the ques- tionnaire: gender, age, living status, duration of tinnitus, previous treatment for tinnitus and whether this treatment had been inter- rupted with the pandemic, diagnosis of previous hearing loss, tin- nitus characteristics, visual analog scale (VAS) of the annoyance caused by the tinnitus, comorbidities [anxiety, depression, insomnia, Neto APF, et al., J Otolaryng Head Neck Surg 2021, 7: 063 DOI: 10.24966/OHNS-010X/100063 HSOA Journal of Otolaryngology, Head and Neck Surgery Original Article Adriana Perez Ferreira Neto*, Marília Batista Costa, Flávia Alencar de Barros Suzuki and Ektor Tsuneo Onishi Department of Otorhinolaryngology-Head and Neck Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, SP, Brazil Tinnitus Increase during the COVID-19 Pandemic in Brazil Abstract Objective: To assess whether tinnitus annoyance increased with the pandemic and to correlate this increase with socioeconomic, psy- chological and health care delivery impacts. Methods: Cross-sectional study carried out at a tertiary referral cen- ter between August and October 2020 by applying a standard ques- tionnaire to outpatients previously followed up for tinnitus, assessed in their frst visit after lockdown. Results: Our study group comprised 71 patients. The impacts resulting from the pandemic included: compliance with social dis- tancing (90.1%), decrease in household income (33.8%), weight changes (52.1%), increased consumption of cafeine and/or sugar (21.1%), and tinnitus treatment interruption (19.7%). Tinnitus annoy- ance increased after the pandemic onset for 29 (40.9%) patients. For these 29 patients, the visual analog scale (VAS) for tinnitus an- noyance increased signifcantly from 5.6 to 8.3 (P<.001). The tinnitus annoyance increased in 80.0% of patients with anxiety, compared to 30.4% among patients with no anxiety (P = .001). No correlation was found between the increase in tinnitus annoyance and the other parameters assessed. Conclusion: Tinnitus annoyance increased for 40.9% of the patients included in our study. We found a signifcant correlation between anxiety and increase in tinnitus annoyance after the pandemic onset. Keywords: COVID-19; Pandemic; SARS-CoV-2; Social Isolation; Tinnitus