Trajectory of Tinnitus Distress Across the COVID-19 Pandemic: A Cross-Sectional Analysis of Self-Reported Symptoms

Purpose: This study aimed to evaluate changes in tinnitus severity and distress associated with the COVID-19 pandemic and vaccination, using validated self-report instruments. It further explored patient-reported onset of tinnitus following vaccination, gender differences in symptom severity, and associations with psychological distress. Method: A cross-sectional online survey was completed by 189 adults between December 2023 and April 2024. Participants self-reported tinnitus onset and severity before, during, and after the COVID-19 pandemic using the Tinnitus Handicap Inventory (THI) and the Tinnitus Reaction Questionnaire (TRQ). Additional items assessed COVID-19 vaccination history, infection status, and adverse vaccine reactions. Repeated measures ANOVAs and chi-square tests were used to examine longitudinal changes and group differences. Results: Mean THI scores increased significantly over time: before (M = 9.57, SD = 16.00), during (M = 29.97, SD = 32.30), and current (M = 36.92, SD = 28.04), with large effect sizes across functional, emotional, and catastrophic subscales (p < .001). TRQ scores also rose significantly from before (M = 7.86, SD = 15.29) to during (M = 26.38, SD = 29.58) and remained elevated at current (M = 29.79, SD = 24.00), p < .001. Approximately 25.9% and 27.0% of respondents reported new or worsened tinnitus after the first and second vaccine doses, respectively. No significant gender differences in symptom severity were observed. TRQ severity classification revealed a marked shift, with moderate or greater distress increasing from 5.8% (before) to 35.6% (current). Conclusion: Tinnitus burden significantly increased during the COVID-19 pandemic and remained elevated at the time of survey completion. A notable proportion of individuals reported new-onset tinnitus following vaccination, though causality cannot be inferred. These findings highlight the need for continued monitoring and comprehensive care addressing both audiological and psychological components of tinnitus.