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Summary: Background: The association of COVID-19 with hearing loss (HL) is unclear among young adults and needs to be investigated. This study was conducted to determine the association of COVID-19 with HL and sudden sensorineural hearing loss (SSNHL) in young adults. Methods: This nationwide population-based cohort study used data from the Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service. The study population consisted of young adult citizens aged 20–39 years without a history of HL. All participants were followed up from July 1, 2022 until HL, death, or December 31, 2022. A positive diagnosis of SARS-CoV-2 infection was determined through laboratory testing employing real-time reverse transcription polymerase chain reaction assays using nasopharyngeal or oropharyngeal swabs. The primary and secondary outcomes were HL and SSNHL, respectively. Age, sex, household income, Charlson comorbidity index, COVID-19 vaccination, hypertension, diabetes, and dyslipidemia-adjusted subdistribution hazard ratios (aSHRs) and 95% confidence intervals (CIs) were evaluated using the Fine–Gray subdistribution hazard regression model, considering overall death as a competing event to compare the aSHRs between COVID-19 positive and negative groups. Findings: A total of 6,716,879 young adults were eligible for the analyses. During 40,260,757 person-months (PMs) of follow–up, 38,269 cases of HL and 5908 cases of SSNHL were identified. The risk of HL (incidence: 11.9 versus 3.4/10,000 PMs; SHR, 3.51; 95% CI, 3.39–3.63; aSHR, 3.44; 95% CI, 3.33–3.56; P |
