Since the update thread is now closed, I’ll post my findings here.
I have posted under Software & Applications as this relates to a side effect of Virtualbox.
After the 28th April update, I noticed terrible, distorted audio on guest (Windows 10) and host after the latest virtualbox updates (6.1.20) were applied.
I discovered that Bluetooth audio (via the PulseAudio volume control) was not affected.
Next, I tried changing the host audio driver to ALSA (see image below), and then all was fine on the guest and host.
Same issue here. I tried on a few different guests and they all had same issue. In my case host system audio was sometimes distorted and sometimes delayed 3 or 5 seconds.
Reverting to version 6.1.18 solved the issue for now.
Did you try ALSA host audio driver before downgrading?
I tried again with a CentOS guest with Pulse Audio, and the sound was distorted in the host. After switching to ALSA driver, the sound was clear again.