Since the beginning of the COVID-19 outbreak a growing number of symptoms and difficulties associated with the virus have emerged, among them are tinnitus and audio-vestibular (hearing and balance) difficulties. Understanding tinnitus, hearing and balance issues can help us diagnose and treat our patients.
What is Tinnitus?
Tinnitus is the perception of sound when no actual external noise is present. Most people refer to it as “ringing in the ears”. Tinnitus can sound like many different things. Some people report buzzing, hissing, whistling, roaring, whooshing, and clicking. Tinnitus can be both a temporary condition or an ongoing condition.
Tinnitus is not a disease itself, but rather a symptom of some other underlying health condition. In most cases, tinnitus is a sensorineural reaction in the brain due to damage in the ear and hearing system. While tinnitus is often associated with hearing loss, there is roughly 200 different health conditions that can have tinnitus as an underlying symptom.
Is there a Connection Between Tinnitus and COVID-19?
Some COVID-19 patients have reported experiencing tinnitus. A 2021 systematic review estimated that 14.8% of people who developed the virus experienced tinnitus as a symptom 1. The reason why COVID-19 may lead to tinnitus is still largely unknown. Tinnitus during the virus is generally believed to be caused by damage or inflammation in the inner ear. This may happen due to viral infection or because of your body’s immune response.
Having COVID-19 may also make pre existing tinnitus worse for some people. In a study published in Frontiers in Public Health, the authors surveyed 3,103 people with pre-existing tinnitus from 48 countries around the world. COVID-19 symptoms aggravated tinnitus in 40% of respondents 2. For many respondents, pandemic-related issues, such as financial concerns, reduced activity, loneliness, and poor sleep, worsened tinnitus symptoms.
COVID-19 and Hearing Loss
An emerging area of research is whether hearing loss can result from COVID-19 and its variants. In a systematic review in 2021 lead by Ibrahim Almufarrij, an estimated 7.6% of people who developed COVID-19 reported hearing loss 1. Those that reported hearing loss stated the difficulties were not part of the initial onset of symptoms but developed days to weeks later.
With the newer variants of COVID-19 such as the Delta variant and Omicron variant, the symptoms reported are possibly linked to more upper respiratory symptoms. Doctors report these variants are putting more pressure on the ears. Extra pressure can possibly cause ear infections, ear pain, congestion, and temporary hearing loss from ear infections.
COVID-19 and Vertigo
The inner ear is commonly known for our sense of hearing. It also consists of the vestibular system or balance system. The vestibular system is located in the inner ear right next to the sensory organ for hearing. It is responsible for providing our brain with information about motion, head position, and spatial orientation. It also is involved with motor functions that allow us to keep our balance, stabilize our head and body during movement, and maintain posture.
The vestibular system is essential for normal movement and equilibrium. An estimated 7.2% of people who developed COVID-19 reported dizziness and rotary vertigo 1. There seemed to be no predictable pattern as to when or why someone might be experiencing this symptom.
Bottom Line on Hearing Loss and Vertigo
How the virus is leading to hearing loss and dizziness is still unknown. More research is needed to discover why hearing loss and vertigo may occur in people who have been diagnosed with COVID-19. Many of the potential explanations are like those that have been mentioned for tinnitus. Damage or inflammation in the inner ear system directly related to the viral infection or the effects of the body’s immune system response.
While scientists and medical experts have learned so much about COVID-19, SARS-CoV-2, and COVID-19 variants, ongoing research is needed to fully understand how the hearing and balance systems are truly affected.
Stress and Tinnitus
Stress from the pandemic may aggravate existing tinnitus. Seeking out support can help. At Texas Sinus and Snoring, Dr. Reyes can assist with managing your tinnitus and hearing difficulties during these stressful times.
If you or your loved one is experiencing any of these symptoms, early detection and treatment is key. Schedule an appointment with our audiologist, Dr. Reyes, so we can assist immediately.
- Almufarrij I, et al. (2021). One year on: An updated systematic review of SARS-CoV-2. COVID-19, and audio-vestibular symptoms.
- Beukes EW, et al. (2020). Changes in tinnitus experiences during the COVID-19 pandemic.