While we know high body temperature, subsequent fever and a continuous dry cough are some of the most established symptoms of Covid-19, the World Health Organization (WHO) is now looking into how common it may be for infected people to experience a loss of smell (anosmia) or taste (ageusia). Thankfully, recent scientific studies show that from the Omicron variant on, these symptoms tend to disappear. Studies show that these types of disorders generally pass over time and patients should regain full functionality of the senses, although much depends on the extent of the initial impact of infection.
While hearing concerns are not generally reported among those infected with Covid, recent studies suggest that ear pain and excessive pressure in the ears may be one of the symptoms of Covid-19 and other ear-related conditions can be related to the virus onset.
Ear pain is one of the least common ear-related covid-19 symptoms. But, since the onset of the Omicron variant, its incidence has increased. This may be due to the fact that the new Covid-19 variants affect the upper respiratory tract more, thus facilitating the onset of symptoms related to the ear. The pain would be generated by the obstruction and the consequent inflammation that Covid-19 causes in the airways.
Indeed, when the upper part of the throat and nose are inflamed, these channels may become blocked thus causing the eustachian tube to no longer function correctly. In turn, this can give rise to discomfort in the ear and cause temporary hearing problems. Evidence for this was discovered by researchers at the Massachusetts Institute of Technology (MIT) and Massachusetts Eye and Ear, who reported evidence that Covid-19 can infect inner ear cells, including hair cells.
Ear pain is not a typical symptom of Covid-19, but some individuals may experience it due to inflammation and congestion affecting the Eustachian tubes. This can lead to pressure changes in the ears.
Additionally, post-Covid complications like sinus congestion or secondary infections may also contribute to ear pain. If ear pain persists, it's best to consult a healthcare provider.
The duration of Covid-19-related ear pain can vary based on the severity of the infection and the underlying cause of the pain. Here’s a general overview:
Probably the most common ear-related symptom of Covid-19 is excessive pressure in the ears and the feeling of clogged ears and ear popping. If you feel ear pressure or clogged ears, do not to use cotton swabs and Q-Tips because you risk making the situation worse.
This feeling of ear pressure, stuffy nose and clogged ear comes from the inflammation that the latest variants of Covid-19 cause in the upper airways. Since many of the symptoms of the virus are like flu ones, this excessive pressure inside the ear is most likely caused by clogged tubes in the ear due to the virus within the system.
More scientifically speaking, when the Eustachian tube (which connects the middle ear to the nasopharynx) becomes blocked, it can lead to a feeling of fullness and pressure in the ear, as well as ear inflammation and otitis media. Therefore, in most cases, once the effect of the virus has ended, the pressure inside the ears should normalize.
For blocked ears related to Covid-19, the goal is often to alleviate congestion or reduce inflammation affecting the Eustachian tubes. Here are some potential treatments:
Here’s how Covid-19 may contribute to ear infections:
A sore throat and itchy ears can be associated with Covid-19, though they are not the most common symptoms. Here’s how they might be connected to the virus:
Ear and jaw pain on one side can occur in relation to Covid-19 due to several possible factors:
A rash behind the ears, though not common with Covid-19, has been reported in some cases due to skin issues during viral infections. Here are some connections to Covid-19:
Tinnitus is the condition of hearing sounds such as ringing or buzzing in the ears, but it can also manifest as the sensation of ears popping or crackling, especially in the case of Covid-19. Here are the main ways the virus may cause or worsen this condition:
Tinnitus is a persistent sound in the ears, which often manifests itself as a very annoying noise like a ring, a hiss or a buzz, and almost always perceived solely by the person affected. The first study on the correlation between tinnitus and Covid-19 was published on the "Frontiers in Public Health" portal and it was on the possibility that Covid-19 can worsen existing tinnitus.
The study was conducted on 3100 people from 48 country, mainly in US and UK, in a population of men and women with prior existing tinnitus aged 18 to 100. The results were quite clear: in fact, 40% of people noticed a worsening of ringing in ears due to Covid-19 infection.
More and more people are complaining about ringing in ears after Covid-19, so researchers started to think that tinnitus can potentially also be a neurological symptom of Post-Covid Syndrome. The aforementioned study confirmed that, as this happened to people with no previous tinnitus. At the same time, data are not consistent yet to affirm tinnitus and post-Covid Syndrome are 100% related.
The association between Covid-19 infection and vertigo and dizziness was initially theorized and confirmed by a study by the University of Manchester and the Manchester Biomedical Research Center, published in the "International Journal of Audiology". The results of the study state that among patients with Covid-19, 7.2% indicate the presence of vertigo as a symptom.
Subsequently, on July 20, 2022, the article “The Prevalence of Dizziness and Vertigo in COVID-19 Patients: A Systematic Review” attempted to pool all the data from 14 previous studies related to vertigo and dizziness as a symptom of Covid-19. 4 of these studies generated case reports, and in all of them, vertigo and dizziness were detected as initial symptoms of Covid-19, preceding those relating to the respiratory tract, which occurred later.
These symptoms usually disappear at the end of the virus infection, however, they can rarely persist in the event of long Covid, as reported in the Manchester study and by Maslovara et al. The study “Post-COVID-19 Benign Paroxysmal Positional Vertigo” revealed the possible persistence of Benign Paroxysmal Positional Vertigo after Covid-19.
An ear infection after Covid-19 can occur as a secondary complication, particularly if the virus caused inflammation in the respiratory system or affected the Eustachian tubes. Here's an overview of the causes of post-Covid-19 ear infections:
Long Covid, or post-Covid syndrome, can lead to various ear-related issues in some individuals. These problems may include:
If these symptoms persist, consulting a healthcare provider or an audiologist is recommended to evaluate and manage ear-related issues caused by long Covid.
To address ear problems caused by Covid-19, you can try several effective strategies.
Finally, if symptoms persist or worsen, it’s essential to seek medical advice to rule out any serious issues or infections that may require targeted treatment.
Learn more about how Covid-19 can affect your ears:
On October 13, 2020, in the journal BMJ Case Reports, the authors reported for the first time a case of sudden hearing loss as a result of the Coronavirus, specifically reporting on a 45-year-old man with asthma who developed sudden hearing loss while on treatment for Covid-19.
The man had never experienced hearing problems and was in good health prior to his diagnosis. After undergoing a physical examination and an MRI scan, doctors were unable to find an alternative trigger for his hearing loss, such as a blockage or swelling. He also tested negative for all other possible causes of hearing loss.
Sars CoV-2, the virus responsible for Covid-19, is known to cause an inflammatory response and has been identified in cells of the middle ear of Covid-19 patients. Suggesting in rare cases, some hearing loss could be related to the coronavirus.
The conclusion is that sensorineural hearing loss can potentially be a rare symptom of Covid-19.
Even if otitis media is not one of the known manifestations of Covid-19, Coronavirus infections and otitis media both have similar symptomatology, such as fever and headache.
Otitis media can surface when Covid-19 affects the upper airways. In this case, the inflammation and consequent obstruction of the Eustachian tube can lead to problems related to the ear, including otitis media. It is therefore not a common symptom, but possibly related to Covid-19.
The study "Labyrinthitis: A Rare Consequence of COVID-19 Infection" published on August 12, 2021 has brought evidence that labyrinthitis may be a rare consequence of Covid-19.
The case study was carried out starting from the case of a 23-year-old English girl who complained of the correlation between the virus and the onset of labyrinthitis. The conclusions of the study state that, in case labyrinthitis is triggered by Covid-19 and there are no other underlying causes, it can be treated with the same conservative measures as most standard viral infections with good outcomes.
Covid-19 can cause ear pain in some individuals, although it is not a primary symptom. This discomfort may stem from Eustachian tube dysfunction, where inflammation and congestion affect the tubes, leading to pressure and pain in the ears.
Additionally, sinus congestion can block nasal passages, creating pressure that impacts the ears and results in discomfort. Furthermore, fluid buildup during recovery can lead to secondary ear infections, contributing to significant pain. If ear pain persists, consulting a healthcare professional is advisable.
Sources:
Increased incidence of otitis externa in covid-19 patients
SARS-CoV-2 infection of the inner ear
The Prevalence of Dizziness and Vertigo in COVID-19 Patients: A Systematic Review
Post-COVID-19 Benign Paroxysmal Positional Vertigo
Sudden irreversible hearing loss post Covid-19
Changes in Tinnitus Experiences during the Covid-19 Pandemic
Labyrinthitis: A Rare Consequence of COVID-19 Infection
