COVID-19 is associated with a wide range of short-term and long-term effects, including sensory deficits. While the loss of taste and smell are among the most common sensory deficits experienced during and after COVID-19 infection, there is a fraction of people who also experience ear infections as well as hearing and balance issues.
Does that mean that COVID-19 can cause hearing loss? And what can be done to prevent it? Read on to find out.
Is there a connection between COVID-19 and ear infections?
Though the chance of experiencing ear infections after contracting COVID is low, it’s not impossible.
Some evidence suggests that COVID-19 may lead to infections of the middle and inner ear. Additionally, a 2021 research review found that about 3% of people with COVID-19 experienced hearing loss, ringing in the ears, and dizziness.
There have also been reports of long COVID patients who experience post-COVID ear problems despite not exhibiting these symptoms when they tested positive.
Middle ear infections and COVID-19
Middle ear infections, also known as acute otitis media, usually occur after an upper respiratory infection.
The middle ear is a small space behind the ear drum that connects to the throat via the eustachian tube. When you contract a bacterial or viral infection, fluid builds up in the eustachian tube and causes it to swell. This can lead to pain, discomfort, muffled hearing (as if you are ‘underwater’), and an infection.
Given that SARS-CoV-2 classifies as a virus, it can potentially cause middle ear infections in the same way that other viruses such as the flu or the common cold can.
Inner ear infections and COVID-19
A team of researchers at Stanford University School of Medicine identified ten patients with COVID-19 who experienced varying degrees of hearing loss, tinnitus, and vertigo after contracting the virus. They then studied the effects of COVID-19 on the human inner ear and found that two types of inner ear cells express the proteins needed for SARS-CoV-2 infection:
- Vestibular hair cells: Vestibular hair cells help us detect motion and keep us in balance.
- Schwann cells: Schwann cells help form the myelin sheath (or protective layer) around the neurons of the peripheral nervous system.
While scientists haven’t proven that COVID-19 can directly damage hearing, some evidence suggests that the virus can reach the middle and inner ear and affect their cells, causing hearing and balance symptoms. In short, the researchers found that it is likely for a SARS-CoV-2 inner ear infection to affect one’s hearing and balance.
What are the symptoms of COVID-19 and ear infections?
COVID-19 and ear infections don’t have very many similar symptoms, save for fever and headache. Below, we highlight the common symptoms of the two illnesses.
Common symptoms of COVID-19
COVID-19 symptoms vary widely across patients. Some patients exhibit mild respiratory symptoms (congestion, cough, sore throat) that can be treated with over-the-counter medications and bed rest. Others with severe cases may experience difficulty breathing, chest pain, and other complications that require hospitalization.
Some of the commonly reported symptoms of COVID-19 include:
- Headache
- Nasal congestion or runny nose
- Sore throat
- Cough
- Loss of taste or smell
- Shortness of breath or difficulty breathing
- Fever or chills
- Fatigue
- A general feeling of being unwell or malaise
- Body aches
- Nausea
- Vomiting
- Diarrhoea
Symptoms of ear infection
Ear infections often cause mild to moderate ear pain, along with the following symptoms:
- Fever
- Headache
- Loss of appetite
- Trouble sleeping
- Fullness in the ear
- Fluid drainage from the ear
- Hearing loss
- Loss of balance
Ear infections are common in children between six months and three years old. Younger children may not have the capacity to understand or explain what they are feeling, so they may exhibit different symptoms and express pain differently from adults.
Here are some common symptoms of ear infections in children:
- Difficulty nursing or loss of appetite
- Difficulty sleeping
- Behavioural problems
- Excessive crying
- Pulling at the ear
- Hitting or banging the side of the head
- Excessive clinginess
- Fever
How long do ear infections last with COVID-19?
With or without COVID-19, ear infections typically improve after two to three days. If symptoms persist, healthcare providers usually prescribe antibiotics to rid the body of any bacteria that could be causing the ear symptoms.
Bear in mind that you should never take antibiotics without the guidance of a medical professional, as improper use of antibiotics could lead to antibiotic resistance. This can make it harder for your body to fight off bacterial infections in the future.
How to manage distressing changes in hearing
Whether temporary or permanent, a hearing impairment diagnosis can be hard to accept. Without the right coping mechanisms, people who experience hearing changes can struggle with anxiety and depression, have trouble communicating, and feel isolated from their loved ones and community.
If you are having a hard time with your hearing loss, consider the following tips:
Surround yourself with a strong support system
Approach your hearing loss like you would any other loss. Allow yourself to grieve and leave space for difficult emotions such as anger and regret.
However, don’t allow yourself to get stuck in the grieving process. To move forward, surround yourself with friends, family, a therapist, or even a support group who can empathize, listen, and be there for you as you process everything.
Be patient with yourself
It takes time for people to adjust to major changes, and that includes losing one’s hearing or getting a new device such as a hearing aid or assistive technology. You may get frustrated, become short with your loved ones, and have doubts about ever getting used to your ‘new normal’. Remind yourself that this is all part of the process and you should not be hard on yourself.
Find new ways to communicate
Hearing impairment can make communicating more challenging, but speech is not the only way to convey your feelings and needs. Sign language and body language are things you can study to fill in the gaps left by hearing impairment.
Protect your hearing
Protect your ears from further damage by using protective gear such as ear plugs or ear muffs. These dampen loud noises and reduce the risk of inflicting even more damage to your ears.
Adopt healthier habits and reduce stress
Regular exercise, good sleep hygiene, and mindfulness practices can all help lower your stress levels and keep anxiety at bay.
Regular exercise lowers your blood pressure and allows your body to release feel-good endorphins, as well as reduces the amount of cortisol (the stress hormone) in your body.
Meanwhile, good sleep hygiene is all about creating a routine and a bedroom that is more conducive to getting restful sleep. Remember that getting enough sleep helps your body repair itself – something you need when dealing with an infection.
Avoid checking your phone at least an hour before bed – the blue light emitted by your phone can affect your circadian rhythm and keep you awake for longer. Having a relaxing bedtime routine can also help you fall asleep faster.
Finally, mindfulness practices help stop the fight or flight response that kicks anxiety off in the brain. Meditation can reduce stress and anxiety and even improve physical pain.
Another way to reduce stress is by minimizing your exposure to stressors. Set healthy boundaries around work, relatives, and situations that give you stress.
When to see a doctor
Hearing changes can range from minor annoyances like straining to understand what people are saying in conversation to serious cases of ear ringing. No matter the degree of change you are noticing, it’s important to get checked by a doctor to make sure nothing serious is happening.
You should also see a doctor if you experience persistent or severe ear pain and tenderness, a fever, dizziness, fluid buildup, and drainage.
Getting treated quickly will help prevent any long-term damage caused by an infection. Even though dealing with any kind of health issue may seem frightening at first, early diagnosis and treatment reduces the risk of problems in the future.
The bottom line
The COVID-19 virus has a wide range of effects on the body, including our sensory receptors. While there is no definitive evidence yet that COVID infection causes hearing loss, there is growing evidence that the virus can affect the inner ear and middle ear and even lead to changes in hearing.
For those who have noticed changes in their hearing after contracting the virus, consult with a healthcare professional right away.
