People infected with COVID-19 sometimes report losing their sense of taste or smell. But another sense is also sometimes implicated as well: hearing. While science is still unraveling how exactly hearing loss is related to this viral infection, there does appear to be a connection.
“Even though it feels like we’ve been living with COVID-19 forever, it’s important to remember that we’re only just starting our third year with this virus, so our knowledge on this topic is limited,” says Kevin Seitz-Paquette, a doctor of audiology and the director of the Phonak Audiology Research Center at SonovaGroup in Aurora, Illinois.
Research, however, has been ongoing throughout the pandemic, and some studies have suggested that the SARS-CoV-2 virus that causes COVID-19 “can infect the inner ear where the hearing organ resides,” Seitz-Paquette says. That impact on the delicate organs in the ear can lead to hearing loss.
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A Rare but Possible Complication
Hearing loss is not believed to be one of the more common complications of COVID-19 infection. That’s according to a study from the University of Manchester that found the prevalence of hearing loss following a COVID-19 infection is about 8%.
However, that study relied on patients to accurately remember and report their hearing status prior to infection, making the findings an estimate, “but certainly not an exact figure,” Seitz-Paquette says. “In other words, the actual figure could be much lower if patients were not aware of or did not report hearing loss prior to having COVID-19.”
Hearing loss after a viral infection isn’t an uncommon occurrence, says Dr. Thuong Trinh, a medical and surgical ENT with Orlando Health St. Cloud Hospital in Florida. “With any viral infection, you can get hearing loss. It doesn’t have to be COVID-19,” she says. The viruses that cause measles and chicken pox/shingles can both cause hearing loss, for example. Though it’s typically only in one ear, it can occasionally occur in both ears.
Types of Hearing Loss
It’s important to note that “not all hearing loss is the same,” Trinh says. And these differences mean different approaches to treating the hearing loss.
For example, hearing loss can occur when nerves in the inner ear become damaged or because medication being used to treat the virus damages hearing.
For some people, conductive hearing loss — which occurs when there’s an obstruction, such as from fluid or a foreign object, or an injury to the eardrum that blocks soundwaves from traveling into the inner ears — can also occur as a result of a viral infection. It may be recognizable as that muffled feeling you have when you have a bad sinus infection.
Trinh says this kind of hearing loss isn’t typically permanent. “That’s just a matter of getting all the mucus out and draining the fluid. There’s pretty much no permanent loss,” she says.
[READ: Latest Treatments for COVID-19.]
How COVID-19 Can Lead to Hearing Loss
Seitz-Paquette notes that because COVID-19 is still such a new disease, “the precise mechanism or mechanisms behind a possible link between COVID-19 and hearing loss has not been established. One possibility is that the virus directly infects and damages the cells of the inner ear.”
This could be happening because “receptors called the angiotensin converting enzyme that are in the alveoli of the lungs” are susceptible to the COVID-19 virus, Trinh says. These ACE receptors are “also in neurons, and it may be that the COVID virus is also attacking these receptors on these neurons that can cause the decreased sense of taste, smell and hearing loss,” Trinh says.
Another theory posits that “COVID-19 indirectly damages the inner ear by causing vascular damage,” Seitz-Paquette says. Because COVID-19 is known to cause damage to blood vessels and the vascular (circulatory) system, changes to the blood vessels in the inner ear work could be to blame.
“Studies have found evidence of possible cardiovascular impacts due to COVID. And, since other cardiovascular diseases are known to be associated with hearing loss, it’s plausible that COVID’s impact on hearing is a secondary effect of a link to cardiovascular health,” Seitz-Paquette says.
Talk to Your Doctor
If you’ve been diagnosed with COVID-19 and you think your hearing might be impacted, talk to your doctor as soon as possible.
Often, hearing loss is overlooked in the urgency surrounding more direct threats to life, such as being unable to breathe. But hearing loss can become permanent, Trinh warns.
“When the virus attacks the nerve, you have a very short period of time to prevent permanent damage to that nerve. That goes with any virus, not just COVID-19,” she says. This is because “the nerve in the ear runs in a very small canal. If the nerve becomes inflamed and the inflammation stays for even just a week or several days, it can cause permanent damage to the neurons.”
Trinh says this is why when a patient with COVID comes in and mentions hearing loss, she moves quickly. “You’ve got to treat them within 72 hours” to limit the extent of permanent hearing loss.
Naturally, many people are more concerned with being able to breathe than hear, so depending on the situation, some people don’t even think to mention that their hearing seems disrupted. But Trinh says it’s important to let your health care provider know if you’ve noticed a change.
You may receive an exam and a hearing test to determine the extent of the impact. “I always tell the emergency room doctors or family doctors that if they see a patient with acute hearing loss and they don’t see any wax or fluid in the ear, the best move is to treat them” for nerve-related hearing loss. This treatment involves a high dose of corticosteroids aimed at decreasing inflammation and swelling in the ear canal. In some instances, the steroid might be injected directly into the eardrum.
With other viruses, such as the herpes virus, “you can treat them with an anti-viral medication.”
[READ: What to Look for in a Hearing Aid.]
Long-Term Ear Problems
While quick intervention can save at least some of your hearing, some individuals may have profound hearing loss as a result of a COVID-19 infection. Trinh says that generally speaking, the younger a person is at the time of infection, the better they heal and the more likely they are to regain some of the lost hearing function.
Some individual may also develop tinnitus — ringing in the ear or ears — as a result of a viral infection, and this can last for a long time. Tinnitus occurs when “those nerve endings can’t pick up sound clearly anymore.”
Vertigo can also be a lasting issue because the ear nerve and the nerve that controlled balance both “run in that same canal that comes out of the brain,” Trinh says.
And because COVID-19 is still so new, exactly when and how hearing loss might show up is still something of an open question, Seitz-Paquette adds. “Hearing loss can sometimes take many years to develop after damage to the inner ear structures, so we may not fully understand the possible link for some time,” Seitz-Paquette says.
Avoid Complications With Vaccination
Hearing loss related to COVID-19 isn’t thought of as a symptom of the disease, rather “it would be best considered a complication,” Seitz-Paquette says. It tends to turn up later in the course of the disease, rather than at the outset of illness. “However, there’s not enough information to give an expected time course or prognosis for those who experience hearing loss associate with COVID-19.”
While hearing loss isn’t on the typical list of symptoms of COVID-19, it should be taken seriously. Because as Trinh notes, time is of the essence in halting the progression of hearing loss and perhaps regaining function. “The most important thing is to tell the doctor exactly every symptom that you’re feeling. Even if you think it’s small or not the major issue, because if can be treated.”
Lastly, it should be added that there’s zero scientific evidence of any connection between hearing loss and the COVID-19 vaccine. Getting vaccinated can help reduce the chances of developing complications like hearing loss if you do become infected with COVID-19.
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COVID-19 and Hearing Loss originally appeared on usnews.com
