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“Viruses and their potential impact on hearing loss have been studied for a long time, particularly in cases of sudden sensorineural hearing loss when there is no other obvious cause for the hearing impairment. It is not surprising that as insidious as COVID-19 has been, that there are some cases associated with hearing loss. The best treatment is prevention which is outlined in this article.” - Drew Sutton, MD, Board-Certified Otolaryngologist
The COVID-19 pandemic has had an immense impact on the world as we know it. In the early days of COVID-19, there was a lot of uncertainty in how the virus impacted people, how it was transmitted, and the best ways to stay safe against the virus.
In almost two years, there has been a mass amount of knowledge gained about the novel virus, such as the best ways to stay safe against COVID-19, treatment options, and potential long-haul symptoms of COVID-19.
COVID-19 hearing loss is not listed as a potential or long-haul symptom of COVID-19, but there are some case reports of individuals experiencing hearing impairment following COVID-19.
While we have learned much about COVID-19, several aspects are still unknown due to small sample size studies. One such concern that has been brought up is the potential of COVID-19-associated hearing loss. It is important to understand how COVID-19 affects the body to understand the link between the two.
Below is everything you should know about COVID-19 and hearing loss.
COVID and Its Effects on the Body
COVID-19 is caused by a viral particle that is transmitted from person to person through respiratory droplets. These microscopic viral particles are capable of immense problems within the body.
From person to person, contracting COVID-19 could result in dramatically different outcomes. Some people who contract COVID-19 show symptoms, while others don’t show any at all. In contrast, others contract COVID-19 and are hospitalized and placed on assisted breathing apparatus.
Below is a closer look at the typical pathophysiology of a COVID-19 infection to better understand how the virus impacts the body.
Initial Infection
The initial COVID-19 infection occurs through inhaling an infective dose of viral particles. Being near a person with an active COVID-19 infection makes it more likely to contract the disease since the virus cannot live outside its host for very long.
When an infective dose is inhaled, the virus attaches to the secretory cells in the nasal cavity. From there, the virus replicates with the help of a host cell and propagates, leading to an increase in the number of SARS-CoV2 viruses.
Involvement of Respiratory Tract
As the number of viral particles increases, the body’s innate immunity starts to take notice and results in many common symptoms of COVID-19, such as elevated temperature, runny nose, cough, congestion, fatigue, or a loss of smell. The immune response is the main reason behind many of the upper respiratory system-related symptoms.
If the virus has propagated enough, it can migrate into the lower respiratory tract, infecting pulmonary alveoli. The infection of the lower respiratory tract can cause more problems and can lead to acute respiratory distress, which is often the case of those with more severe COVID-19.
Ways To Mitigate COVID Transmission
COVID-19 is a virus that has taken the world by storm, and we are still in the dark when it comes to many things regarding how it impacts the body. What we do know, however, are strategies to prevent its transmission.
There are several ways to do this, including social distancing, wearing masks, getting vaccinated, contact tracing, and of course, using standard hygiene practices.
Hand Hygiene and Disinfect High Touch Areas
Hand hygiene and disinfection of high-touch surfaces is one of the universal ways that you can prevent the transmission of bacteria, viruses, and other microorganisms from person to person and object to person. Handwashing may seem like a trivial task, but this is such an effective tool for keeping you and your loved ones safe. The five steps to washing your hands are:
1. Get your hands wet with lukewarm water.2. Get soap on your hands and spread across all surfaces of the hands
3. Rub your hands together with soap for at least 20 seconds. That is about the amount of time it takes to sing happy birthday twice
4. Once you have scrubbed your hands thoroughly, rinse the soap off with water
5. Dry your hands off with a paper towel, clean fabric towel, or with an air dryer
In addition to washing your hands, you can also clean the surfaces around you. When choosing the best areas to clean, consider the ones that are considered “high traffic.” This includes objects like doorknobs, TV remotes, light switches, cell phones, and tabletops.
By eliminating the germs on your hands and the surfaces in your home and work, you can hopefully reduce your risk of contracting COVID-19 and dealing with unwanted symptoms or run the risk of developing long COVID-19 symptoms.
Get Tested
COVID-19 testing has become a mainstay for preventing the spread of the virus and initiating prompt treatment. COVID-19 testing is done when you contact a known COVID-positive person or are experiencing COVID-19 symptoms.
The sooner COVID-19 is detected via a COVID-19 test, the sooner you can get the help you need, especially if it is a severe case with symptoms. For some things, like respiratory decline, prompt treatment is very important in preventing future complications.
This same concept applies in the unlikely event of developing sudden-onset sensorineural hearing loss where early treatment could significantly decrease lasting effects.
COVID and Hearing
COVID-19 has several other effects on the body, from just the infection of the respiratory system. As more long-haul symptoms of COVID-19 are popping up, one emerging area of concern is if COVID-19 affects the ability to hear.
It is well documented that some viruses can cause hearing problems, and delineating whether that is the case with COVID-19 is ongoing. There are many anecdotal and small-scale studies, but larger, more robust studies are needed to understand the full scope of COVID-19 and hearing.
The auditory system is a complex system that involves the ear canal, tympanic membrane, inner ear bones, cochlea, auditory nerve, and brain. If any part of this delicate system is hindered, it can result in difficulty hearing.
Can COVID Cause Conductive Hearing Loss?
The most common and likely form of hearing impairment due to COVID-19 is expected due to conductive hearing loss. Conductive hearing loss has to do with an impairment of the outer and middle ear.
When sound enters the ear canal, it vibrates the tympanic membrane, oscillating the bones in the middle ear.
Many upper respiratory illnesses pose a risk for temporary conductive hearing loss as the eustachian tubes can become blocked, leading to fluid accumulation and an earache within the middle ear. When fluid fills the middle ear, it can reduce the ability of the bones to oscillate and result in muffled sounds. This can also cause lead to the development of pulsatile tinnitus.
In addition to muffling noise, these factors can also result in a middle ear infection, resulting in pain, discomfort, muffled hearing, and drainage of fluid from the ear. Once a middle ear infection is resolved, auditory acuity is typically regained, and people can go on with their normal day-to-day.
Because COVID-19 causes upper respiratory symptoms, it may lead to conductive hearing loss due to an accumulation of inflammation and mucus in the upper respiratory tract, which can, in turn, clog the eustachian tubes. One such case has been documented in Turkey where the only indication of their COVID-19 viral infection was an ear infection.
Generally, adult middle ear infections will resolve on their own, but treatment may be necessary in some cases. If your ears begin to hurt excessively and you are concerned, you should seek medical expertise to give you peace of mind.
Can COVID Cause Sensorineural Hearing Loss?
Of greater concern to many is the risk of sensorineural hearing loss. Sensorineural hearing loss is a form of hearing loss that affects the cochlea and neurological functions necessary for hearing. While conductive hearing loss can be temporary, sensorineural hearing loss is typically permanent.
The main reason why sensorineural hearing loss is of concern when discussing COVID-19 is that there is evidence that the virus may impact the nervous system. Neurological manifestations of COVID-19 include confusion, a loss of smell, taste, and headache. Additionally, it is likely that viral infections play a role in a condition known as sudden-onset sensorineural hearing loss (SSNHL).
Studies surrounding the relationship between COVID-19 and SSNHL are far and few between, but the case study of a 45-year-old patient points to the possibility of SSNHL following COVID-19. Supporting evidence has yet to provide a clear connection between the two conditions, but being aware of cases can ensure you are vigilant when it comes to odd symptoms following COVID-19.
Conclusion
COVID-19 has several different manifestations in people, and we are truly only at the beginning of fully understanding all of the ways COVID-19 impacts the body. COVID-19 hearing loss is certainly a possibility.
However, the likelihood of developing hearing impairment following COVID-19 appears to be low. There is still a lot to be done in terms of research surrounding how COVID-19 can impact hearing, but for now, staying vigilant and reducing your chances of infection are effective means of avoiding the possibility of having COVID-19 hearing loss.
Sources:
Ear infection (middle ear) - Symptoms and causes | Mayo Clinic
Hearing Loss in SARS-CoV-2: What Do We Know? | NCBI
New type of corona virus-induced acute otitis media | NCBI
When and How to Wash Your Hands | CDC
Sudden irreversible hearing loss post COVID-19 | Case Reports
