Covid-19 inner ear infections affecting balance and hearing

Understanding audio-vestibular symptoms in Covid-19 patients. Photo by Fusion Medical Animation on Unsplash.

Pandemic health measures have so far concentrated on mouths and noses but according to a new study, Covid-19 inner ear infections are quite possible and may lead to balance issues and hearing loss.

As a neuro-vestibular physiotherapist, my interest is to raise understanding of audio-vestibular symptoms in Covid-19 patients and contribute to remedial and prevention strategies within the medical sector.

Researchers at the Massachusetts Institute of Technology (MIT), have shown how the SARS-CoV-2 virus can infect particular cells in the ear, explaining why some patients can suffer hearing loss and balance issues.

Researchers in the right place at the right time

Doctors Konstantina Stantovic and Lee Gherke were investigating why mumps and hepatitis impact hearing, when Covid-19 arrived. So, in May 2020, they turned their attention to the pandemic, to explore why coronavirus patients were experiencing sudden hearing loss, dizziness, or tinnitus.

While it still remains unclear how the virus reaches the inner ear, the researchers have outlined two possible methods.

Firstly, they think Covid-19 might use the Eustachian tube, which connects the middle ear to the upper throat and the back of the nasal cavity (nasopharynx).

Secondly, as Dr Stankovic explains, “the virus may also be able to escape from the nose through small openings surrounding the olfactory nerves, that would allow it to enter the brain space and infect cranial nerves, including the one that connects to the inner ear.

In my practice, I’ve long known that vestibular dysfunction has been caused by viral infections, which is why this paper, Direct SARS-CoV-2 infection of the human inner ear may underlie COVID-19-associated audiovestibular dysfunction, is an important step in understanding audio-vestibular symptoms in Covid-19 patients.