Does Covid-19 Cause Tinnitus and Hearing Loss?

According to a recent study supported by the NIHR Manchester Biomedical Research Center, a significant number of patients have reported having trouble with their hearing eight weeks after being discharged from the hospital.

The study was conducted by Wythenshawe Hospital, which is part of Manchester University NHS Foundation Trust. In total, one hundred and twenty one adults participated in the study conducted by phone survey. The study found that 13.2% of the participants reported that they experienced some form of hearing loss and that 6.6% experienced tinnitus.

Although there is still a lot of uncertainty around the novel coronavirus (COVID-19) and the long term impacts on health, there is a growing number of individuals that have reported issues with hearing loss and tinnitus.

“We already know that viruses such as measles, mumps and meningitis can cause hearing loss and coronaviruses can damage the nerves that carry information to and from the brain. It is possible, in theory, that COVID-19 could cause problems with parts of the auditory system including the middle ear or cochlea. For example, auditory neuropathy, a hearing disorder where the cochlea is functioning but transmission along the auditory nerve to the brain is impaired could be a feature,” states Professor Kevin Munro, Professor of Audiology at The University of Manchester and NIHR Manchester BRC Hearing Health Theme Lead.

The New York Post helped surface this issue and the symptom that was experienced by a 20 year old American who tested positive for COVID-19 when she returned to the United States after being in Italy.

The next day, “hearing in both ears was significantly less,” and she said she could feel phlegm in the back of her throat, but simply brushed it off as a cold symptom. “As Italy was starting to become a place of concern, our program urged us to return home,” she wrote. Her condition worsened on her last full day in Italy. “I still couldn’t hear, and at this point I lost all ability to taste and smell, yet I did not have a runny nose or cough,” she wrote. “I had a headache constantly during the day which I just treated with Tylenol. I left the next morning to return to America.”

(credit: The New York Post)

However, more research is needed to more confidently identify why there is an association between the virus and hearing problems and if this is simply an association or causality. The review identified reports of hearing loss and tinnitus, but there were only a small number of studies and the quality of evidence was low given that they were self reported.

“While we are reasonably confident in the differentiation of pre-existing and recent changes in hearing and tinnitus, we urge caution. It is possible that factors other than COVID-19 may impact on pre-existing hearing loss and tinnitus. These might include stress and anxiety, including the use of face masks that make communication more difficult (try these), medications used to treat COVID-19 that could damage the ear (ototoxicity) or other factors related to being critically ill. That is why we believe there is an urgent need for high-quality studies to investigate the acute and temporary effects of COVID-19 on hearing and the audiovestibular system. Timely evidence for decision-makers is urgently needed, so we need to be able to act quickly.”

Updated: 10.14.20

Recently, a 45 year old man in the United Kingdom experienced sudden and permanent hearing loss in one of his ears after a severe case of COVID-19 (coronavirus). He was admitted to intensive care with COVID-19, ventilated, and given medications that included intravenous steroids and the antiviral remdesivir.

He developed tinnitus (a ringing sound) in his left ear a week after leaving the intensive care unit. Then he lost hearing in his left ear.

There were no problems with his ear canals or ear drums and the team says none of the medications the man was given would be expected to cause damage to his hearing (ototoxicity).

Although this seems to be a rare case of sudden hearing loss, his physicians are advising that others take caution of this serious symptom of COVID-19. There have been several cases popping up around the world. The new report was published in the journal BMJ Case Reports.  

So does COVID-19 cause tinnitus or hearing loss?  Although it does seem like there is a correlation between the two, we are not 100% sure that COVID-19 has long term impacts on hearing health and hearing loss and tinnitus. It is always best to stay informed and understand the health impacts COVID-19 and potential treatments may have on our hearing health and wellness.

The letter, “Self-reported changes in hearing and tinnitus in post-hospitalization COVID-19 cases,” is published in the International Journal of Audiology and you can find the original article here.

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