SARS-CoV-2 infection may cause such complications as post-COVID-19 syndrome, which includes chronic fatigue, myalgia, arthralgia, as well as a variety of neurological manifestations, e.g., neuropathy of small fibers, hearing and vestibular dysfunction, and cognitive impairment. This clinical case describes a 41-year-old patient suffering from post-COVID-19 syndrome and chronic fatigue syndrome. A detailed examination was performed, including an in-depth study of peripheral and central hearing and vestibular functions, as well as small nerve fibers length and density in the skin and cornea of the eye. Contrary to expectations, no peripheral nervous system dysfunction was detected, despite the presence of dizziness and gait instability in the patient. Hearing tests (gap detection test and dichotic test) showed central auditory processing disorders. The evaluated lesion in the processing of temporal and verbal auditory information can be a significant factor contributing to additional overload of the neural activity and leading to chronic fatigue when performing daily activities in patients with CFS and post-COVID-19 complications.

BACKGROUND: The pandemic has led to a development of various immunological complications of COVID-19 including the chronic fatigue syndrome and fibromyalgia. These syndromes, which often manifest themselves on a background of autoimmune diseases, may develop with an entrainment of vestibular function into the pathological process. AIM: Aim of the study was to estimate vestibular function in groups of patients with autoimmune dysfunctions accompanied by the chronic fatigue syndrome and fibromyalgia, who have had COVID-19 and those have not had COVID-19 in their anamnesis, and to compare it with vestibular function of healthy volunteers. MATERIALS AND METHODS: A functional investigation of vestibular system called Vestibular passport and the anamnesis taking by a standard questionnaire were performed in patients with an implied autoimmune dysfunction and presence of the chronic fatigue syndrome, fibromyalgia and/or postural orthostatic tachycardia, and also for a control group of healthy participants. RESULTS: Patients who have had COVID-19 in their anamnesis demonstrated significantly higher percentage of cases of vestibulopathy than healthy volunteers (33 and 6 %, respectively). In patients without COVID-19 in their anamnesis the percentage of vestibulopathy cases did not differ significantly from the corresponding percentage in healthy volunteers (14 and 6 %, respectively). Patients complaints which indicate a vestibular pathology were confirmed in 2/3 of all cases. CONCLUSIONS: Patients with chronic fatigue syndrome and fibromyalgia who have had COVID-19 were more prone to vestibulopathies than patients without COVID-19 in their anamnesis, whose vestibular indices did not differ from that in healthy volunteers. The data obtained shoul be considered as preliminary.