Assessment of Hearing and Vestibular Functions in a Post-COVID-19 Patient: A Clinical Case Study

Abstract

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.

fNIRS‐based evaluation of the impact of SARS‐CoV‐2 infection central auditory processing

“…This finding is consistent with the central auditory processing disorder result consistent which evaluated auditory attention in a patient with normal hearing following SARS-CoV-2 infection (Andreeva et al, 2022). The vmPFC regions are associated with higher working memory performance during working memory retention phase, and vmPFC is associated with higher working memory performance during encoding phase (Mukahirwa et al, 2021;Krawczyk, 2002); moreover, there are neuroimaging studies showing that STG has a strong connection with speech flow in the presence of background noise, which has a significant contribution to cognitive function (Stevens et al, 2000), and that MTG, which has functions such as voice recognition, language processing, understandable speech, and verbal mental arithmetic processing, is active during auditory target detection Kiehl et al, 2005;Xu et al, 2015).…”

Evaluating the impact of COVID-19 on vertigo and hearing impairment: A post-recovery analysis

“…[9] The auditory and vestibular symptoms associated with COVID-19 present a new dimension to the disease's complexity and pose unique challenges in clinical management. [10][11][12] Vertigo, frequently characterized as a perceptual phenomenon of rotation or motion, represents a symptomatic manifestation that can markedly impair an individual's life quality. [13] It can be accompanied by dizziness, nausea, and balance issues, and arises from various causes, including inner ear disorders, neurological conditions, and, as recent evidence suggests, viral infections.…”

“…[9] The auditory and vestibular symptoms associated with COVID-19 present a new dimension to the disease’s complexity and pose unique challenges in clinical management. [10–12]…”