Vestibular Cochlear Manifestations in COVID-19 Cases

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a high transmissible infectious disease that primarily impacts the respiratory system and leads to death as it worsens. Ever since the World Health Organization declared the disease as a global pandemic, the pathophysiology, clinical manifestations, and disease prognosis has been discussed in various literature. In addition to impaired respiratory health, the symptoms also indicated the involvement of the cardiovascular and neurological system after SARS-CoV-2 infection. Despite the pulmonary, cardiovascular, and neurological complications, many reports also revealed the prevalence of vestibulocochlear symptoms like dizziness, vertigo, vestibular neuritis, sudden sensorineural hearing loss, and tinnitus. Though many clinical reports and scientific reviews reported the vestibular and cochlear impairments associated with coronavirus disease 2019 (COVID-19) infection, the underlying pathological mechanisms are still unclear and unexplored. In this review, we discussed the published clinical reports, research articles, and literature reviews related to vestibulocochlear manifestations following SARS-CoV-2 infections. We also summarized the current knowledge about the prevalence, epidemiological and clinical features, and potential pathological mechanisms related to vestibular and cochlear manifestations resulting from COVID-19 infections.

Otovestibular Symptoms of COVID-19 and Its Vaccines/Treatments

“…Early in the pandemic, the author began evaluating patients with laboratory confirmation of SARS-CoV-2 infection who complained of auditory symptoms (such as hearing loss or tinnitus) and/or dizziness. This matches the evolving clinical literature, which reports dizziness [31], auditory symptoms (such as hearing loss or tinnitus), or both [32].…”

“…A third potential mechanism for inner ear dysfunction due to COVID-19 infection is labyrinthine ischemia secondary to hypoxia [32]. COVID-19 infection increases the risk of thrombosis and can deoxygenate erythrocytes; since the inner ear's circulation is entirely dependent on the small and tenuous labyrinthine artery, this mechanism is plausible.…”

Prevalence of New‐Onset Tinnitus after COVID‐19 Vaccination with Comparison to Other Vaccinations

“…COVID‐19 infection, like many other viral infections, has been shown to be associated with audiological and vestibular pathologies. 9 , 10 A recent meta‐analysis of COVID‐19 infection symptomatology found tinnitus as a statistically significant side effect of infection. 11 Multiple case reports 12 , 13 , 14 and reviews 15 , 16 describe tinnitus as a direct symptom of COVID‐19 infection, likely secondary to systemic inflammation.…”

COVID-19 and transtympanic injections for sudden sensorineural hearing loss

“…Sudden sensorineural hearing loss (SSNHL) is an otologic emergency requiring aggressive, timely intervention to prevent permanent hearing loss. Early in the COVID-19 pandemic, reports surfaced linking SSNHL to COVID-19 infections [1] , [2] . Multiple other limited reports have since suggested COVID-19 infection may place patients at increased risk for SSNHL [3] , although several other studies have failed to demonstrate an association [4] , [5] , [6] .…”