COVID-19 can cause sudden permanent hearing loss in rare cases

As the coronavirus disease (COVID-19) pandemic evolves, symptoms of the virus continue to spread throughout the human body. Caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), coronavirus infection causes many serious complications in some people, especially those with a higher risk of developing serious illness.

Transmission electron micrograph of SARS-CoV-2 virus particles isolated from a patient. Image captured and enhanced in color at the NIAID Integrated Research Facility (IRF) at Fort Detrick, Maryland. Credit: NIAID

Many complications, including heart disease and long-term breathing problems, have been reported in a group of people called “long-haul carriers.” Now a disturbing new finding shows that COVID-19 can cause sudden and irreversible hearing loss in patients.

A team of researchers from University College London reports on some cases of hearing loss, diagnosed as sudden onset sensorineural hearing loss (SSNHL) after being infected with COVID-19.

What is Sudden Sensorineural Hearing Loss (SSNHL)?

SSNHL, commonly known as sudden deafness, is a rapid and unexplained loss of hearing at one time or for a few days. It occurs due to a problem with the sensory organs of the inner ear.

SSNHL is also defined as a hearing loss of at least 30 dB in at least three consecutive frequencies that have developed in three days. It is a common condition seen by doctors, with an incidence of 5 to 160 cases per 100,000 people each year.

People affected by the disorder often experience hearing loss upon waking up in the morning. Accompanying symptoms include a feeling of fullness in the ear, tinnitus or ringing in the ear, and dizziness.

COVID-19 and SSNHL Case Study

The study, published in the journal BMJ Case Reports, analyzes the case of a 45-year-old man with asthma who was admitted to intensive care for COVID-19. He had been intubated for 30 days and suffered from complications such as bilateral pulmonary emboli, ventilator-associated pneumonia, anemia, and pulmonary hypertension.

The patient received medications, including the antiviral remdesivir and intravenous steroids. He developed hearing loss and tinnitus one week after being extubated and sought medical attention in the ENT department.

Other than asthma, he had no other medical conditions before becoming infected with SARS-CoV-2. When the doctor examined her ear canal, it was not blocked and there was no swelling. The tympanic membranes were intact, but she exhibited sensorineural hearing loss on the left side with a negative Rinne test on the side and the Weber test lateralizing to the opposite ear. By having a pure tone audiogram, it was confirmed that he had hearing loss and he underwent a series of intratympanic steroid injections.

What other studies say

Sensorineural hearing loss has long been studied in the field of otorhinolaryngology, focusing on the optimal route of steroid administration for treatment. But, amid the coronavirus pandemic, the link between COVID-19 and SSNHL has not been well studied.

To explore the relationship between the two conditions, the team conducted a systematic review of the literature using the EMBASE and PubMed databases between 1950 and 2020. The researchers used keywords such as “hearing loss”, “coronavirus”, “COVID-19 “and” neurosensory “. hearing loss. “The team landed with three case reports and two case-control studies.

Although some studies address the link between COVID-19 and SSNHL, studies of tissues from SSNHL patients revealed loss of hair cells and supporting cells of the organ of Corti, a part of the inner ear, with no inflammatory infiltrate.

“This is the first reported case of sensorineural hearing loss after COVID-19 infection in the UK. Given the widespread presence of the virus in the population and the significant morbidity from hearing loss, it is important to investigate this further, ”the team explained.

“This is especially true given the need to quickly identify and treat hearing loss and the current difficulty in accessing medical services. We suggest that patients are asked about hearing loss in ITU settings where appropriate, and any patient reporting acute hearing loss should be referred to an emergency otolaryngologist, ”they added.

Sudden SSNHL appears to follow COVID-19 infection. Like idiopathic SSNHL, more research is needed to consider the benefit of inflammation from steroids.