COVID-19 has had a devastating impact on the world. Since the initial outbreak, nearly 500 million have been infected, 6 million have died, and countless others have suffered economic hardships and emotional distress. The highly contagious and deadly virus may also be causing a pandemic of tinnitus.
Medical researchers have also found a significant incidence of hearing loss and tinnitus symptoms among coronavirus patients. Let’s explore the relationship between COVID-19 and tinnitus.
What is Tinnitus?
Tinnitus is the perception of sounds that no one else can hear. Though it’s often described as a “ringing in the ears,” it also presents as a humming, buzzing, clicking, whirring, or whooshing.
Tinnitus symptoms are frequently associated with hearing loss, ear infection, and other ear conditions. Other causes include:
- Cardiovascular disease
- Neurological conditions
- Psychological disorders
Does COVID-19 Cause Tinnitus?
There is a connection between tinnitus and COVID-19, but the precise nature of the relationship is still unclear.
A systematic review of early research published in the International Journal of Audiology found that tinnitus occurs in about 15 percent of COVID-19 patients.
Nearly 8 percent of COVID-19 patients reported hearing loss, and 7 percent experienced vertigo, which is common when people have a medical problem affecting one ear.
While tinnitus isn’t a typical symptom of COVID-19, the pandemic seems to be driving a surge in tinnitus cases.
The British Tinnitus Association reported a 256 percent increase in the number of contacts to its website in the year after the virus first appeared.
Those with existing tinnitus also reported that coronavirus made their symptoms worse.
How Are COVID-19 and Tinnitus Linked?
Medical research still doesn’t fully understand the complexities of tinnitus, much less the various ways the novel coronavirus can affect the human body and interact with other health conditions.
Furthermore, existing studies on COVID-19 and tinnitus don’t cover a large enough population, and they rely on retroactive self-reporting.
While more studies are needed to gain a better understanding of the connection between COVID-19 and tinnitus, scientists can apply what they know about viral infections and known causes of tinnitus to theorize about how COVID-19 might contribute to tinnitus.
Here are some plausible explanations.
Anxiety, Depression and Stress
One possible explanation for the surge in tinnitus cases is psychological. The pandemic has had a big impact on mental health. Fear of dying, worry about one’s livelihood and general concern about the future are all tremendous sources of stress.
What’s more, the social isolation caused by lockdowns and distancing measures robbed people of essential coping mechanisms and ways to relieve stress.
According to the American Tinnitus Association, psychological conditions like anxiety and depression are major risk factors for tinnitus.
According to the association, anywhere between half to three-quarters of people experiencing tinnitus have some form of associated mental health symptoms.
Defects in blood vessels, high blood pressure, blood disorders and various other cardiovascular conditions are known to cause tinnitus. Two essential parts of the ear—the semicircular canals and the eardrum—have no backup blood supply, so they’re vulnerable to blood flow restriction or ischemia.
COVID-19 can affect the cardiovascular system, causing:
- Coagulation abnormalities
- Inner ear thrombosis
All of these are possible explanations for reported hearing loss and tinnitus in COVID-19 patients.
Tinnitus is commonly linked to hearing loss, and some form of hearing loss was reported by slightly less than one out of 10 COVID-19 patients.
This is consistent with the prevalence of hearing-related complications caused by other viral infections, such as meningitis.
In one case study published by the Mayo Clinic, researchers looked at a healthy 60-year-old man who previously had normal hearing. Though he had no known history of chronic or episodic hearing problems, the man experienced sudden hearing loss after contracting COVID-19 and went completely deaf in one ear.
The researchers concluded that his hearing loss was most likely due to an inflammatory response to the virus.
COVID-19 can disrupt the immune system, provoking an overproduction of proinflammatory cytokines.
Another paper found that antibodies or T-cells might damage the inner ear, mistaking inner ear antibodies for the virus.
Several medications are known to be ototoxic, meaning they are potentially harmful to the ear. Tinnitus is a common side-effect of these medications.
Many ototoxic medicines are used to treat COVID-19, including:
- Chloroquine and hydroxychloroquine
If ototoxicity is causing hearing issues, the patient will develop tinnitus in both ears. Fortunately, this is reversible in most cases by simply discontinuing the medication and switching to something else.
Researchers believe that reports of tinnitus and dizziness might be attributed to COVID-19’s impacts on the brain, auditory nerve and other parts of the nervous system. Scientists theorize that neurological causes could account for other common COVID-19 symptoms, such as a loss of taste and smell.
Studies on past coronavirus outbreaks show some evidence of brain and nervous system involvement. The virus may directly attack neuronal tissue or indirectly harm nerves by restricting blood flow to them, causing neurological symptoms, including vertigo.
Tinnitus and Long COVID
Public health officials and medical researchers are only now starting to investigate the alarming trend of COVID “long-haulers.”
Many people with so-called long COVID continue to experience some COVID-19 symptoms long after the more debilitating aspects of the illness fade away.
Common long COVID symptoms include:
- Shortness of breath
- Heart palpitations
- Hair loss
- Mood disorders
- Gastrointestinal issues
Medical experts say that long COVID is caused by the permanent long-term damage COVID-19 inflicts on various bodily systems, including the brain and the auditory system.
Diagnosis and Treatment
If you’re experiencing tinnitus or other hearing symptoms after contracting COVID-19, it may be a sign of long-term damage and shouldn’t be ignored.
When to Seek Help
You should contact your primary care provider for diagnosis and treatment if you’re experiencing any of the following symptoms after recovering from COVID:
- Ringing, high-pitched tones, humming, clicking or buzzing in one or both ears
- Muffled sounds or other trouble hearing
- Sensitivity to loud sound or noise
Your doctor will take the following standard steps:
- Review your medical history and medications
- Conduct an initial physical examination of your ears
- Ask questions about your symptoms
- Administer hearing tests to check for signs of hearing loss
If you’re experiencing hearing symptoms, your doctor will likely refer you to an audiologist to further probe potential hearing loss.
While tinnitus can often be reversed by treating the underlying conditions, it’s permanent in many cases. The good news is that several evidence-backed treatment methods can help people with tinnitus lead a normal life.
Here are some tinnitus treatment options:
- Tinnitus retraining therapy
- Tinnitus masking therapy
- Hearing aids
Many patients report that they hear a ringing in their ears while they are battling COVID and, in some cases, long after. While more research is needed to better understand the relationship between tinnitus and COVID-19, doctors can apply what they already know to provide relief and improve the lives of people struggling with these conditions.
“What Patients Wish They Knew About Long COVID.” American Medical Association (2022).
“Tinnitus and equilibrium disorders in COVID-19 patients: preliminary results” European Archives of Oto-Rhino-Laryngology (2020).
“One year on: an updated systematic review of SARS-CoV-2, COVID-19 and audio-vestibular symptoms” International Journal of Audiology (2021).