Can COVID-19 Really Cause Permanent Hearing Loss?

Emerging evidence suggests there may be a connection

By Julia Métraux

There’s no doubt that COVID-19 has triggered fear in all of us. “Will I get it?” and “How will I fare?” are questions that have flickered through most of our minds at one time or another. Yet as more people contract the illness and survive it, we discover new concerns, like the symptoms that afflict people known as “long-haulers” — those who cope with symptoms weeks or months after they recover.

It’s been well-documented that some patients lose their sense of smell and taste. But, one open question remains about COVID-19’s effects on the senses: Can coronavirus cause hearing loss? Specialists who spoke to Hearing Tracker shared that while evidence is preliminary, and inconclusive, early data suggests there may be a link.

What the Research Reveals

A recent study in the International Journal of Audiology found that 16 adults — out of a group of 121 hospitalized with COVID-19 — reported experiencing changes in hearing or tinnitus after hospitalization. However, the findings may not be generalizable to the general public, according to lead researcher Dr. Kevin J. Munro, Director of the Manchester Centre for Audiology and Deafness (ManCAD) and Deputy Director of the NIHR Manchester Biomedical Research Centre.

Many of the patients who experienced changes in hearing had co-morbidities like diabetes, which Dr. Munro believes could underlie the development of more serious symptoms and complications from COVID-19. “They’ve been more susceptible to damage because their body has these other health problems,” Dr. Munro explained. Due to the small sample size, Dr. Munro cautioned against over-generalizing his findings.

Dr. Stefania Koumpa, an otolaryngology trainee at the Royal National Throat Nose and Ear Hospital in England, documented the case of a 45-year-old patient with no history of hearing loss who experienced a sudden sensorineural hearing loss (meaning due to damage to the inner ear or the nerve from the ear to the brain) after spending a week in the ICU for COVID-19 treatment. The patient had left-sided tinnitus and sudden-onset hearing loss which sadly did not improve after taking oral steroids.

“Even one-sided hearing loss can have a significant impact on quality of life,” Dr. Koumpa explained. “It affects many functions we rely on such as hearing conversation in noisy environments, being warned by alarms and moving vehicles, and being able to tell from which direction a sound is coming.”

Too Soon to Know the Full Story?

While cases like these are certainly sobering, the medical professionals we spoke with say it’s too early to draw conclusions. Understanding of COVID-19 is still in its early stages, despite the hunger for intel and answers. As Dr. Nicholas Reed, an assistant professor of epidemiology at Johns Hopkins Medicine, says, “The media climate and everything with COVID-19 is so demanding that you’re seeing a lot of things come out and people might make conclusions before we really know anything,” Dr. Reed said. “It’s not that the research is bad, it’s informing the next step. It’s not that COVID doesn’t cause hearing loss. We don’t know.”

For COVID-19 patients who self-report hearing loss, Dr. Munro also questions whether the fatigue that COVID-19 long-haulers may experience could contribute to perceived hearing loss. “I have wondered that when they have got a hearing problem or it’s really because they are so tired and fatigued and not able to concentrate,” Dr. Munro said.

If Sudden Hearing Loss Strikes

For now, the advice is that if someone experiences sudden hearing loss during or after a bout with COVID-19, they should follow the same steps they would under any other circumstances. “Report it to a physician so it can be medically managed first,” says Dr. Reed, stressing the importance of a professional evaluation. “I would say that any audiologic considerations like hearing aids come second.”

Typically, a hearing assessment like an audiogram would be a critical step, according to Dr. C. Matthew Stewart, associate professor of otolaryngology at Johns Hopkins Medicine, to detect the degree of loss before treatment is started. “The known treatments for sudden sensorineural hearing loss involve a high dose of steroid, typically in the form of an oral medication like prednisone,” Dr. Stewart explained. “Work from the United Kingdom has shown hearing recovery in patients with COVID-19.”

This promising news is part of a “don’t panic” outlook on whether there is a correlation between hearing loss and COVID-19. Dr. Stewart does not believe there should be undue alarm over what appears to be an uncommon complication. “I don’t think there should be unnecessary worry, but if a person has any evidence of hearing loss, do seek treatment.”

Research Update: Feb 2021

Update from the editor’s desk: On February 3, 2021, a pre-proof paper was published in the peer-reviewed Journal of Otology entitled SARS-CoV-2 and hearing: an audiometric analysis of COVID-19 hospitalized patients. In the paper, the authors detail the the hearing results of 60 patients (120 ears)—patients with moderate-to-severe COVID-19 disease symptoms and controls—and found that the the group with moderate-to-severe symptoms had significantly poorer hearing when compared to the control group, even after adjusting for age, gender, and comorbidities.