Tinnitus and COVID-19 connection explained by experts

As researchers continue to unravel the myriad health issues people face after having COVID-19, tinnitus and hearing loss are emerging as possible troublesome symptoms for some.

Tinnitus — marked by a ringing, buzzing or hissing sound in one or both ears — in particular, made headlines when Texas Roadhouse restaurant chain chief executive officer Kent Taylor recently died by suicide after suffering from post-COVID symptoms, including severe tinnitus. There’s also new research published in the International Journal of Audiology, which looked at data from 24 different studies and found an association between COVID-19 and auditory problems. The researchers estimated that nearly 15 percent of people infected with COVID experienced tinnitus, nearly 8 percent reported hearing loss and more than 7 percent developed rotatory vertigo, which leaves patients feeling dizzy like they’re on a merry-go-round.

Co-author of the study, Kevin Munro, Ph.D., a professor of audiology at the University of Manchester in the U.K., tells Yahoo Life that the study shows “the long term health consequences of COVID might be quite wide and extend well beyond a respiratory disease.” While Munro points out that “we need a definitive study to confirm” the research findings, he says this is the “best estimate of prevalence” of auditory problems after having COVID-19.

However, Deyanira Gonzalez, an audiologist at Baylor College of Medicine, tells Yahoo Life that tinnitus and hearing loss directly associated to COVID-19 has been “rare” — though developing auditory problems after certain illnesses, including measles, mumps and meningitis, is not unheard of. “Many viral infections can result in auditory symptoms such as hearing loss and tinnitus,” Gonzalez says. “However, our understanding of the relationship between viral infections such as COVID-19 and the auditory system has been evolving. At this point, the degree to which hearing loss and tinnitus are a direct result of COVID-19 is unclear.”

Gonzalez explains that “patients who come to our office reporting tinnitus and hearing loss in association with COVID-19 have expressed quite a bit of variability in their tinnitus severity or in the duration after it was noticed. It is our experience that not everyone who has gotten COVID-19 has reported hearing loss or tinnitus, so it has been difficult to determine if these symptoms were truly a result of COVID-19 or other factors.”

How COVID-19 might affect hearing

COVD-19 patients may develop tinnitus or other auditory symptoms because of a “dysregulation of the immune system due to virus entry into the neural pathways,” says Gonzalez, while Munro explains that “some viruses damage the delicate sensory cells in the ear and/or the hearing nerve.” Munro adds: “For some people, it might not be damage caused by the virus, but related to other factors such as changes in lifestyle.”

How long COVID patients experience tinnitus also varies. “Some have reported the tinnitus to be short lasting while symptomatic, [and] others have reported from weeks to months of tinnitus following COVID-19,” says Gonzalez. However, Gonzalez points out that not everyone with COVID-19 experiences tinnitus, and “it can be hard to determine if tinnitus was truly a result from COVID-19 or other factors, such as existing hearing loss, noise exposure, middle ear fluid, etc. Due to these other factors, research data has not been successful in truly identifying COVID-19 as a factor that can cause permanent tinnitus.”

It’s worth noting that tinnitus itself is “incredibly common,” Dr. Maura Cosetti, director of the Cochlear Implant Center at the Ear Institute of the New York Eye and Ear Infirmary of Mount Sinai, tells Yahoo Life, affecting an estimated 50 million Americans. So it’s also possible that patients may have had some underlying hearing loss and “COVID is maybe an exacerbation of that,” Cosetti says.

Best treatment options for tinnitus and hearing loss

If you’re dealing with tinnitus or hearing loss, whether or not you were infected with COVID-19, the first step is to get evaluated by a physician. That’s because “simple things can also cause tinnitus, like a buildup of earwax,” says Cosetti. “Getting an evaluation can be helpful because there are some instances where the wax is pushed into your ears because of the earbuds” many of us are wearing during the day on video calls for work or school. Or there may be a structural abnormality in the ear. “Have an ear exam to make sure it’s not an immediately identifiable cause,” suggests Cosetti.

The next step is to get a hearing test. “Most people don’t experience hearing loss as hearing loss,” says Cosetti. “They feel like something is blocking their ear or they experience tinnitus, which results from damage to the inner ear. Some of those auditory nerve cells are putting off an alarm bell of sorts — they are misfiring. That’s often the experience of hearing loss. You may not be experiencing ‘hearing loss’ per say.”

Other factors that can lead to tinnitus include noise exposure, middle ear infections, temporomandibular joint disorder (TMJ), or certain medications, explains Gonzalez. “If there is a sudden onset of tinnitus or hearing loss, it is strongly recommended to see a ENT physician, as steroid treatment may be suitable,” Gonzalez says.

Cosetti points out that there is a link between tinnitus and depression and anxiety, and says “there is good evidence” that treating the depression and anxiety can help the auditory problem. Along with tinnitus retraining therapy, most tinnitus treatments involve cognitive behavioral therapy, which “focuses on reducing the tinnitus perception and also your reaction to it,” says Cosetti. That can be combined with other methods including sound “masking” — namely, using white or pink noise machines and apps or sleeping with the fan on — to reduce tinnitus noise, especially at night when the quiet can make the condition more noticeable. Yoga, meditation, and practicing mindfulness can also be “quite effective,” says Cosetti.

But if the hearing loss doesn’t respond to medical treatment, Gonzalez says, “We often recommend the use of hearing aids, bone-anchored implants, or cochlear implants.”

If you or someone you know are experiencing suicidal thoughts, call 911, or call the National Suicide Prevention Hotline at 1-800-273-8255 or text HOME to the Crisis Text Line at 741741.

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