It is believed that more than one hundred million people experienced health consequences from COVID long after they were negative for infection. According to one study, more than 40% of people who have had COVID have or have had long-term effects after their recovery from the initial infection.

The lingering symptoms, sometimes referred to as long-haul COVID (or if you want to get scientific: post-acute sequelae of SARS-CoV-2, or PASC) can be both frustrating and uncomfortable.

What Are Long-Term COVID Symptoms?

According to The Centers for Disease Control, post-COVID conditions include a “wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19.”

Our knowledge about the virus’ health impact continues to evolve with time and research. Based on the information available, the CDC has posted a comprehensive list of post-COVID conditions. Some of the more common persistent health issues include:

• shortness of breath
• cough
• fatigue
• difficulty concentrating (“brain fog”)
• sleep disruptions
• chest pain
• headache

Possible Long-Term Effects on the Ears, Nose, and Throat

In addition to a cough, some of the potential long-term effects of coronavirus on the ears, nose, and throat include changes in smell or taste, hearing loss, tinnitus, and vestibular problems.

Loss of Taste and Smell

The loss of taste and smell was one of the earliest and most tell-tale symptoms of early COVID infections. In fact, anywhere from 20-85% of people with COVID infections experienced some degree of smell and taste loss. However, changes in taste and smell have been less common with newer variants.

There are many possible reasons you may experience a dulling of these senses including:

• Age (especially over age 60)
• Illness or infection (such as COVID-19)
• Obstructions like nasal polyps
• Medications
• Cancer treatment
• Head or brain trauma

Our senses impact our ability to enjoy life’s pleasures. They also affect our safety if we are unable to smell smoke or gas or cannot taste that food is spoiled. Unsurprisingly, research has confirmed that patients whose sense of taste and smell was affected by COVID had a loss of quality of life and safety as a result.

Researchers are continuing to explore therapies that may treat the loss of these senses in patients with long-haul COVID.

Hearing Loss and Tinnitus

Findings published in the International Journal of Audiology identified 56 studies that observed an association between COVID-19 and auditory and vestibular problems, such as vertigo. Researchers compiled data from 24 of these studies to estimate that the prevalence of hearing loss was 7.6%, tinnitus was 14.8% and vertigo was 7.2%.

Sensorineural hearing loss (SNHL) is caused by inner ear damage. Experts speculate that COVID-19 may cause damage due to a viral infection in the inner ear, an autoimmune response that accidentally attacks the inner ear, or clots that block the blood supply to the cochlea or semicircular ear canals.

Tinnitus may be an intermittent or continuous sound in one or both ears. Its pitch can go from a low roar to a high squeal or whine, or it can have many sounds. Researchers are not sure whether there’s a causal relationship between the coronavirus and tinnitus. However, some theorize that isolation and depression from staying at home for prolonged periods of time may have drawn more attention to someone’s tinnitus symptoms.

It’s also worth noting that research looking at a possible connection between hearing loss and
tinnitus included confirmed, probable, and suspected coronavirus cases.

(For information on whether there may be a connection between sudden sensorineural hearing loss (SSNHL) and the COVID vaccine, read this blog.)

Vertigo

Of the audiovestibular (hearing and balance) changes for patients after a coronavirus infection, the least commonly reported is vertigo. An article published in the International Journal of Audiology evaluated 20 studies that estimated the prevalence of vertigo was 7.2%.

More generally, we do know that infections can cause vestibular (meaning “originating in the inner ear”) balance disorders. Symptoms include:

• Dizziness
• Feeling off-balance
• Feeling as if you are floating or as if the world is spinning
• Blurred vision
• Disorientation
• Falling or stumbling

However, the authors of this study caution that much of the data was collected from self-reported questionnaires and that physicians sometimes used the terms “vertigo” and “dizziness” interchangeably and the latter can have causes that are not vestibular.

Have You Noticed Changes in Your Hearing, Taste, or Smell?

Despite the multiple reports of symptoms, more research needs to be done to determine how a COVID-19 infection may affect (or have affected) your ear, nose, and throat health long term.

If you have seen changes in your ear, nose, or throat health, whether you’ve had COVID-19 or not, an otolaryngologist can work with you to diagnose and treat your condition.

To schedule an appointment at ENT Memphis to discuss your concerns, click here.