Nearly four years since COVID-19 first made headlines, we now know that the disease is not just a respiratory problem. Non-breathing-related issues like joint pain, fatigue and even rashes are all documented COVID-19 symptoms. But one potential effect that’s less familiar to people is hearing loss.
Diminished hearing can lead to many physical, social and emotional challenges and an overall lower quality of life, particularly for those who rely on their ability to hear for work. Musician Paul Simon recently opened up about the sudden hearing loss in his left ear and its impact on his career as a performer.
“Something happens to you when you have some sort of disability that changes your awareness or changes how you interact with life,” he said last week.
Simon noted earlier this year that he’d survived a difficult bout with COVID-19, but neither he nor any doctor treating him has stated that his hearing loss is related to the disease. Still, his remarks have sparked conversation about the lesser-known link between COVID-19 and hearing issues.
So how clear is that connection? Here’s what you should know:
Some cases of hearing loss have been linked to COVID infections.
“There are case reports of hearing loss being associated with COVID-19, and it is known that virus can enter the cells of the ear,” Dr. Amesh Adalja, an infectious disease expert and senior scholar at the Johns Hopkins University Center for Health Security, told HuffPost.
However, Adalja said that many questions remain about how this rare complication might happen. “The concern is that SARS-CoV-2 ― or the immune response to it ― may damage the cells of the ear responsible for transmitting sound information to the brain,” he said.
A growing body of research has shed some light on the potential connection, as have anecdotal reports.
“While the link between COVID and hearing loss hasn’t been definitively proven, there have been several studies suggesting that problems with hearing can be a side effect of COVID,” said Dr. John Schumann, an internal medicine specialist with Oak Street Health in Tulsa, Oklahoma. “For example, one study earlier this year that examined 58 adults between the ages of 23 and 75 years old who’d had COVID in the previous six months found that some amount of hearing loss had occurred in 12-13% of them.”
The study noted that COVID-19 “can damage the inner ear as well as the auditory pathway.” It added that while hearing loss can be the sole symptom someone experiences, this complication might also appear later “due to postinfectious inflammation of the nerve tissue as a symptom of long COVID-19.”
So basically, COVID-19′s impact on the nervous system means that the virus may damage the cochlear nerve, which connects the brain to the inner ear, or cause harmful swelling and inflammation around this area. As a result, hearing could be impaired.
Shelley Borgia, a doctor of audiology and founder of NYC Hearing Associates, previously told HuffPost that she has seen patients who experienced “total, sudden loss, and others who struggled to understand speech” after being infected with COVID-19.
“Most commonly, my patients are encountering persistent ringing or hissing sounds in their ears, also known as tinnitus,” she said at the time. “As an ‘invisible’ condition without an external source present, tinnitus is often unique to each individual.”
Schumann noted that COVID-19-linked tinnitus and hearing loss might be more a matter of correlation than causation. “But since COVID is not just a respiratory virus, and we’ve seen it affect the passageways that connect the nose to the ear, it’s not out of the question that it could cause issues with hearing,” he said.
Overall, the symptom is rare — but doctors are still searching for solutions.
Hearing-related symptoms of COVID-19 can clear up over time, though some people with long COVID have reported a seemingly more permanent impact.
Borgia pointed to COVID-19′s effect on blood flow, noting that just as “adequate blood circulation is essential throughout the rest of our body, it’s equally as important in our cochlea, or inner ear cavity. When that blood flow is damaged or slowed, it can lead to hearing loss.”
She added, “So if a patient is infected with COVID-19, the lack of blood and oxygen throughout their systems can also restrict their ability to hear.”
Long COVID has been known to cause chronic issues related to blood flow, including heart problems, so it’s not unreasonable to believe that hearing impairment could be a rare side effect of the condition as well.
Researchers continue to study the link between COVID-19 and hearing loss. But even as we learn more about it, this effect of the virus remains uncommon.
And it’s not always permanent, particularly for those who reach out to a doctor and receive treatment ― which often involves steroids to reduce swelling around the cochlear nerve.
“Someone experiencing sudden hearing loss should seek medical attention,” Adalja said.
Schumann recommended having a doctor check your hearing at least once a year as a general practice.
“Hearing exams are an important benchmark,” he said. “If you do experience hearing loss at some point later in time, your doctor will have something to compare it to. These annual exams are also important in checking for dementia, especially in older people.”