New case study suggests that COVID-19 can lead to sudden permanent...

One recently in the British Medical Journal (BMJ) reported the first case of Sudden Sensorineural Hearing Loss (SSNHL) in a COVID-19 patient in the UK.

SSNHL is a common ear, nose and throat disease affecting around five to 160 people per 100,000 each year. In most cases, the cause of the disease is unknown but is attributed to damage to the inner ear and the neurons that connect the ear to the brain, mainly due to a viral infection, an immune response, or a stress response from body cells. Various viral infections, including herpes and cytomegalovirus infections, have been linked to hearing loss.

Hearing loss was observed in COVID-19 patients as early as April 2020. Some studies suggest damage to nerves and cochlear hair (tiny hairs in the inner ear that send and receive signals from the brain to make it easier to perceive and interpret sounds) may be responsible for COVID-19-related hearing loss. However, more studies are needed to understand sensorineural hearing loss.

The case study

The case study included a 45-year-old man who had hearing loss while receiving treatment for COVID-19 in a hospital.

The man was hospitalized on day 10 of the COVID-19 symptoms and had to be intubated. He was taken to the intensive care unit and intubated for a month. He suffered from bilateral pulmonary embolism, ventilator-associated pneumonia, anemia, and pulmonary hypertension. He was on remdesivir, plasma exchange, and steroids, and his condition gradually improved. About seven days after extubation, he noticed tinnitus in his left ear and sudden hearing loss.

The man had no history of hearing loss and showed no damage or inflammation in the eardrum. However, the laboratory tests showed sensorineural hearing loss. He was given intratympanic steroid injections, after which his hearing improved somewhat.

Infection or inflammation

SARS-CoV-2, the causative agent of COVID-19, uses ACE2 receptors present on the surface of healthy cells to identify and invade these cells. It has previously been suggested that ACE2 receptors are present in the temporal lobe of the brain and that various ear cells have ACE2 receptors.

Experts suggest that it may be a combination of the infection and the inflammation caused by the virus in the ear that may be responsible for sensorineural hearing loss in COVID-19 patients. The study suggested that coronavirus patients should be screened for hearing loss so that they can receive timely treatment and prevent permanent hearing loss in these patients.

In addition, more studies are needed to understand the benefits of steroid use in idiopathic SSNHL.

For more information, see our article on COVID-19.

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