young women having ear pain

Can Post-COVID Cause Inner Ear Problems?

We all know COVID can cause you to lose your ability to taste your food and wreck your sense of smell, but what about COVID-related ear and hearing problems?

Post-COVID inner ear problems aren’t universal, but they aren’t uncommon. In this article, Harbor Audiology & Hearing Services audiologists answer your questions about inner ear problems in long COVID.


What kinds of inner ear problems show up after COVID?

Dr. Lee Gehrke at the Massachusetts Institute of Technology and Dr. Konstantina Stankovic of Stanford University’s School of Medicine did an in-depth study of 10 patients who displayed inner ear-related health problems and hearing loss after they had COVID.

In the group of patients studied, all 10 had hearing loss. Some in the group had just mild hearing loss. Some were nearly deaf.

Nine out of 10 patients in the group had tinnitus. They reported a ringing or buzzing noise in one of both ears.

Six of the 10 COVID patients reported vertigo. This inner ear condition may manifest as dizziness, feeling like you are always about to fall, leaning to one side, difficulty following an object with your eyes, and/or fatigue and depression.

These symptoms don’t occur in every person who has had COVID. A study sponsored by the National Institutes of Health found that just 3.1 percent of people infected with the virus develop hearing or inner ear problems. That was enough people to establish that there actually is a relationship between COVID infection and problems with hearing and balance. Still, it also suggests that most people who get COVID do not have these problems. There has also been a study that found that the effects of COVID infection are not permanent, at least in young and middle-aged people.


How does COVID damage tissues in the ear?

The COVID virus has to encounter certain kinds of proteins on the surface of a cell before it can infect it. The hair cells and the Schwann cells of the inner ear have these kinds of proteins, so they can be infected.

  • Hair cells detect sound waves for hearing. They also detect motion for balance.
  • Schwann cells form a defensive lining around the nerves that lead from the inner ear to the brain.
  • In the lab, COVID can infect and destroy both kinds of cells.


Does COVID cause inner ear pain?

Most people who come down with COVID don’t experience inner ear pain. It is a relatively rare symptom of the disease. COVID destroys cells in the inner ear without causing pain or drainage, most of the time. Of course, you can have other ear infections and COVID simultaneously.


Can COVID make my inner ear congested?

Not exactly.

COVID can trigger inflammation in the nose and the nasopharynx. (That’s the upper part of the throat, just behind the nose.) It can also inflame the Eustachian tube, which connects the nose and the middle ear.

COVID won’t cause congestion in your inner ear. But you can experience post-COVID infection in your middle ear.


How can I Determine if my Hearing Problems are Related to Long COVID?

Harbor Audiology & Hearing Services often see post-COVID patients referred to us by their primary care providers when they report tinnitus or hearing loss.


Hearing Problems

Testing your hearing is as easy as pushing a button, although you will be pressing the button, not your audiologist.

In your hearing test, we will ask you to wear a pair of headphones. We will play sounds at different frequencies and different decibel levels. You just press a button when you can hear them.

If there is some reason you can’t press a button (and occasionally patients can’t), we will just ask you to say “yes” when you hear a sound.

We may do a bone conduction test to determine if wax or fluid buildup is interfering with your hearing. We place a small device over the bone behind the ear and let it vibrate to see if you can detect it.

We may test you to find out the softest speech you can hear or your auditory brainstem response to see if you generate brain waves in response to sound. And we can also do an otoacoustic emissions test that listens for the faint sound of the hair cells in your inner ear when sound waves hit them.

This information together tells us how post-COVID inflammation affects your hearing and balance. Once we know where the problem is, we can prescribe the right technology to compensate for it.


Balance Problems

If you are suffering from vertigo, one of the first things we will do is determine whether your balance issues originate in your inner ear or brain. We do this with a procedure called videonystagmography testing. You can refer to it as VNT.

In the first part of VNT testing, we ask you to wear goggles that illuminate your eyes with infrared (IR) light. You won’t be able to see the IR light. A video camera inside the goggles records how your eyes move during the test.

You’ll be sitting in front of a large TV screen. Your audiologist will ask you to watch a series of objects on the screen, and the goggles will record how well your eyes track the objects on the screen.

We run a similar test asking you to sit in a slowly rotating chair in a dark room. The same goggles record your eye movement in the chair to tell whether your balance problems originate in your inner ear or brain.

We may also do an electrocochleography test to determine whether you have a buildup of fluid in your inner ear that is causing balance problems. Once we know where your symptoms originate, we can prescribe the technology that helps you the most.


Harbor Audiology & Hearing Services Inc. is Here to Help

Harbor Audiology & Hearing Services serves patients from all over the Puget Sound region. We will do our best to accommodate your schedule. We will work with your insurance company or medical benefits program to ensure you get all the benefits you are entitled to. Call or text us at (253) 999-9649 for further information or to make your appointment today!



Reviewed by Dr. Porter on May 25, 2023

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