New research reveals that tinnitus, a common condition that causes the perception of noise in the ear and head, is being exacerbated by COVID-19, as well as the measures helping to keep us safe. The study, which involved 3,103 participants from 48 countries, found that 40 percent of those displaying symptoms of COVID-19 simultaneously experience a worsening of their tinnitus.
While tinnitus can be triggered by a variety of factors, including exposure to loud noises, inner ear damage and stress, experts say the stress of the pandemic could be linked to worsening tinnitus symptoms but new research indicates that the virus itself could also play a role.
The study, published in the journal Frontiers in Public Health, was led by Anglia Ruskin University (ARU), with support from the British Tinnitus Association and the American Tinnitus Association. The study involved participants from 48 countries, with the vast majority coming from the US and the UK.
In the roughly one-third of study participants who had tinnitus before the pandemic, “a combination of lifestyle, social and emotional factors during the pandemic” appears to have made it worse, said the study’s lead author, Eldre Beukes, a research fellow at Anglia Ruskin University in Cambridge, England.
The study also identified seven participants who said they first noticed changes in their hearing when they developed symptoms of Covid-19, suggesting that hearing damage could be a symptom of the illness for some people. The cause is still unclear, but it’s not the first time Covid-19 has been linked to hearing problems.
A study published in the International Journal of Audiology in July found that nearly 15 percent of 138 hospitalized Covid-19 patients reported impaired hearing eight weeks after being discharged. The majority of the patients didn’t report having had hearing issues before their Covid-19 diagnoses. And a case report published in The BMJ, a British medical journal, described a man in the U.K. who lost his hearing when he was hospitalized with severe Covid-19.
“A lot of viruses do affect the ear, so it is possible that being infected with the SARS-Cov-2 virus did cause tinnitus in some people,” said Beukes, referring to the virus that causes Covid-19. “However, people who go through really stressful periods can also develop tinnitus as a result of that stress.”
Research has already linked excessive stress with tinnitus symptoms. Beukes’ study found that nearly one-third of people reported stressors, including fear of getting Covid-19, financial worries, loneliness and trouble sleeping, as factors that made their tinnitus worse.
The new study also found that a large proportion of people believe their tinnitus is being made worse by social distancing measures introduced to help control the spread of the virus. These measures have led to significant changes to work and lifestyle routines.
Damage to tiny blood vessels
Although SARS-Cov-2 is a respiratory virus, what has struck scientists, doctors and patients alike is the range of symptoms — unrelated to the respiratory system — that it can cause.
One of those symptoms is loss of smell, and experts say that the same mechanisms behind that strange symptom may also contribute to hearing loss. When people are infected with the coronavirus, the body floods the bloodstream with platelet-making cells that usually reside in bone marrow. The cells, which are larger than most blood cells, can get stuck in the tiny blood vessels of the nose. The blockages, as well as blood clots — another complication of Covid-19 — can lead to loss of nerve function in the nose, which may explain why loss of smell is a common symptom of Covid-19, according to experts.
Another theory is that rather than being caused by the virus itself, hearing damage could be an unintended consequence of the body’s immune system response, which can cause the body to attack its own organs while trying to fight off invaders, said Kevin Munro, director of the Manchester Centre for Audiology and Deafness in England.
“Tinnitus is sometimes the first sign of damage to the ear,” said Munro.
More research is still needed to determine whether tinnitus is a true Covid-19 symptom or a consequence of stress. Munro will soon begin a study that aims to better understand whether the virus directly affects the mechanisms that allow humans to hear. He also hopes to determine why some people with Covid-19 have tinnitus and others don’t and which underlying conditions may be at play.
“The number of patients with tinnitus right now are quite high, and the people presenting might need additional support,” Munro said. “We need to take them seriously, and the next thing is understanding whether or not the ear damage is psychological so we can properly treat them.”