Oto-neurological manifestation in post COVID-19 patients: a randomized prospective observational study


  • Ram Siya Singh Department of ENT, M.L.N. Medical College, Prayagraj, Uttar Pradesh, India
  • Sivendra Pratap Singh Department of ENT, M.L.N. Medical College, Prayagraj, Uttar Pradesh, India
  • Sankalp Keshri Department of ENT, M.L.N. Medical College, Prayagraj, Uttar Pradesh, India
  • Anand Prakash Department of ENT, M.L.N. Medical College, Prayagraj, Uttar Pradesh, India




COVID-19, SNHL, Tinnitus, Dizziness, Thrombosis


Background: The corona virus disease (COVID-19) is caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) and is characterized by symptoms of the lower respiratory tract involvement, such as fever, cough, dyspnea, and chest heaviness. Sensorineural hearing loss (SNHL) is most frequent audio-vestibular symptom described, occurring alone or in association with tinnitus and vertigo.

Methods: This study was conducted in COVID-19 tertiary care center Prayagraj. COVID-19 positive patients who were included in moderate to severe category were taken up for the study and data was collected from 1st June 2021 to 1st July 2022 for audiological assessment and presence of equilibrium disorder. All patients were investigated on basis of closed ended questionnaire.

Results: Out of 1000 patients incidence of ear heaviness was found in 3.3%., decreased hearing in 0.9%., tinnitus in 1.9%., equilibrium in 0.4% and migraine in 0.4%, which was higher as compared to the normal population but not significant.

Conclusions: SARS-CoV-2 infection may cause thrombosis in audiovestibular artery and may alter the blood flow in cochlea and vestibule and cause otoneurological manifestation.


Author Biography

Ram Siya Singh, Department of ENT, M.L.N. Medical College, Prayagraj, Uttar Pradesh, India

ENT and head neck surgery


Sharma R, Agarwal M, Gupta M, Somendra S, Saxena SK. Clinical Characteristics and Differential Clinical Diagnosis of Novel Coronavirus Disease 2019 (COVID-19). Coronavirus Disease 2019 (COVID-19). 2020;55-70.

Rodriguez-Morales AJ, Cardona-Ospina JA, Gutierrez-Ocampo E, Villamizar-Pena R, Holguin-Rivera Y, Escalera-Antezana JP et al. Clinical, laboratory and imaging featureof COVID-19; a systemic reviewand meta-analysis. Travel Med Infect Dis. 2020;101623.

Vaira LA, Deiana G, Fois AG, Pirina P, Madeddu G, De Vito A et al. Objective evaluation of ansomnia and ageusia in COVID-19 patients: Single-center experience on 72 cases. Head Neck. 2020;1.

Paniz-Mondolfi A, Bryce C, Grimes Z, Gordon RE, Reidy J, Lednicky J et al. Central nervous systeminvolvement by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). J Med Virol. 2020;92(7):699-702.

Gu J, Gong E, Zhang B, Zheng J, Gao Z, Zhong Y et al. Multiple organ infection and the pathogenesis of SARS. JExp Med. 2005;202(3):415-24.

Huang YH, Jiang D, Huang JT. SARS-CoV-2 detectedin cerebrospinal fluid by PCR in a case of COVID-19 encephalitis. Brain Behav Immun. 2020;87:149.

Wu Y, Xu X, Yang L, Liu C, Yang C. Nervous systemdamage after COVID-19 infection: presence or absence? Brain Behav Immun. 2020;87:55.

Moriguchi T, Harii N, Goto J, Harada D, Sugawara H, Takamino J et al. A first case of meningitis/encephalitis associatedwith SARS-Coronavirus-2. Int J Infect Dis. 2020;94:55-8.

OzcelikKorkmaz M, Egilmez OK, Ozcelik MA, Guven M. Otolaryngological manifestations of hospitalised patients with confirmed COVID-19 infection. Eur Arch Otorhinolaryngol. 2020;10.

Ralli M, Stadio A, Greco A, Vincentiis M, Polimeni A. Defining the burden of olfactory dysfunction in COVID-19 patients. Eur Rev Med Pharmacol Sci. 2020;24(7):3440-41.

Lechien JR, Chiesa-Estomba CM, De Siati DR. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020;277(8):2251-61.

Fancello V, Hatzopoulos S, Corazzi V, Bianchini C, Skarżyńska MB, Pelucchi S. SARS-CoV-2 (COVID-19) and audio-vestibular disorders. Int J Immuno-pathol Pharmacol. 2021;35:20587384211027373.

Degen C, Lenarz T, Willenborg K. Acute Profound Sensorineural Hearing Loss After COVID-19 Pneumonia. Mayo Clin proceedings. 2020;95(8):1801-3.

Perret M, Bernard A, Rahmani A, Manckoundia P, Putot A. Acute Labyrinthitis Revealing COVID-19. Diagnostics (Basel, Switzerland). 2021;11(3):482.

Hanff TC, Mohareb AM, Giri J, Cohen JB, Chirinos JA. Thrombosis in COVID-19. Am J Hematol. 2020;95:1578-89.

Braun EM, Stanzenberger H, Nemetz U, Luxenberger W, Lackner A, Bachna-Rotter S et al. Sudden unilateral hearing loss as first sign of cerebral sinus venous thrombosis? A 3-year retrospective analysis. Otol Neurotol. 2013;34:657-61.

Saniasiaya J, Kulasegarah J. Dizziness and COVID-19. Ear Nose Throat J. 2021;100:29-30.

Malayala SV, Mohan G, Vasireddy D, Atluri P. A case series of vestibular symptoms in positive or suspected COVID-19 patients. Infez Med. 2021;29:117-22.

WHO. Clinical management of COVID-19; interim guidance. 2020.

Cohen BE, Durstenfeld A, Roehm PC. Viral causes of hearing loss: a review for hearing health professionals. Trends Hear. 2014;5.

Abramovich S, Prasher DK. Electrocochleography and brain-stem potentials in Ramsay Hunt syndrome. Arch Otolaryngol Head Neck Surg. 1986;112(9):925-8.

Sriwijitalai W, Wiwanitkit V. Hearing loss and COVID-19: a note. Am J Otolaryngol. 2020;41(3):102473.

Chetty R, Batitang S, Nair R. Large artery vasculopathy in HIV-positive patients: another vasculitic enigma. Hum Pathol. 2000;31(3):374-9.

Gilden DH, Kleinschmidt-DeMasters BK, Wellish M, Hedley-Whyte ET, Rentier B, Mahalingam R. Varicella zoster virus, a cause of waxing and waning vasculitis. Neurology. 1996;47(6):1441-6.






Original Research Articles