How COVID-19 Can Attack the Inner Ear – Healthline

Written by George Citroner on November 2, 2021 Fact checked by Dana K. Cassell

Hearing loss after COVID-19 has already been observed, but new research from the Massachusetts Institute of Technology (MIT) and Massachusetts Eye and Ear has been able to break down what is happening when the coronavirus attacks the inner ear.

The study, recently published in the journal Communications Medicine, analyzed cellular models of the human inner ear and adult human inner ear tissue with SARS-CoV-2 infection to discover what effect it might have.

Findings suggest that the ear is yet another part of our bodies that is susceptible to infection with SARS-CoV-2, the virus that causes COVID-19.

This article provides very compelling evidence that SARS-CoV-2 infects the inner ear, and may be causally related to the hearing and balance symptoms in a number of patients with COVID-19 infection, Dr. Yuri Agrawal, a professor of otolaryngology-head and neck surgery at Johns Hopkins School of Medicine, who was not involved in the study, said in a statement.

For this research, scientists developed novel cellular models of the inner ear and used hard-to-obtain adult human inner ear tissue.

According to the study authors, limited availability of this tissue had hindered previous research into how SARS-CoV-2 and other viruses can damage hearing.

They found a pattern of inner ear infection consistent with symptoms observed in a study of 10 patients with COVID-19 who had reported a range of ear-related symptoms.

Having the models is the first step, and this work opens a path now for working with not only SARS-CoV-2 but also other viruses that affect hearing, Lee Gehrke, PhD, the Hermann L.F. von Helmholtz professor in MITs Institute for Medical Engineering and Science, who co-led the study said in a statement.

The study included 10 adult patients who tested positive for COVID-19 and developed symptoms that included hearing loss, tinnitus (ringing in the ear), or dizziness within 3 weeks of diagnosis.

Researchers analyzed inner ear tissue sourced from humans and mice to create in-vitro cellular models of the inner ear.

They discovered that both human and mouse inner ear tissue contained molecular machinery to allow SARS-CoV-2 entry, like the ACE2 receptor. Researchers also found that the virus could infect two types of cells in the inner ear called Schwann and hair cells.

Our findings suggest that inner ear infection may underline COVID-19-associated problems with hearing and balance, the study authors wrote.

Vestibular hair cells serve as sensory receptors in the inner ear that function to assess and monitor head motion, a sense of balance, allowing humans and animals to orient themselves, Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York, told Healthline.

Schwann cells, also found in the specialized apparatus of the inner ear known as the cochlea, are vital to hearing, he continued.

According to Glatter, the takeaway is that this study found that vestibular hair cells and Schwann cells express proteins that are essential for SARS-CoV-2 to enter cells.

These proteins include the ACE2 receptor, which is found on the surface of cells, he said, and two enzymes called furin and transmembrane protease serine 2 (TMPRSS2), which allow SARS-CoV-2 to attach to the host cell.

According to the study authors, the developing inner ear is notoriously sensitive to congenital (born with) viral infection, and congenital cytomegalovirus (CMV) accounts for many cases of hearing loss at birth.

Viruses such as CMV as well as HIV can lead to hearing loss, said Glatter. CMV accounts for up to 40 percent of congenital hearing loss.

He added that HIV could also lead to hearing loss via direct effects on ear structures or specialized ear cells themselves, or indirectly, by suppressing the immune response that protects against bacterial or fungal infection.

Researchers noted that they observed SARS-Cov-2 infection of OPCs, a cell type present in the developing fetal inner ear.

The Centers for Disease Control and Prevention (CDC) recommends that pregnant people get vaccinated against COVID-19 to prevent infection that could cause complications like this and others in newborns.

Glatter emphasized the need to pay extra attention to symptoms like dizziness, hearing loss, and tinnitus in those exposed to COVID-19, as well as those who test positive for the coronavirus.

While fever, loss of taste and smell, and respiratory symptoms may be more common in those ultimately diagnosed with COVID-19, said Glatter, neurological presentations including dizziness, hearing loss, vertigo, and stroke-like symptoms can also be important presenting symptoms of COVID-19.

Some people with long COVID, also known as long-haul COVID-19, report dizziness and tinnitus among other symptoms long after their initial infection.

New research finds that cells in the ear are susceptible to infection with SARS-CoV-2, causing symptoms that include dizziness, ear ringing, and hearing loss.

Experts say that other viruses may also cause hearing loss, and newborns can be especially at risk.

They also say that while neurological symptoms of SARS-CoV-2 infection are less common, theyre still very important signs of disease that should be considered in those who test positive for, or are exposed to, COVID-19.

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How COVID-19 Can Attack the Inner Ear - Healthline