COVID-19, primarily known as a respiratory illness, can affect ear health and potentially lead to an ear infection. While ear infections are commonly associated with other upper respiratory infections, ear problems can emerge during or after a COVID-19 illness. The SARS-CoV-2 virus can impact various parts of the body beyond the lungs, including the ears, leading to a range of ear-related symptoms.
How COVID-19 Can Affect Ear Health
COVID-19 can contribute to ear problems through indirect and direct mechanisms. One way is through inflammation and swelling of the Eustachian tubes, narrow passages connecting the middle ear to the back of the throat. When these tubes become inflamed or blocked due to congestion from a COVID-19 infection, fluid can build up in the middle ear. This fluid accumulation creates an environment conducive to bacterial growth, which can then lead to a secondary bacterial ear infection.
SARS-CoV-2 may also directly infect cells within the ear. Ear tissue, including hair cells and Schwann cells in the inner ear, contains ACE2 receptors, which are entry points for the virus. The virus can infect these cells, potentially causing direct damage and inflammation. This direct infection of inner ear cells may explain why some individuals with COVID-19 experience hearing and balance problems, such as hearing loss, tinnitus (ringing in the ears), and dizziness.
The virus might also reach the inner ear through other pathways, such as by entering the central nervous system. Another potential route involves the endolymphatic sac, a protective buffer for the inner ear. While COVID-19 is a viral infection, its systemic inflammatory effects and potential for direct ear cell infection can predispose individuals to bacterial ear infections or cause ear issues directly.
Identifying Ear Infection Symptoms
Recognizing ear infection symptoms, especially after a COVID-19 illness, involves noting specific signs beyond general viral symptoms. Ear pain (otalgia) is a common indicator, ranging from a dull ache to sharp, intense discomfort inside or around the ear. This pain might be persistent or intermittent.
A feeling of fullness or pressure in the ear is another frequent symptom, often accompanied by muffled hearing or a noticeable decrease in hearing ability. This sensation arises from fluid buildup behind the eardrum. Fluid drainage from the ear, which can be clear, yellowish, or pus-like, may indicate a ruptured eardrum or severe infection.
Other symptoms that may point to an ear infection include fever and a general feeling of being unwell. In young children, signs such as difficulty sleeping, increased crying, pulling at the ear, or changes in eating habits can suggest an ear infection. While COVID-19 itself can cause ear pain and other ear-related symptoms like dizziness or tinnitus, the presence of specific signs like significant ear pain, fluid discharge, or persistent muffled hearing may indicate an ear infection.
When to Seek Medical Care
Knowing when to consult a healthcare professional for ear symptoms after a COVID-19 infection can help prevent complications. Seek medical attention if you experience severe ear pain that does not improve with over-the-counter pain relievers, or if your symptoms worsen. Persistent ear symptoms lasting more than one to two days also warrant a medical evaluation.
A high fever accompanying ear pain is another reason to contact a doctor. Any fluid discharge from the ear should prompt immediate medical assessment, as this can indicate a more serious infection or a ruptured eardrum. Additionally, if there is a noticeable change in hearing or new hearing loss, or if you experience dizziness or vertigo, professional medical advice is recommended. For infants and young children, any signs of an ear infection should lead to a prompt consultation with a healthcare provider.