While not as widely recognized as a cough or fever, an earache is a symptom some individuals experience with a COVID-19 infection. The pain can occur in one or both ears. This article explores how the infection causes an earache, how to distinguish it from other issues, and what steps can be taken for relief.
How COVID-19 Causes Ear Pain
A primary way a COVID-19 infection leads to ear pain is through inflammation of the upper respiratory tract. This inflammation can affect the Eustachian tubes, the small passageways connecting the throat to the middle ear that regulate pressure. When these tubes become swollen or blocked from viral congestion, fluid can build up in the middle ear, causing fullness, pressure, and pain.
Another potential cause involves the virus’s ability to enter and affect cells within the ear itself. Studies have identified the presence of SARS-CoV-2 in the middle and inner ear. Certain cells in the inner ear have ACE2 receptors, which the virus uses to enter and infect cells, causing inflammation and damage that can result in pain, dizziness, or hearing loss.
A weakened immune system focused on fighting the COVID-19 infection can create an opportunity for secondary bacterial infections to develop. The fluid buildup in the middle ear caused by viral inflammation creates a favorable environment for bacteria to grow. This can lead to a secondary ear infection, known as otitis media, which adds bacterial-related inflammation and pain on top of the initial viral effects.
Identifying a COVID-Related Earache
An earache from COVID-19 rarely appears as an isolated symptom. It develops alongside or after the onset of more common signs of the infection, such as a sore throat, nasal congestion, a cough, or a fever. The presence of these other symptoms helps contextualize the ear pain as part of the broader illness.
While the character of the earache is not unique, its timing and associated symptoms are informative. Unlike a standard ear infection that might arise after a common cold, a COVID-related earache is directly tied to the inflammatory response triggered by SARS-CoV-2. The pain is often described as a constant, dull ache or a feeling of intense pressure from within the ear, which may fluctuate with sinus congestion.
Distinguishing this ear pain from other causes involves considering the complete clinical picture. For instance, an ear infection in a child may be their only complaint. In contrast, an adult with an earache alongside the sudden loss of taste or smell is more likely dealing with a symptom of COVID-19.
At-Home Care and When to See a Doctor
For mild to moderate ear pain associated with a COVID-19 infection, several at-home measures can provide relief. Over-the-counter pain relievers such as acetaminophen or ibuprofen can help manage the discomfort and reduce inflammation. Applying a warm, dry compress to the outside of the affected ear for 15-20 minutes may also help to soothe the ache.
Monitor your symptoms closely. While mild pain can be managed at home, you should seek medical attention if certain signs appear, as they could indicate a more serious secondary infection or other complications.
Consult a healthcare provider if you experience:
- Severe ear pain not managed by over-the-counter medications
- Fluid, pus, or blood draining from the ear
- Sudden or significant hearing loss in the affected ear
- Dizziness or vertigo
- A high fever that does not respond to medication