Vertigo is a sensation of spinning or feeling off-balance, often described as if you or your surroundings are moving. This distinct feeling differs from general lightheadedness or faintness. This article explores the potential connection between vertigo and COVID-19.
What is Vertigo?
Vertigo is a specific type of dizziness characterized by a false sensation of motion, such as spinning, swaying, or tilting. This feeling can be quite disorienting and may be accompanied by nausea or vomiting. It is important to distinguish vertigo from general lightheadedness, which is a feeling of faintness or wooziness without the rotational sensation.
The body’s balance system, known as the vestibular system, plays a central role in maintaining equilibrium. This system includes structures within the inner ear, such as the otolith organs and semicircular canals, which detect head movements and send signals to the brain. Problems in this system, either in the inner ear or the brain, can disrupt balance and lead to vertigo.
Common causes of vertigo unrelated to COVID-19 include:
Benign Paroxysmal Positional Vertigo (BPPV), a condition where tiny crystals become dislodged in the inner ear
Meniere’s disease
Vestibular neuritis (inflammation of the vestibular nerve)
Labyrinthitis (inner ear infection)
Migraines
How COVID-19 Can Cause Vertigo
COVID-19 can lead to vertigo through several mechanisms, directly affecting the balance system or indirectly through systemic effects. The virus may directly infect and inflame the inner ear or the vestibular nerve, which transmits balance information to the brain. This direct viral impact can result in conditions like vestibular neuritis, characterized by sudden and persistent vertigo. The SARS-CoV-2 virus can infect inner ear cells, including hair cells important for hearing and balance.
Neurological involvement is another pathway, as COVID-19 can trigger inflammation in parts of the brain responsible for balance, such as the brainstem or cerebellum. The widespread inflammatory response throughout the body can also contribute to inner ear and vestibular system issues. Systemic effects of severe illness, such as dehydration, fever, and fatigue, can indirectly cause dizziness or worsen existing balance problems. Reduced blood flow can also affect the sensitive inner ear, which relies on consistent blood supply.
Vertigo can also manifest as a symptom in “Long COVID,” also known as Post-Acute Sequelae of SARS-CoV-2 (PASC). The sensation can persist for weeks or months beyond the acute phase of the infection. Many individuals with Long COVID report experiencing dizziness or vertigo. These long-term effects might be due to ongoing inflammation or persistent viral damage to neurological tissues.
Identifying COVID-Related Vertigo
Vertigo is often not the sole symptom of COVID-19, usually appearing alongside other common signs of infection. When linked to COVID-19, it occurs with symptoms such as fever, cough, fatigue, headache, and body aches. Some people also report loss of taste or smell, respiratory issues, and a general feeling of being unwell. These accompanying symptoms provide a broader context that might suggest a COVID-19 infection.
The timing of vertigo can also offer clues. It might appear during the acute phase of the infection, sometimes even as an early symptom before respiratory issues become prominent. Alternatively, vertigo can develop later as a post-COVID symptom. Experiencing vertigo alone is insufficient for a COVID-19 diagnosis. A medical professional considers the full range of symptoms and recent exposures to make an accurate assessment.
When to Consult a Doctor
It is advisable to seek medical attention if you experience any new, severe, or persistent vertigo. While many cases of vertigo resolve on their own, a medical professional can help determine the underlying cause. There are specific “red flag” symptoms that warrant immediate medical evaluation, regardless of whether COVID-19 is suspected.
Seek emergency care if vertigo is accompanied by:
A sudden, severe headache
Double vision
Difficulty speaking
Weakness or numbness in the arms or legs
Difficulty walking
Loss of consciousness
New hearing changes
If vertigo is experienced with other typical COVID-19 symptoms or following known exposure, getting tested for COVID-19 is recommended. A medical professional can accurately diagnose the cause of vertigo and advise on appropriate treatment or management strategies.