Earache with COVID-19: Symptoms and Treatment

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Earache with COVID-19: Symptoms and Treatment

Ear pain is a possible symptom of COVID-19, in addition to hearing loss or dizziness. The signs of an ear infection with COVID can be similar to those of an ear infection caused by other viruses and bacteria.

Long COVID can cause ear symptoms as well. Hearing loss and a ringing in the ears may show up after the infection has resolved. You could still get long COVID symptoms affecting your ear even if you didn’t have any other symptoms of COVID-19.

Illustration by Jessica Olah for Verywell Health


How COVID Affects Ears

Respiratory symptoms, like cough and labored breathing, may be the best-known symptoms of COVID, but they are not the only ones. Ear pain (otalgia) may occur around the ear or in the ear canal. In addition to earache, COVID can cause other ear symptoms such as:

  • Vertigo/dizziness: Vertigo is a commonly reported ear symptom of COVID. If you have vertigo, you may feel unstable standing or walking or feel like the room is spinning. These ear symptoms may become more intense when you change body positions.
  • Hearing loss: Loss of hearing has been reported as a symptom of COVID, sometimes as the only symptom.
  • Tinnitus: Some people with COVID have reported tinnitus, or a ringing in the ears.
  • Sensation of fullness: Fullness in the ears is a classic symptom of eustachian tube dysfunction. The eustachian tubes are passages that connect the back of your nose to your middle ear. They can become blocked because of an upper respiratory viral infection, like COVID. The sensation of fullness may be occasional or come and go, but sometimes it’s continuous. In most cases, it’s tolerable.

Can COVID Cause an Ear Infection?

SARS-CoV-2, the virus that causes COVID, can cause ear infections. It can infect the inner ear as well as the middle ear. The inner ear is responsible for your sense of balance and hearing. Viral infections of the inner ear can cause balance and hearing problems in some people with COVID.

When the virus infects the middle ear, it can cause otitis media with effusion. This condition occurs when fluid builds up in the middle ear, creating an ideal environment for viruses or bacteria to multiply. With a middle ear infection, you may experience:

  • Mild to moderate hearing loss
  • Cracking sounds when you swallow
  • Fullness in the ear

Hearing and/or balance problems appear to occur equally regardless of the variant of the virus you get infected with. In a 2022 study, the alpha/beta, delta, and omicron variants of SARS-CoV-2 were equally likely to cause ear problems like fullness, hearing loss, tinnitus, and dizziness.

Risk Factors for Earache With COVID

Risk factors for an earache with COVID can include smoking, year-round or seasonal allergies, and a cold or respiratory infection. Earache can occur more often in children because of their smaller eustachian tubes, but many of these symptoms overlap. If you or your child are experiencing symptoms that you think could be either COVID or an ear infection, see your healthcare provider for diagnosis.

Long COVID and Ear Problems

Long COVID refers to any medical condition that lasts for four weeks or more after the initial SARS-CoV-2 infection has resolved. The following ear symptoms may be a sign of long COVID:

  • Hearing loss
  • Tinnitus
  • Vertigo/dizziness

Post-acute symptoms may last for three to 12 weeks, while chronic symptoms can last 12 weeks or more. COVID tests won’t likely show that you have COVID even though you may still be having long-lasting symptoms related to the virus.

Other COVID Symptoms

Ear problems aren’t the typical symptoms you would expect if you think you have COVID. More commonly, you may have one or more of the following symptoms:

Other Causes of Ear Pain

SARS-CoV-2 is not the only infectious agent that can cause an ear infection. Other viruses and bacteria can infect the ear as well. The illness may start out as a seemingly benign cold or a respiratory infection.

While ear infections are more common in children, adults can get them too. A cold or allergy can cause inflammation and swelling of the eustachian tube. When this happens, fluid builds up behind the eardrum. Viruses and bacteria can multiply in this fluid, causing an infection of the middle ear.

Ear pain can be caused by more conditions than an ear infection, including those listed below:


Diagnosis

Given how variable both COVID-19 and ear infections can be, you shouldn’t try to self-diagnose. Both COVID-19 and an ear infection can cause similar symptoms like fever and headaches.

If you think you have COVID or an ear infection, see a healthcare provider or an ear, nose, and throat (ENT) specialist for:

  • COVID testing: A PCR test or an antigen test of a swab specimen from your airway (nose, mouth) will identify an active infection. You also can discuss next steps following results of an at-home test.
  • Ear evaluation: An otoscope can be used to visualize your tissues for signs of infection or injury. A pneumatic otoscope can blow air to evaluate fluid buildup. Tympanometry also uses air pressure to check for fluid retention in the middle ear.

When to See a Healthcare Provider

See a healthcare provider if you have chronic (recurrent) ear infections, fluid that refuses to drain away, or symptoms that aren’t improving after two or three days. Get immediate medical treatment if you or someone else has these serious signs of COVID-19:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

Ear Infections Doctor Discussion Guide

Doctor Discussion Guide Child

Treatment

COVID ear symptoms may go away on their own as your body works on getting rid of the virus. Long COVID, however, can cause symptoms to last for weeks, months, or even years after you recover.

See a healthcare provider or ENT specialist to get specific treatment for your ear symptoms. They can include:

  • A steroid administered to the eardrum to improve some forms of hearing loss. Other forms of hearing loss are permanent and may not improve.
  • Removal of fluid or earwax buildup that leads to tinnitus.
  • Sound therapies and behavioral therapies to reduce the symptoms of tinnitus. There is no medication that specifically treats tinnitus.
  • Antivirals or antibiotics, depending on the cause.

Decongestants, antihistamines, or nasal steroids may be in order to help clear blockage. Pain medication can be used to alleviate discomfort.

Chronic ear infections that recur often or that present consistent fluid buildup in the middle ear may require treatment with ear tubes, which are small cylinders that are positioned through the eardrum to allow easy passage of air into the middle ear. They are inserted during an outpatient surgical procedure known as a myringotomy.

Summary

COVID-19 can lead to ear infections, causing symptoms like hearing loss, ringing in the ears, and fullness. It can also cause ear pain and dizziness. Sometimes ear symptoms go away on their own. In other cases, they may linger as a result of long COVID.

If you find yourself experiencing symptoms of either COVID-19 or an ear infection, consult your healthcare provider right away. It is important that you be tested for COVID-19 to prevent the spread of the virus.

An ear infection that doesn’t go away on its own and is left untreated can result in pain and hearing problems. If your symptoms become more extreme, seek medical attention right away.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

COVID-19 Doctor Discussion Guide

Doctor Discussion Guide Old Man
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Brian Mastroianni Journalist

By Brian Mastroianni

Mastroianni is a health and science journalist based in New York with a master’s degree in journalism.

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