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CORONAVIRUS AND TINNITUS

CORONAVIRUS AND TINNITUS

The psychosomatic aspect: The coronavirus has caused a significant increase in anxiety worldwide. With endless lockdowns, cancellations, travel restrictions, and rapidly rising unemployment, life as we know it changed completely within a few weeks. As factors that can cause stress have increased both consciously and unconsciously, it is not surprising to see a connection between the coronavirus and tinnitus.

Why Does the Coronavirus Cause Such Anxiety?

The main source of anxiety regarding the coronavirus is its unpredictability. The uncertainty of what will happen next, along with the lack of control over the situation, contributes significantly. We don’t know how to manage this pandemic, as we've never experienced something like this before. The threats the coronavirus poses to optimism, people, and the things we value have negatively impacted individuals.

Anxiety and stress are perceived in the limbic system, the emotional part of the brain that controls our mood, personality, and decision-making. While anxiety is a healthy and normal response to changes in the world around us, it can negatively affect our sense of well-being and cause symptoms such as tinnitus.

Why Does Coronavirus Anxiety Increase My Tinnitus?

Tinnitus is processed in the limbic system of the brain, which is why stress and anxiety can exacerbate tinnitus. Many patients experience emotional reactions to tinnitus, which leads to overactivity in the limbic system. This heightened stimulation of the limbic system can increase the feelings of uncertainty related to the coronavirus, as well as the uncontrollable thoughts and emotions associated with the disease. The loss of control over emotions further worsens tinnitus, leading to irritability, impatience, and increased stress.

How Can I Relieve Stress Related to Coronavirus-Induced Tinnitus?

It’s essential to stop following city rumors and meaningless claims about the coronavirus. These are often misleading and unreliable, dragging you deeper into chaos and anxiety. Constantly tracking these can only increase your worries and fears.

Follow coronavirus updates from reliable sources. Limit checking updates and social media posts to once a day. The best sources for virus news and strategies are the Centers for Disease Control (CDC), the World Health Organization (WHO), health ministries, and municipal websites.

Continue practicing healthy habits. Keep a regular sleep schedule, eat healthily, and exercise at least twice a week. Research shows that maintaining healthy living standards boosts the immune system. If gyms are closed, try walking outside or use an exercise app on your phone to stay active.

Avoid Silence. When working from home and isolated from your colleagues and social environment, leave low-level calming music playing in the background to help focus and stay relaxed. Also, consider using sound therapy near your bed at night to aid your sleep.

Practice deep breathing and relaxation exercises. Try deep breathing exercises for a few minutes two or three times a day. Progressive muscle relaxation exercises are also beneficial for calming tinnitus. To maximize the benefits, try these relaxation strategies while using sound therapy (low-level music). Like exercise, these relaxation strategies require practice, so do them often.

The Impact of Coronavirus on the Hearing System: Damage

Scientific studies have shown that viral infections, including COVID-19, can have harmful effects on the outer hair cells in the cochlea. However, it is not guaranteed that a person’s cochlear function is completely healthy due to a lack of prior knowledge about their hearing. Viral infections typically cause damage to the outer hair cells and secondary auditory system damage inside the cochlea. This damage may involve direct viral effects on the Corti, stria vascularis, or spiral ganglion. Some viruses may even affect the auditory brainstem, indicating that the damage could be more widespread.

Does the COVID-19 Vaccine Cause Tinnitus?

Among about 40,000 vaccinated people, one person reported tinnitus, but there is insufficient evidence to conclude that the COVID-19 vaccine causes tinnitus.

Tinnitus can be triggered by pre-existing conditions and environmental factors. Individuals who experience tinnitus after vaccination should report their symptoms to healthcare professionals.

Although some individuals have reported tinnitus after receiving the COVID-19 vaccine, the Centers for Disease Control and Prevention (CDC) does not officially list tinnitus as a common side effect. However, more cases have been reported recently.

In clinical trials for the Johnson & Johnson vaccine, six mild cases of tinnitus were reported, but the FDA later determined they were unrelated to the vaccine. By August 2021, the Vaccine Adverse Event Reporting System (VAERS) documented about 9,000 cases of tinnitus after vaccination with any vaccine brand. In the UK, by November 2021, approximately one in 8,000 people reported that their tinnitus worsened after receiving the COVID-19 vaccine. This led the British Tinnitus Association to label tinnitus after vaccination as a rare side effect.

Peter Gulick, an infectious disease expert at Michigan State University, stated that the fear of developing tinnitus should not prevent people from getting vaccinated. While tinnitus after vaccination is very rare, individuals with a history of tinnitus may experience a flare-up after receiving the vaccine.

Pandemic-Related Worsening of Tinnitus Symptoms

According to the Hearing Health Foundation, at least 10% of people in the U.S. experience chronic tinnitus, which can range from mild to severe and may negatively impact sleep and overall well-being. Research suggests that COVID-19 can contribute to or worsen existing tinnitus symptoms.

In a study published in Frontiers in Public Health in November 2020, researchers observed that people with pre-existing tinnitus experienced worsening symptoms during the pandemic. Among 3,100 participants from 48 countries, about 32% of those with tinnitus reported increased discomfort due to lifestyle changes during the pandemic. Furthermore, 86% of those with tinnitus reported less social interaction, and 58% felt more isolated. These feelings made it more difficult for individuals to manage their tinnitus during the pandemic.

Additionally, 40% of COVID-19 patients with tinnitus reported significant worsening of their symptoms.

Research on the Link Between Coronavirus and Tinnitus

While tinnitus is not listed as a COVID-19 symptom by the CDC or WHO, an increasing number of cases report that individuals with COVID-19 also experience tinnitus.

A study published in the Journal of International Audiology in March 2021 found that 15% of 60 COVID-19 patients also had tinnitus. Prof. Kevin Munro from the University of Manchester reported receiving numerous emails from people with tinnitus and COVID-19 after the publication of the study. Some viruses, such as measles and mumps, are already known to affect hearing health, and it is believed that the coronavirus can also damage the nerves that transmit information to and from the brain.

Ongoing Research on the Coronavirus and Tinnitus Connection

Researchers are also exploring how COVID-19 treatments, including medications, may contribute to tinnitus. While the exact effects of COVID-19 on the sensory and nervous systems are not fully understood, it is believed that the virus may cause neurological and sensory dysfunction in some patients, potentially leading to issues such as tinnitus.

In cases where hearing loss or tinnitus occurs after COVID-19, further evaluation and tests should be conducted to understand the full extent of the damage.

Conclusion

While tinnitus management typically follows general strategies, addressing both stress and the physiological effects of the virus can help alleviate symptoms. Stress is a known trigger for many health problems, including tinnitus. Therefore, identifying and addressing auditory system issues and managing stress with a dual approach can improve outcomes. For individuals experiencing sudden hearing loss or tinnitus, diagnostic tests such as high-frequency audiograms, tympanometry, and MRI scans are necessary to guide treatment strategies. Further, treatments like neuromodulatory therapies, TMS, or CBT may be beneficial depending on the condition's severity.

Sources

  • Centers for Disease Control and Prevention. About the vaccine adverse event reporting system (vaers).
  • American Tinnitus Association. Tinnitus Causes.
  • Centers for Disease Control and Prevention. Possible side effects after getting a covid-19 vaccine.
  • U.S. Food & Drug Administration. Fact sheet for healthcare providers administering vaccine (vaccination providers).
  • British Tinnitus Association. Coronavirus vaccines and tinnitus.
  • Drug Discovery and Development. Researcher: neuroinflammation may be behind tinnitus reports in some covid-19 vaccine recipients.
  • Beukes EW, Baguley DM, Jacquemin L, et al. Changes in tinnitus experiences during the covid-19 pandemic. Front Public Health. 2020;8:592878. doi:10.3389/fpubh.2020.592878
  • Schlee W, Hølleland S, Bulla J, et al. The effect of environmental stressors on tinnitus: a prospective longitudinal study on the impact of the covid-19 pandemic. J Clin Med. 2020;9(9):2756. doi:10.3390/jcm9092756
  • Centers for Disease Control and Prevention. V-safe after vaccination health checker.
  • Cleveland Clinic. Tinnitus.
  • Centers for Disease Control and Prevention. Symptoms of covid-19.
  • National Institutes of Health. SARS-CoV-2 infection of the inner ear.