For most people, COVID-19 is associated with symptoms we have become very familiar with: fever, fatigue, cough, congestion, loss of smell or taste, headache, and body aches. However, as researchers have followed patients during and after COVID-19 infection, another group of symptoms has received increasing attention: changes in hearing, tinnitus, dizziness, and other problems involving the auditory and balance systems.
Some people report that their ears suddenly feel blocked after COVID. Others notice that conversations seem less clear, particularly when there is background noise. Some develop tinnitus, a ringing, buzzing, humming, hissing, or other sound that occurs without an external source, while people who already had tinnitus before becoming sick sometimes report that it suddenly becomes louder or more noticeable.
Naturally, these experiences raise an important question: Can COVID-19 actually affect your hearing?
The answer appears to be yes, but there is still a great deal we are learning about exactly how often this happens, why it happens, and how long these symptoms may last. Hearing loss and tinnitus have been reported during acute COVID-19 infection as well as in people experiencing long COVID, also known as post acute sequelae of SARS-CoV-2 infection, or PASC. [1-6] At the same time, experiencing tinnitus or hearing difficulty after COVID does not necessarily mean that the virus permanently damaged your ears. Many people improve over time, although persistent or sudden changes in hearing should not simply be ignored.
Hearing Loss and Tinnitus Have Been Reported After COVID
Researchers have now documented a range of ear related symptoms during and following COVID-19. These include hearing loss, tinnitus, dizziness or vertigo, difficulty understanding speech, and sensations of pressure or fullness in the ears. [1-6]
Determining exactly how common these symptoms are has been challenging because different studies have produced very different estimates. One review reported hearing impairment in approximately 3% of patients with COVID-19 and tinnitus in approximately 5%. [2] More recent analyses have reported higher estimates, including hearing loss in approximately 8% and tinnitus in approximately 14% of patients following infection. [4]
Individual studies have sometimes found even higher rates. For example, a 2024 study of 468 people following COVID-19 infection found that approximately 23% reported tinnitus, 14% reported hearing loss, 22% experienced a feeling of fullness in their ears, and 15% reported dizziness. [6] In another study involving more than 1,000 adults experiencing long COVID, approximately 30% reported tinnitus many months after their initial infection. [5]
These numbers need to be interpreted carefully. Hearing loss and tinnitus were common health conditions long before COVID-19 existed, and studies relying on surveys cannot always determine whether COVID directly caused someone’s symptoms, worsened a preexisting condition, or simply occurred around the same time. The studies also differ substantially in how patients were recruited, how hearing problems were defined, and how long after infection symptoms were measured.
Nevertheless, when the research is considered as a whole, there is growing evidence that hearing and tinnitus symptoms can occur during or following COVID-19 infection in at least a subset of patients. What researchers are still trying to determine is why.
How Could COVID Affect the Hearing System?
To understand how COVID could potentially affect hearing, it helps to remember that hearing involves much more than the ear. Sound enters the ear and is converted into neural information inside the cochlea, a tiny sensory organ located within the inner ear. That information travels through the auditory nerve and multiple neural pathways before reaching the brain, where sound is processed, organized, and ultimately understood.
This entire system depends on extremely delicate sensory cells, healthy neural connections, adequate blood supply, and normal brain function. Researchers have proposed several ways that COVID-19 could potentially interfere with one or more parts of this system, although these mechanisms remain under investigation.
One possibility involves inflammation and the immune response. COVID-19 can trigger substantial immune activity, and researchers have proposed that inflammatory molecules and oxidative stress associated with infection could potentially affect structures within the inner ear or auditory nervous system. [7] This type of inflammatory response has been investigated as one possible explanation for auditory symptoms associated with both acute COVID and long COVID.
Another possibility involves the vascular system and blood supply to the inner ear. The cochlea has an exceptionally delicate blood supply, and normal hearing depends on adequate circulation and oxygen delivery. Because COVID-19 has been associated with vascular inflammation, abnormal clotting, hypoxia, and microvascular changes in some patients, researchers have investigated whether these processes could interfere with normal cochlear function. [7,8]
Scientists have also explored the possibility of direct effects of the virus on structures within the inner ear. Some research has identified biological pathways that could theoretically allow SARS-CoV-2 to interact with cells involved in auditory function, including structures within the cochlea and auditory nerve. [6,7] For patients experiencing long COVID, researchers are additionally investigating whether persistent immune activity, neuroinflammation, or changes within the central nervous system could contribute to ongoing tinnitus and auditory symptoms. [1,4]
These mechanisms are scientifically plausible, but there is an important distinction between a plausible biological explanation and proof of causation. We do not currently have evidence showing that every case of tinnitus or hearing loss occurring after COVID results from direct viral damage to the ear. The biology is likely more complicated and may differ considerably from one person to another.
What About Tinnitus After COVID?
Tinnitus deserves particular attention because, for some people, it can become one of the most distressing symptoms following an illness. Tinnitus is the perception of sound when no corresponding external sound is present. People commonly describe ringing, buzzing, humming, hissing, static, crickets, or other sounds that may be present in one ear, both ears, or seemingly somewhere inside the head.
For some people, tinnitus begins during or shortly after COVID-19 infection. For others, tinnitus that existed before COVID becomes significantly louder or more intrusive. Research involving long COVID populations suggests that tinnitus can persist for months in at least some patients, although the severity and duration vary considerably from person to person. [4,5]
There are several possible explanations for why this occurs. Changes in hearing, even relatively subtle ones, can alter the amount or quality of auditory information reaching the brain. The brain may respond to this change by altering neural activity or reorganizing how auditory information is processed, mechanisms that are believed to contribute to many forms of tinnitus.
COVID may potentially add another layer through inflammation or changes in neural activity, but there are also indirect factors to consider. Being sick can significantly disrupt sleep, increase stress, reduce physical activity, and create substantial fatigue. Stress and sleep deprivation can make tinnitus much more noticeable, while spending more time in quiet environments during recovery can make an internal sound that was previously easy to ignore suddenly seem much louder.
For this reason, worsening tinnitus following COVID does not automatically mean that the virus permanently damaged the auditory system. There may be several interacting factors contributing to the change, and identifying those factors can be an important part of determining the appropriate treatment.
Most importantly, patients experiencing bothersome tinnitus should not simply be told that they need to “learn to live with it.” Tinnitus can and should be properly evaluated, and there are evidence based approaches available to reduce its impact on daily life.
Can COVID Cause Sudden Hearing Loss?
One particular hearing condition requires immediate attention: sudden sensorineural hearing loss, commonly abbreviated SSNHL. Sudden sensorineural hearing loss involves a rapid decline in hearing, typically developing over hours or several days. It commonly affects one ear and may occur along with tinnitus, pressure or fullness in the ear, or dizziness.
Sudden hearing loss has been reported in association with COVID-19 infection. A 2025 case control study conducted in Malaysia found approximately twice the risk of idiopathic sudden sensorineural hearing loss among individuals who had COVID-19 infection at the time of diagnosis. [7] Other reports and reviews have also documented sudden hearing loss occurring during acute COVID infection. [3,8]
However, the scientific literature remains inconsistent, and researchers have appropriately cautioned against assuming that every case of sudden hearing loss occurring around the time of COVID was directly caused by the virus. From a patient’s perspective, though, determining the exact cause at home is not the priority. Recognizing the symptoms and seeking appropriate care is.
Sudden hearing loss should be treated as a medical urgency. If you suddenly experience a significant loss of hearing, particularly in one ear, do not simply assume that your ear is clogged from congestion or that your hearing will return when your COVID symptoms disappear. Prompt medical and audiological evaluation is important because treatment for sudden sensorineural hearing loss can be time sensitive.
Do Hearing and Tinnitus Symptoms Improve Over Time?
For many patients, this may be the most reassuring part of the research. Evidence suggests that hearing and tinnitus symptoms following COVID improve over time in many people, particularly among nonhospitalized patients. [4] Improvement, however, does not always happen immediately or follow a predictable timeline.
Long COVID itself is remarkably variable. One person may experience symptoms for several weeks, while another continues experiencing them for months. Symptoms may improve steadily, fluctuate from day to day, disappear and return, or occasionally emerge well after the initial infection appears to have resolved.
A large Scottish study examining the natural history of long COVID found that hearing problems could sometimes emerge later in recovery, including beyond six months after infection. [8] This finding reinforces an important point about long COVID: there is not necessarily one standard trajectory that applies to everyone.
That variability can understandably be frustrating for patients, but it also means that persistent symptoms should not automatically be interpreted as permanent symptoms. Having tinnitus for three months does not mean that the tinnitus will remain unchanged forever. Similarly, noticing hearing difficulty six months after COVID does not mean that nothing can be done. At the same time, waiting indefinitely and hoping that persistent hearing problems simply disappear is not necessarily the best strategy.
When Should You Have Your Hearing Tested?
If you have noticed a persistent change in your hearing following COVID, a comprehensive hearing evaluation is reasonable. This is especially important if you are having difficulty understanding conversations, struggling to hear in restaurants or groups, experiencing persistent or bothersome tinnitus, noticing fullness or pressure in the ears, experiencing dizziness or imbalance, or noticing that hearing seems different between your two ears.
A comprehensive hearing evaluation should look beyond whether you can simply hear a series of beeps in a quiet room. Depending on your symptoms, testing may include measures of hearing sensitivity, speech understanding, middle ear function, inner ear function, and the ability to understand speech when background noise is present. Tinnitus should also be evaluated in the context of your overall hearing and auditory function rather than treated as an isolated symptom.
Patients experiencing sudden hearing changes, significant dizziness, neurological symptoms, or other concerning findings may also require additional medical evaluation. The goal is not simply to determine whether COVID “caused” the problem. The more important clinical question is to determine what has changed and what can be done about it.
What If My Hearing Test Is “Normal,” But I Still Struggle?
This is an especially important issue because some patients describe very real hearing difficulties even though a traditional hearing test falls within what has historically been considered the “normal” range. A person may be able to hear quiet tones in a testing booth yet still struggle tremendously to understand speech in a restaurant, follow a conversation when several people are talking, or hear clearly when there is competing background noise.
These concerns should not automatically be dismissed simply because a basic audiogram appears normal. A traditional audiogram measures hearing sensitivity across a limited range of frequencies in a highly controlled environment. It is an important clinical tool, but it does not measure every aspect of auditory function.
Real world hearing is far more complicated. The ears and brain must rapidly detect sound, separate speech from competing noise, encode complex acoustic information, maintain attention, and interpret what another person is saying. Difficulties anywhere within that process may affect someone’s ability to communicate even when basic hearing sensitivity appears relatively good.
For someone experiencing post COVID auditory complaints, additional testing such as speech in noise testing or measures of cochlear function may therefore provide useful information that a simple hearing screening does not. The goal should be to understand how well you are hearing and functioning in everyday life, not simply whether the results of one test fall inside a particular range.
Can Post COVID Hearing Loss and Tinnitus Be Treated?
There is currently no single medication or treatment specifically designed to reverse every case of post COVID hearing loss or post COVID tinnitus. Treatment depends on the nature of the symptoms, the results of the evaluation, and the individual needs of the patient.
If measurable hearing loss is present, appropriate hearing treatment may improve communication and, for some patients, reduce the perception or impact of tinnitus. If tinnitus is the primary concern, treatment may include education, counseling, sound based approaches, appropriate hearing technology, sleep management, stress management, and strategies designed to reduce the brain’s attention and emotional response to the tinnitus.
The appropriate approach depends heavily on the individual. Two people can both develop tinnitus after COVID and have very different hearing profiles, medical histories, symptoms, and treatment needs. This is why treating COVID tinnitus as though it were one single disease is unlikely to be helpful. A better approach is to determine what has changed within that particular person’s hearing and auditory system and develop an individualized treatment strategy.
The Bottom Line: Do Not Panic, But Do Not Ignore It
Hearing loss and tinnitus have been reported during and after COVID-19 infection, including among people experiencing long COVID. The scientific community is still working to determine exactly how frequently these problems occur, which patients are most susceptible, and the biological mechanisms responsible. Current research supports an association between COVID and auditory symptoms, but it does not prove that COVID directly causes every case of hearing loss or tinnitus that occurs following infection.
For many people, these symptoms appear to improve with time. For others, however, they persist and can meaningfully affect communication, sleep, concentration, emotional wellbeing, relationships, work, and overall quality of life. Those patients deserve more than being told to wait indefinitely and hope the problem disappears.
If your hearing has changed since having COVID, or if tinnitus appeared or became significantly worse following your illness, there is no reason to panic. There is, however, good reason to understand what has changed. A comprehensive hearing and tinnitus evaluation can help identify measurable changes in auditory function, rule out other potential causes, and determine whether treatment may help.
Hearing is not simply an ear function; it is part of a much larger neurological system involving the inner ear, auditory nerve, brain, attention, memory, and communication. If that system seems different following COVID, it is reasonable to have it properly evaluated.
Sources
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- Degen CV, Mikuteit M, Niewolik J, et al. Self-reported tinnitus and vertigo or dizziness in a cohort of adult long COVID patients. Frontiers in Neurology. 2022;13:884002. doi:10.3389/fneur.2022.884002
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- Abdul Rahim NS, Lim XJ, Leong EL, et al. Association of COVID-19 infection and COVID-19 vaccination with idiopathic sudden sensorineural hearing loss in Malaysia: a case-control study. BMC Public Health. 2025;25(1):920. doi:10.1186/s12889-025-21765-w
- Hastie CE, Lowe DJ, McAuley A, et al. Natural history of long-COVID in a nationwide, population cohort study. Nature Communications. 2023;14(1):3504. doi:10.1038/s41467-023-39193-y