In addition, 7-15% of adults in some studies of acute Covid symptoms report audiovestibular symptoms, either tinnitus or hearing loss or both. Some patients with acute Covid report vertigo.
NICE defines long Covid as signs or symptoms that develop with acute Covid infection, continue for longer than 12 weeks and are not explained by an alternative diagnosis.3 It lists loss of taste or smell, tinnitus and earache as common long Covid ENT symptoms, along with sore throat and dizzines.
Over 50% of patients in one survey reported anosmia continuing after 12 weeks.4 Although tinnitus and hearing loss are also reported to be part of long Covid, the incidence is not known.5
Management of tinnitus
Stress is linked to tinnitus, so financial worries, bereavement, depression and isolation, all of which have increased during the pandemic, are factors that have to be taken into account. A holistic approach to assessment and management is needed. An audiogram can be helpful, as tinnitus and hearing loss are often co-existent.
The prognosis for long Covid-related tinnitus is not clear. Often, explanation and reassurance are enough. Treatment of coexisting depression or anxiety is often appropriate, and cognitive behavioural therapy can help. Night-time symptoms can be treated by distraction, using quiet music or soothing sounds. Occasionally low-dose amitriptyline can be used to help sleep.