The effects of COVID-19 on the vestibular system

Introduction: The symptoms and severity of SARS-CoV-2 infection vary greatly across the spectrum, from asymptomatic infection to severe pneumonia with acute respiratory distress syndrome and even death. Dizziness is a frequently reported symptom of SARS-CoV-2 viral infection. However, the extent to...

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Hauptverfasser: Zaubitzer, Lena (VerfasserIn) , Ludwig, Sonja (VerfasserIn) , Berkemann, Michelle (VerfasserIn) , Walter, Beatrice (VerfasserIn) , Jungbauer, Frederic (VerfasserIn) , Held, Valentin (VerfasserIn) , Hegemann, Stefan C. A. (VerfasserIn) , Rotter, Nicole (VerfasserIn) , Schell, Angela (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 10 March 2023
In: Frontiers in neurology
Year: 2023, Jahrgang: 14, Pages: 1-8
ISSN:1664-2295
DOI:10.3389/fneur.2023.1134540
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3389/fneur.2023.1134540
Verlag, lizenzpflichtig, Volltext: https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1134540/full
Volltext
Verfasserangaben:Lena Zaubitzer, Sonja Ludwig, Michelle Berkemann, Beatrice Walter, Frederic Jungbauer, Valentin Held, Stefan C.A. Hegemann, Nicole Rotter and Angela Schell

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520 |a Introduction: The symptoms and severity of SARS-CoV-2 infection vary greatly across the spectrum, from asymptomatic infection to severe pneumonia with acute respiratory distress syndrome and even death. Dizziness is a frequently reported symptom of SARS-CoV-2 viral infection. However, the extent to which this symptom results from the effect of SARS-CoV-2 on the vestibular system remains unclear. Materials and methods: In the present single-center, prospective cohort study, patients with a previous SARS-CoV-2 infection underwent a vestibular assessment consisting of the Dizziness Handicap Inventory to assess dizziness during and after infection, a clinical examination, the video head impulse test, and the subjective visual vertical test. When the subjective visual vertical test result was abnormal, vestibular-evoked myogenic potentials were performed. Vestibular testing results were compared to pre-existing normative data of healthy controls. In addition, we performed a retrospective data analysis of patients admitted to hospital presenting with acute symptoms of dizziness who were also diagnosed with acute SARS-CoV-2 infection. Results: A total of 50 participants have been enrolled. During and after the SARS-CoV-2 infection, women were significantly more likely than men to suffer from dizziness. A significantly reduced semicircular canal or otolith function was not observed in either women or men. Acute SARS-CoV-2 infection was diagnosed in nine patients who presented to the emergency room with acute vestibular syndrome. Six of the patients exhibited acute unilateral peripheral vestibulopathy upon diagnosis. A different patient was diagnosed with vestibular migraine, and two individuals had a posterior inferior cerebellar artery infarct revealed by magnetic resonance imaging. Discussion/conclusion: Overall, a persisting structural affection of the vestibular system by SARS-CoV-2 seems to be unlikely and could not be confirmed by vHIT, SVV, and VEMPS in our study. It seems possible but unlikely that SARS-CoV-2 induces acute vestibulopathy. Nevertheless, dizziness is a common symptom in patients with COVID-19, which should be taken and worked through seriously. 
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