Evidence suggests that the Covid-19 coronavirus may affect your ear and hearing, even if you are ... [+] otherwise asymptomatic. But how strong is this evidence. (Photo: Getty)

Seemingly every week more evidence emerges that the Covid-19 coronavirus is like a really bad box of chocolates. You never know what you're gonna get.

Well, hear is more to consider. Some scientific publications have suggested that the virus may affect your hearing. In fact, theres the possibility that hearing loss could occur even if you dont have any other symptoms. So you think that youve gotten away with no symptoms from a Covid-19 coronavirus infection, but is that really the case?

Just take a look at a post on Medium by Shin Jie Yong, who describes himself on the site as a 20 year old neurobiology postgrad in Malaysia with the life goal of being able to afford a place with dogs. While his article didnt specify exactly why his current place cant have dogs or how much money would be required to have a doggified place, it did list some of the evidence that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may have an ear-ry effect.

For example, he cited a letter published in the American Journal of Otolaryngology. It wasnt one of those, hey, how are you doing or you move me, and it isnt my bowels letters. Instead this was a very, very brief case report letters that mentioned the case of an old female in Thailand who was diagnosed with Covid-19 and suffered from hearing loss. This letter contained very few details about the case, including what the authors considered old. So this letter alone didnt provide too much evidence and probably deserved a letter grade of a D minus.

Earning better than a D minus was a subsequent publication in the American Journal of Otolaryngology. This publication was certainly more substantive as it detailed a study conducted by M.W.M.Mustafa of the Qena Faculty of Medicine, South Valley University in Egypt. Mustafa administered hearing tests to 20 people who had tested positive for Covid-19. Now twenty isnt a lot unless you are talking about people in an elevator. But it is certainly more than one. None of the study participants had any other known symptoms from the infection. The study participants were between 20 and 50 years of age and had no history of hearing loss either. Nevertheless, they performed significantly worse than normal on some parts of the hearing tests, including the high frequency pure-tone thresholds and the transient evoked otoacoustic emissions (TEOAE) amplitudes.

Then, there was the letter published in Acta Otorhinolaryngologica Italica. This letter was more of a case series than a formal study. It described six patients, ranging from 22 to 40 years of age, who had more typical Covid-19 symptoms like fever, cough, and shortness of breath as well as seemingly ear-related symptoms. Two had vertigo, with one case being very mild. Four had ringing in the ears. All six had some type of hearing loss, more on one side.

Of course, just because you test positive for the Covid-19 coronavirus doesnt mean that the virus is responsible for everything that you are suffering. So Yong did mention a letter published in the International Journal of Immunopathology and Pharmacology that had the following title: Dont forget ototoxicity during the SARS-CoV-2 (Covid-19) pandemic! It isnt super common for the title of a scientific publication to have an exclamation point at the end of it. Nevertheless, this letter was to warn health professionals that a number of medications being tried to treat the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can have ototoxicity. While the OTO is apparently a magical order that was founded in Germany in 1901 and focused on sex magic, in this case, oto instead stood for ear. Thus, ototoxicity means toxic to or may damage the ear. The list of drugs that are potentially ototoxic includes chloroquine, hydroxychloroquine, azithromycin, remdesivir, favipiravir and lopinavir. Thus, could hearing problems be the result of medications taken rather than the virus? Perhaps.

On the flip side, it wouldnt be too surprising if the virus were to somehow affect ear function. After all, as Yong pointed out, other viruses such as the herpes simplex virus type 1 (HSV-1), the herpes zoster virus (HZV), the cytomegalovirus, the measles virus, and the human immunodeficiency virus (HIV) can affect the ear and cause ear-related symptoms.

Furthermore, theres already been growing evidence that the virus seems to know no boundaries, kind of like that guy who will mention his testicles during a a dinner party or a work meeting. Cases have shown that the virus may spread well beyond the respiratory tract into the nervous system. For example, in a research letter published in JAMA Otolaryngology Head and Neck Surgery, a team from the Johns Hopkins School of Medicine (Kaitlyn M. Frazier, MD, Jody E. Hooper, MD, Heba H. Mostafa, MBBCh, PhD, D(ABMM), and C. Matthew Stewart, MD, PhD) described how they detected SARS-CoV2 in the mastoid or middle ear of three patients.

All in all, the evidence to date merely suggests that the Covid-19 coronavirus can affect your ears and potentially leave you with some hearing loss. More studies woule be necessary to form firmer conclusions. Future studies should entail testing more and a wider variety of patients, preferably with hearing tests before and after infection. Plus, its not clear how long such effects may last so following patients for longer periods of time would provide further insight.

Nevertheless, any possibility of hearing loss needs to be taken seriously. Hearing loss is already of significant problem around the world. In the U.S., approximately one in three people between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 has difficulty hearing, according to the National Institute of Aging (NIA). But hearing loss is not just an issue for older adults. The Hearing Loss Association of American (HLAA) website has a statistic that one in five teens experience some degree of hearing loss. If the Covid-19 coronavirus could indeed affect your hearing, will this pandemic make all of these statistics worse?

The widespread use of face masks may help reduce the transmission of the Covid-19 coronavirus but ... [+] can make it more challenging for the hearing impaired who rely on reading lips for communication. (Photo by Alexi Rosenfeld/Getty Images)

The pandemic has already brought new challenges to those with existing hearing issues. As Janice S. Lintz, CEO, Hearing Access & Innovations, pointed out, the coronavirus prevents people from lip reading since people are wearing face masks. If Covid-19 coronavirus infections end up adding to the total number of people suffering from hearing loss, Lintz added that this will make a bad situation worse.

This would make an already complex infection even more complex. This would be further evidence that a single number alone like deaths or hospitalizations cannot capture the full impact of the Covid-19 coronavirus. It is not just like a cold or the flu. Chances are that your immune system has never seen a virus like this. That means that your body is a wonderland to the virus, but not in a John Mayer type of way. Scientists are rushing to figure out what this virus can do to your body. The rush to re-open prematurely and return society to normal, which by the way aint going to happen anytime soon, for political and business reasons can have bad, long-standing consequences. Instead, people have to listen to science. Heck not listening could end up affecting your hearing in more ways than one.

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Can Covid-19 Coronavirus Cause Hearing Problems Even With No Other Symptoms? - Forbes