Bokhary Haider, Chaudhry Shiza, Abidi S M Rafey
Emergency Medicine, University Hospital of North Tees, Stockton-on-Tees, GBR.
Medicine, Shifa International Hospital, Islamabad, PAK.
Cureus. 2021 Aug 12;13(8):e17121. doi: 10.7759/cureus.17121. eCollection 2021 Aug.
Since the declaration of coronavirus disease 2019 (COVID-19) as a pandemic, it remains a widespread infection with a major impact on global resources and health infrastructure. The hallmark of COVID-19 continues to be the well-documented effects it has on the respiratory system. With the passage of time, the involvement of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus in other systems has become more apparent, with the increased incidence of thromboembolic events, cardiac involvement as well as gastrointestinal and neurological symptoms secondary to the infection. Our case report demonstrates a presentation of vertigo, hearing loss, tinnitus, and aural fullness. Our patient was diagnosed as positive for COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR) nine days prior to developing these symptoms. Her COVID-19 infection was otherwise relatively mild, for which she did not seek any medical intervention. A careful assessment ruled out cerebrovascular causes and led us to the diagnosis of SARS-CoV-2-induced labyrinthitis. Our patient was successfully treated as an outpatient without unnecessary investigations and responded well to standard therapy for viral labyrinthitis as per National Health Service (NHS) guidelines. She eventually reported having made a full recovery within three weeks of the initial encounter. Audio-vestibular consequences of COVID-19 are less reported compared to other symptoms of neurological involvement, such as gustatory or olfactory dysfunction, which have become key indicators aiding in the diagnosis of the infection. Among these disorders, the commonly reported presentation is that of vestibular neuronitis. Our case report demonstrates that labyrinthitis is also among the neurological manifestations to be considered as a result of COVID-19, which can be safely managed in the community with the same strategies as those employed for other viral triggers. It also reveals the need for further research into the effects that COVID-19 may have on the audio-vestibular system.
自2019冠状病毒病（COVID-19）被宣布为大流行病以来，它仍是一种广泛传播的感染病，对全球资源和卫生基础设施产生重大影响。COVID-19的标志仍然是其对呼吸系统有充分记录的影响。随着时间的推移，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒对其他系统的影响变得更加明显，血栓栓塞事件、心脏受累以及继发于感染的胃肠道和神经系统症状的发生率增加。我们的病例报告展示了眩晕、听力损失、耳鸣和耳闷的症状表现。我们的患者在出现这些症状九天前经逆转录聚合酶链反应（RT-PCR）检测被诊断为COVID-19阳性。她的COVID-19感染相对较轻，因此她未寻求任何医疗干预。经过仔细评估排除了脑血管病因，从而诊断为SARS-CoV-2诱发的迷路炎。我们的患者作为门诊病人成功接受治疗，无需进行不必要的检查，并且按照英国国家医疗服务体系（NHS）的指南，对病毒性迷路炎的标准治疗反应良好。她最终报告称在初次就诊后的三周内已完全康复。与其他神经系统受累症状（如味觉或嗅觉功能障碍，这些已成为辅助诊断该感染的关键指标）相比，COVID-19对听觉前庭系统的影响报道较少。在这些疾病中，常见的表现是前庭神经炎。我们的病例报告表明，迷路炎也是COVID-19导致的神经系统表现之一，可在社区中采用与其他病毒引发疾病相同的策略进行安全管理。它还揭示了需要进一步研究COVID-19可能对听觉前庭系统产生的影响。
