COVID-19-vaccine associated cochlear-vestibular symptoms

ABSTRACT

Introduction As part of the immune response to the COVID-19-vaccine a multitude of anti-COVID-antibodies is formed. A part of these antibodies can bind to the body-s own tissue and facilitate autoinflammatory processes. Such autoimmune-inflammatory processes are suspected to be behind various symptoms of the COVID disease and the long-COVID syndrome. So far, numerous reports on neuro-otological symptoms in the context of COVID infection have been published. The present report describes patients who presented in a university ENT outpatient department with vestibulo-cochlear symptoms in connection with a COVID vaccination. Methods All patients who presented with dizziness, tinnitus and hearing impairment for the first time in a direct temporal context (max. 3 days after vaccination) tot he vaccination were examined by an ENT specialist and further examined using subjective and objective audiometry and, depending on the symptoms, using vestibular diagnostics. Results An otitis media was not found in any patient. A cochlear genesis of the vestibulo-cochlear symptoms could be demonstrated in all patients. One patient has isolated symptoms with hearing loss, all others also suffered from tinnitus or dizziness. In all patients, the symptoms resolved after drug therapy was carried out. Discussion Vaccine-associated hearing loss has also been described in the case of influenza vaccination. We were unable to provide direct evidence of the COVID vaccination as the triggering factor for the vestibulo-cochlear symptoms. An association of these symptoms with the vaccination cannot be ruled out though. The most likely mechanism is an immunoglobulin-triggered specific autoimmune response.