Category: Covid-19

Right now, the best answer anyone can give to this question is maybe. Although a definitive link has not yet been established, there is some evidence to suggest COVID infection may contribute to hearing loss in some patients. Why? Here is what we currently know:

While it is not yet possible to prove that COVID-19 infection is directly responsible for hearing loss, the virus can and does enter the ear probably through the Eustachian tube, which connects the nose and middle ear. Once it gains entry to the ear, the virus can actively infect both the cochlear (hearing) and vestibular (balance) hair cells, potentially causing:

In addition, COVID-19 is not just a respiratory disease. It can affect almost all of the major organ systems in the body, including the vascular system. Vascular effects may include blood vessel damage and/or the formation of microemboli (tiny clots) that can interrupt blood flow. If the artery that supplies blood to the inner ear is damaged or blocked, it can affect both the cochlea (a highly vascularized organ in the inner ear responsible for hearing) and the vestibular organs responsible for balance.

COVID-19 is a viral illness and, like any virus, it infects the body by invading cells and using components of that cell to make copies of itself and spread. Although COVID-19 often has far more serious health implications than other viruses like the common cold and influenza, it does have one thing in common with them it frequently results in upper respiratory symptoms such as coughing along with nasal and sinus congestion.

And, because COVID-19 causes inflammation in the nose and nasopharynx (the upper part of the throat located behind the nose), the Eustachian tube (the tube that connects the nose and middle ear) may also become inflamed during the course of the infection and lead to middle ear congestion.

Inflammation of the Eustachian tube often results in an acute buildup of fluid in the middle ear space, says ear, nose and throat specialist, Sarah Mowry, MD. This middle ear fluid results in congestion, fullness and a feeling of underwater hearing. This fluid often clears spontaneously within a few weeks of the inflammation. If it doesnt, a physician can drain the fluid to improve the hearing-related symptoms, usually with a simple office procedure.

There are some anecdotal reports of patients experiencing tinnitus and/or dizziness after receiving the two-dose vaccine regimens from Moderna and Pfizer. However, the reason for this is unclear because the vaccines do not actively affect the inner ear tissues. It is, therefore, unlikely that hearing and balance symptoms are directly linked to vaccination.

Since COVID-19 was first recognized in early 2020, we have gained much understanding of how the virus can affect the body both during the initial phase of infection and in the weeks and months that follow. When symptoms persist or develop well after the acute infection, it is often called Long Haul Syndrome or Long COVID.

Although relatively rare, there are a few studies that have documented hearing symptoms in post-COVID patients that were not present earlier in the infection process. Symptoms included mild to profound hearing loss, vertigo and/or tinnitus in one or both ears.

Much more research is needed before we can fully understand how COVID-19 and its variants affect hearing and balance. In the beginning, much of the research being done was related to the prevention, diagnosis and treatment of the virus in the acute phase of infection. As the pandemic winds down, research efforts will likely become more focused on the long-term effects of the virus and how it can affect various body functions, including hearing and balance.

If your hearing loss is sudden, consider it a medical emergency. You should always seek care right away at an emergency room or from an ear, nose and throat physician. There can be numerous reasons for sudden hearing loss and, the sooner it is diagnosed, the more likely your hearing can be restored.

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Can COVID-19 Cause Hearing Loss? - University Hospitals

What is Coronavirus?

Coronaviruses are a type of virus that are common in animals and, rarely, infect humans. A newly identified coronavirus emerged in humans in Wuhan, China in December 2019. Its called coronavirus because it is covered with pointed structures that look like a corona, or crown. COVID-19 is the respiratory illness caused by the new coronavirus.

People with the virus have reported symptoms that range from mild to severe, including illness resulting in death. Mild cases may be difficult to distinguish from colds or flu.

Symptoms may appear two to 14 days after exposure. They include:

Most patients will get symptoms like fever, sore throat or cough, says Elie Saade, MD, UH Director for Infection Control. In a minority of patients, that will progress to cause severe pneumonia and that can lead to death.

If you develop symptoms, call your doctor.

CHECK YOUR SYMPTOMS Think you or a loved one may have coronavirus? Well help you find the right care. Check your symptoms now.

Feeling feverish? Have a cough? Trying not to rub itchy eyes? If you're feeling ill but are unsure what illness you may have, check out our symptom guideon The Science of Health blog.

The coronavirus is a respiratory disease that appears to spread like the flu virus person-to-person and through the air. Virus-containing droplets from coughs or sneezes land in the mouth or nose of another person. You also can pick up the virus by touching an infected surface with your hand, and then touching your eyes, nose or mouth.

People with the virus may be able to spread it before symptoms appear but, in general, people are thought to be most contagious when they are the most symptomatic.

People have little or no immunity to the virus because it is new. This allows the virus to spread quickly from person to person around the world. It may be months before an effective vaccine is developed.

People who have a higher chance of getting very sick from COVID-19 are:

If you are at higher risk for serious illness from COVID-19 because of your age or because you have a serious long-term health problem, it is extra important for you to take actions to reduce your risk of exposure to the disease.

Most people infected with the coronavirus will have mild symptoms and can recover at home without seeing a doctor for treatment.

If you have symptoms of COVID-19, follow these steps:

Call your physician. Call your physician as the first step in your care and follow your physicians advice for treatment at home. Your doctor will determine if you need to be tested. If you dont have a physician, visit a UH Testing Sitefor evaluation by a clinician.

Stay home. Try to stay in one room and away from other people. Do not share dishes, drinking glasses, towels or bedding, and wash them after use. Use a separate bathroom, if possible. Do not go into public places, such as a grocery store, or use public transportation or ride-sharing services.

Monitor and treat your symptoms. Take your temperature. You can take acetaminophen (sold under brand names such as Tylenol) to reduce fever and relieve body aches. Drink plenty of fluids and rest.

Watch for severe signs. If you develop trouble breathing, seek medical attention. Be sure to call your doctor or emergency room before going in and tell them your symptoms.

CHECK YOUR SYMPTOMS Think you or a loved one may have coronavirus? Well help you find the right care. Check your symptoms now.

If you suspect you have COVID-19 because of symptoms or confirmed exposure to someone with the virus, use the evaluation and testing guidelines to determine when and where to go for care.

A government website,COVID.gov,can help you find locations near you that offer COVID-19 testing, medications, vaccines, masks and more. The site can help you find test-to-treat locations, where you can receive antiviral medication on the spot if you test positive for COVID-19. There are currently more than 2,000 of these one-stop-shop locations in the U.S., including many in Northeast Ohio. The websitecan also help you find where you can receive COVID-19 vaccines and high-quality masks. You can also order at-home test kits through the website.

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Coronavirus: What You Need to Know - University Hospitals

Since the earliest days of the pandemic, doctors treating people with COVID-19 noticed that a sudden loss of smell was a hallmark of the illness. As the vast majority of our sense of taste derives from our sense of smell, these COVID-19 patients also may have experienced a loss of taste as well.

After recovering from COVID-19, many patients fail to recover their sense of smell right away, and some may worry the situation could be permanent.

A recent study has encouraging news for these patients. The results showed that nearly all patients who lost their sense of smell after having COVID-19 regained the ability.

A French research team tracked the sense of smell of 97 patients averaging about 39 years of age. All had lost their sense of smell after contracting COVID-19.

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The patients were asked about any improvements in their smelling ability at four months, eight months and then a full year after the loss of smell began. About half were also given specialized testing to gauge their ability to smell.

By the four-month mark, objective testing of 51 of the patients showed that about 84 percent had already regained a sense of smell, while six of the remaining eight patients had done so by the eight-month mark. Only two out of the 51 patients whod been analyzed using the specialized tests had some impaired sense of smell one year after their initial diagnosis, the findings showed.

Overall, 96 percent of the patients objectively recovered by 12 months, the researchers reported.

The study was published online June 24 in JAMA Network Open.

The good news is that the vast majority of people who get COVID will recover their smell and taste entirely or will not be affected, says Kenneth Rodriguez, MD, Chief of Sinus and Skull Base Surgery at UH.

For those that do lose their sense of smell for a prolonged period, there can be concerns that extend beyond the pleasure of tasting ones food.

A lot of people dont realize how much they miss their sense of smell until it is gone. For example, not being unable to smell something burning can be a health hazard, says Brian DAnza, MD, a UH rhinologist and sinus surgeon.

One type of treatment that has shown promise is smell retraining therapy. It involves exposing the patient to different strong scents for several minutes at a time for three months.

It is a simple concept, but has shown evidence of significantly improving smell over time. I offer the therapy to all my patients, says Courtney McAvinew, CNP, a rhinology and sinus specialist at UH.

Smell retraining therapy can be effective for many different causes of smell loss, and not just COVID.

Finding the right treatment starts with a precise diagnosis. Our board-certified ear, nose and throat (ENT) physicians have the experience and advanced diagnostic techniques to pinpoint your specific nasal, sinus or allergy condition and prescribe the right medications and treatments for fast, long-term relief. Learn more about nose, sinus and allergy treatment at UH.

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Smell and Taste Loss After COVID: Should You Be Worried?

Pulmonary

Respiratory complaints after acute COVID-19 often include, shortness of breath, chest pain and coughing. While generally such symptoms resolve over time, if they are persistent or are worsening they may indicate a given individual is developing a post-acute COVID respiratory complication, including pneumonia; worsening asthma; or blood clots within the lungs (pulmonary emboli).

The clinicians at the UH COVID Recovery Clinic will conduct a thorough assessment of each patient to determine how serious their condition is and create a customized treatment plan. Based on a given person's complaints the evaluation may include a chest X-ray, pulmonary functions tests, CT scan, echocardiography and even ultrasounds of the legs. If diagnostic testing is considered urgent it will be conducted the same day so results are available quickly and the appropriate treatment can begin.

In addition, it should be understood that shortness of breath is not always caused by respiratory dysfunction alone, but is often related to cardiac issues since the heart and lungs work in tandem. As a result, when evaluating shortness of breath in a patient recovering from COVID, cardiac testing is often needed as well.

Using a team-based, multidisciplinary approach, therapies for patients with respiratory symptoms may include:

Cardiac symptoms may include chest pain, irregular or rapid heartbeats, shortness of breath, dizziness and feeling faint. These symptoms can occur because COVID has caused damage to your heart muscle, blocked blood flow in your coronary arteries, caused inflammation of the lining around your heart or damaged the nerves that control your heart rhythm.

The clinicians at the UH COVID Recovery Clinic will conduct a thorough assessment of each patient to determine the severity of their condition. The evaluation will involve a variety of diagnostic tests which may include:

Using a team-based, multidisciplinary approach, the heart specialists at the UH COVID Recovery Clinic will devise a customized treatment plan for each patient with cardiac symptoms. Treatments may include medications and/or cardiopulmonary rehab to strengthen the heart muscle.

Sleep disturbances can lead to a dysfunctional sleep/wake cycle; worsening insomnia; new or worsening sleep apnea; daytime fatigue; weakness; excessive sleepiness; and even cognitive impairment. Those who had sleep problems like insomnia or sleep apnea before COVID may see worsening symptoms in the weeks and months that follow recovery. This may be due in part to the stress they experienced during their active treatment, particularly if it included hospitalization and/or intubation.

The sleep specialists at the UH COVID Recovery Clinic will evaluate those patients who report sleep-related health issues and prescribe the appropriate therapies to improve their sleep. These may include:

The UH COVID Recovery Clinic has a multidisciplinary sleep medicine group that includes specialists in neurology, psychiatry, family medicine and internal medicine who work together to devise the best treatment plan to restore and improve sleep for each patient. In addition, we collaborate with our colleagues in behavioral medicine and integrative health to provide patients with the tools to promote relaxation, manage stress and restore sleep health.

Behavioral health conditions in post-COVID patients may include heightened stress levels; new or worsening anxiety, depression or paranoia; and, in extreme cases, suicidal thoughts. In addition, patients hospitalized with COVID, particularly those requiring treatment in the intensive care unit, can have symptoms similar to Post Traumatic Stress Disorder (PTSD).

The clinical teams at the UH COVID Recovery Clinic are prepared to manage a broad range of behavioral health conditions and can assist with referrals to specialists as appropriate. We work together with neurology, sleep medicine, psychology, social work and the Connor Whole Health to provide patients with the best path forward to restore their mental health and get back to living the life they love. Treatments may include:

In some people, their response to COVID-19 infection may include symptoms of confusion, memory loss, headache, dizziness, numbness, tingling and paralysis due to brain inflammation (encephalitis), stroke, neuropathy, spinal cord damage and damage to the autonomic nervous system. While neurologic complications of COVID occur more commonly in patients requiring hospitalization, related symptoms can persist and even newly develop during the recovery phase of COVID-19. In these situations, a comprehensive clinical assessment is necessary.

The clinical team at the UH COVID Recovery Clinic collaborates with neurologists and neuropsychologists to determine the best possible treatment plan for patients with neurological symptoms. Depending on the severity of their diagnosis, treatments may include:

Joint pain or swelling, fatigue, muscle pain and weakness, and new or ongoing chronic pain are symptoms that are often seen in the post-COVID patient. It is important that patients experiencing these symptoms be evaluated to determine if they are experiencing heightened inflammation related to COVID-19 or if an auto-immune disorder or infection is causing the problem.

For symptoms such as these, the clinical team at the UH COVID Recovery Clinic will collaborate with specialists in rheumatology, infectious disease and immunology to determine the root cause of the problem and devise an appropriate, multidisciplinary treatment plan. The first step will be to have the patient undergo a comprehensive physical exam that includes taking a complete medical history (pre- and post-COVID), blood tests and imaging exams. Depending on the findings of the exam, treatments may include:

Persistent loss of taste and smell, sore throat, nasal congestion or drainage are the most common ENT symptoms reported by post-COVID patients. The wind pipe (trachea) may even be damaged during the acute course of COVID-19.

If a patient seen at the UH COVID Recovery Clinic reports symptoms related to the ear, nose and throat, such as those listed above, we will consult with a UH otolaryngologist and, when appropriate, refer the patient for specialized diagnosis and treatment.

Infection with COVID-19 can affect the GI tract by disrupting its functioning and reducing its ability to absorb fluids and electrolytes from the body. The liver, pancreas and gall bladder may also be damaged by the inflammation caused by COVID. Gastrointestinal symptoms may include appetite changes, upper abdominal pain, diarrhea, gastric reflux (acidity) and vomiting. Furthermore, elevated liver functions may be a sign liver damage.

If a patient seen in the UH COVID Recovery Clinic reports symptoms such as those described above, our team will conduct a thorough evaluation and make the appropriate referrals for specialty care. Digestive disorders such as these must be addressed quickly to avoid further complications such as bleeding in the GI tract. Recommended treatments may include:

Some patients may experience deficits of the endocrine system in the weeks and months after an acute COVID-19 infection. These may include new or worsening diabetes, thyroid damage and/or kidney damage leading to impaired renal function.

If a patient seen at the UH COVID Recovery Clinic reports any symptoms that indicate endocrine/metabolic dysfunction, such as those listed above, our team will conduct a thorough evaluation, which may include a physical exam, blood tests and imaging studies. When appropriate, we will consult with a UH endocrinologist and refer the patient for specialty care.

Most patients will experience some degree of physical disability after an acute COVID-19 infection, particularly if they were hospitalized. This may be simply due to the deconditioning that results from having spent more time in bed, or it may be as a direct result of damage caused by the virus. Patients may have weakness in their legs, hands and fingers; generalized muscle pain; persistent fatigue; loss of physical endurance; and balance problems - all of which can lead to difficulties in performing the activities of daily living, and ultimately a loss of function and independence.

At the UH COVID Recovery Clinic, we have a team of physical medicine & rehabilitation specialists with the unique training and expertise to evaluate these symptoms in patients and, in collaboration with other team members, determine if they are caused by existing medical conditions like arthritis, or if they are COVID-related.

If symptoms are determined to be COVID-related, our physical and occupational therapists will work to create a customized exercise program for each patient, designed to improve their overall functioning and help them get back to their life and the activities they enjoy.

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UH COVID Recovery Clinic - University Hospitals

Monkeypox, a rare disease usually found in West and Central Africa, is hop-scotching across continents, with cases growing in the United States, Europe and Australia. While the outbreak is attracting headlines, there is little threat of a massive global pandemic and no comparison to COVID-19.

There are important differences that make monkeypox a much less serious threat than COVID-19, says Amy Edwards, MD, University Hospitals Rainbow Babies & Childrenspediatric infectious disease specialist. These include:

Unlike COVID-19, this virus doesnt transmit human to human very efficiently, Dr. Edwards says. Its also much easier to isolate infected individuals and prevent the spread.

Symptoms of monkeypox are skin rashes or lesions that spread on the body. The virus also can produce flu-like symptoms. Dr. Edwards shares more information about the virus and answers common questions.

Dr. Edwards: Transmission happens during close contact prolonged physical contact or direct contact with body fluids or lesions. It may also spread face to face through respiratory droplets or contact with contaminated bedding or clothing.

It doesnt spread through the air like COVID-19, as far as we know. And unlike COVID-19, monkeypox isnt contagious until the infected person becomes symptomatic. That makes it much easier to isolate infected individuals and prevent the spread.

Dr. Edwards: The incubation is relatively long, up to one to two weeks. The smallpox vaccine or a newer smallpox/monkeypox vaccine that came out in 2019 can prevent the disease in a person who has been exposed or who is at risk of being exposed, such as a caregiver or household contact.

The fact that we already have an effective vaccine is another factor that sets monkeypox apart from COVID-19, which was a novel virus that required development of a new vaccine. We know how to handle monkeypox because its so closely related to smallpox.

Dr. Edwards: Most people will have a relatively minor infection. A strain from West Africa that is spreading has a fatality rate of less than 1 percent. But thats the mortality rate in Africa. It seems to be very different in developed countries where medical care is better.

When monkeypox jumps to another continent, its always the West African strain. Nobody in the United States has ever died from the West African strain. That continues to hold true during the current outbreak, though it is important to note that vulnerable populations (children, elderly and immunocompromised people) have been spared from infection so far.

There is another strain from Central Africa that is more severe. That strain is not involved in the current outbreak in North America, Europe and Australia.

Dr. Edwards:There is no specific monkeypox treatment needed for most people, but a vaccine and antiviral drugs that were developed for smallpox are effective against monkeypox.

Dr. Edwards: We should take the viral outbreak as another warning that we need a strong public health sector to protect us. Right now, the monkeypox outbreak is primarily contained in adult men, who can fight the virus in most cases. If the virus jumps to large populations of children or seniors, the outlook could quickly change. The other concern is that monkeypox could jump to our rodent population and become endemic to the United States.

This outbreak shows us that our public health infrastructure isnt sufficient. The monkeypox virus should have been manageable, but it is becoming a bigger deal every day. COVID-19 brought to light deficiencies in our underfunded public health system and now monkeypox reminds us that strong public health is our best defense.

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Monkeypox and COVID-19: Here Are Key Differences

Most of us are familiar with the common symptoms of COVID-19: fever, shortness of breath, fatigue and loss of smell or taste. But some research has emerged recently that suggests that COVID-19 might also lead to erectile dysfunction (ED).

One study found that COVID-19 survivors might develop short and long-term sexual and reproductive health issues, including ED. COVID-19 has been detected in the testicle, so it could affect how well your testicles can work. This could affect both sperm production and testosterone production.

Researchers are unsure of the link between COVID-19 and ED. But several factors could lead to the potential onset of ED after COVID-19.

One factor is that the virus causes issues in the bodys blood vessels. The virus causes a high level of inflammation in the body as a defense response. The high level of inflammation can cause small blood clots to form, as well as inflammation of the lining of the blood vessels. These two features combined can disrupt blood flow one of the most important factors in achieving an erection.

Indirectly, COVID-19 can worsen an already existing heart condition such as heart inflammation or an irregular heartbeat. Medicines to treat these conditions, such as beta-blockers, can cause ED as a side effect.

Another hypothesis is that long-term COVID-19 complications may lead to scarring of the erectile tissue.

COVID-19 causes severe physiologic and psychological stress, which leads to lower testosterone levels and increased release of stress hormones. While testosterone levels should return to normal after the illness subsides, loss of testosterone might lead to fibrosis of the penile tissue, which is a more difficult and less reversible condition to treat.

There also is evidence to suggest that the coronavirus has an impact on the testicles. The virus enters cells with the help of a protein that is prevalent in the testicles. The testicles are where the majority of testosterone is made in men, and so COVID-19 may cause decreased testosterone levels in the body.

Lower testosterone levels can contribute to erectile dysfunction, as well as decreased energy, libido and muscle mass. Lower testosterone levels also could exacerbate the bodys inflammatory response, causing heightened damage to the blood vessels.

Even if you do not have COVID-19, the stress of disrupted routines because of the pandemic can take an unexpected toll on your sexual life.

Being in the right frame of mind is an important part of being able to engage in sexual activity and achieving an erection. Stress, anxiety and depression can be potential causes of erectile dysfunction. As these emotions become heightened during the prolonged pandemic, more men might experience ED as well.

Nannan Thirumavalavan, MD, is a urologist at University Hospitals.

If youre like many men, you dont pay much attention to your health until something goes wrong. But letting an undiagnosed medical condition go untreated can endanger your best chances for recovery. Your best strategy is to take charge of your health and schedule an annual checkup with a University Hospitals primary care physician. Learn moreabout Men's Health services at University Hospitals.

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How Having COVID-19 May Affect Men's Sexual Health

After a COVID-19 infection, athletes and exercise enthusiasts may wonder when its safe to resume workouts.

In the early days of the pandemic, there were concerning reports about athletes with COVID-19 developing myocarditis inflammation of the heart muscle. A return to physical activity too soon could cause more heart damage in people with myocarditis.

Fortunately, exercise has been shown to be safe in the vast majority of cases.

Athletes and weekend warriors recovering from COVID-19 with lingering symptoms should be evaluated before returning to play and exercise, says University Hospitals cardiologist Chad Raymond, DO.

But if youre not feeling any symptoms like shortness of breath, chest pain or extreme fatigue, its safe to resume normal activities.

The general rule of thumb is if you had COVID-19, recovered and youre not having symptoms, theres no reason you cant go back to everyday activities, and that includes exercise, Dr. Raymond says.

COVID-19-related myocarditis is extremely rare, Dr. Raymond says. And the vast majority of myocarditis cases resolve on their own quickly with no lasting heart damage.

Still, athletes diagnosed with myocarditis should abstain from most exercise for 3 to 6 months, according to the latest guidelines.

Symptoms of myocarditis include:

Some patients experience a range of post-COVID-19 symptoms, known as long COVID, that may last weeks or months.

Some symptoms shortness of breath, fatigue and chest pain are similar to myocarditis symptoms. But having these symptoms after a COVID-19 infection doesnt mean you have myocarditis.

If you have any of these symptoms or youre not quite feeling normal, you should follow up with your primary care doctor, who may refer you to a cardiologist or pulmonologist, says Dr. Raymond.

Routine screening for myocarditis after COVID-19 is not recommended unless symptoms dictate otherwise, he says. If theyre feeling okay, I feel confident advising people to regular resume exercise. But ease back into it.

The experts at University Hospitals Harrington Heart & Vascular Institutehave the advanced training and experience to diagnose and treat all types of cardiovascular conditions, including hypertension. Our expertise ranges from the management of chronic diseases to the most complex open heart surgical procedures and everything in between.

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When Is It Safe to Start Exercising After a COVID-19 Infection?

Youth Suicide Rates Increased During the COVID-19 Pandemic  National Institute of Mental Health

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Youth Suicide Rates Increased During the COVID-19 Pandemic - National Institute of Mental Health

Company that Fired Worker with COVID-19 Concerns Held in Contempt  SHRM

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Company that Fired Worker with COVID-19 Concerns Held in Contempt - SHRM

Op-ed: Ventilators and the learning curve of COVID-19 treatment  Chicago Tribune

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Op-ed: Ventilators and the learning curve of COVID-19 treatment - Chicago Tribune