Ear Infection and COVID-19 - Verywell Health

COVID-19 and ear infections cause similar symptoms, such as headaches and fevers. However, each condition also has its unique symptoms.

Ear infections themselves are not a common symptom of COVID-19. If you're noticing changes in your health and unsure if you have an ear infection or COVID-19, consult your healthcare provider to get an accurate diagnosis and develop a treatment plan.

Verywell / Jessica Olah

Symptoms

An ear infection can occur in both adults and children, and it's usually one of the most common reasons why your child might need to see a healthcare provider. Ear infections are generally the result of a bacterial or viral infection in the middle ear, with fluid building up in the space behind your eardrum.

COVID-19 is caused by the virus SARS-CoV-2. It isn't exclusively a respiratory illness, but the majority of its common symptoms are respiratory.

Overlapping Symptoms

Both COVID-19 and an ear infection can cause fever and headaches.

Ear infections can result in fevers of 100 F to 104 F. It's reported that about 50% of children who get ear infections will have a fever. Headaches are most regularly found in people with middle ear infections.

Given that COVID-19 is still a relatively new disease, much is still unknown about its symptoms. While some people diagnosed with COVID-19 can be asymptomatic, many can develop symptoms like fever and headache.

When to See a Doctor

Given how variable both COVID-19 and ear infections can be, you shouldn't try to self-diagnose. To ensure you don't spread COVID-19 to others, you should reach out to a healthcare provider or seek local resources in your area to find a place to get tested. The same goes for an ear infection. You should seek medical attention if you are unsure what is causing your symptoms. If your headaches or fever become increasingly severe, seek out medical attention right away.

Symptoms Unique to COVID-19

Common symptoms specific to COVID-19 can include:

Some COVID-19 symptoms are more serious than others, and there are also some that are less likely to present themselves in some cases. If you begin to experience any of the following, contact your healthcare provider right away:

• COVID toes: This refers to purplish or red discoloration of your toes. Your toes may feel painful and itchy.
• Delirium: Confusion and disorientation can be caused by COVID-19 affecting the body's central nervous system. This can be very serious, so seek immediate medical attention if you experience delirium.
• Deep vein thrombosis: Some people with COVID-19 may be at higher risk of developing this blood clotting in the lower leg or thigh. This can be serious since it can lead to a pulmonary embolism, where the blood clot travels up to the blood vessels of the lungs. If you notice your legs showing signs of this condition, like swelling, cramping, discoloration, and itching, consult your healthcare provider right away.
• Stroke: Blood clots can lead to a stroke, but this is particularly rare. It's been found that people with underlying cardiovascular issues are at higher risk of stroke if they have COVID-19. Make sure you see your healthcare provider right away if you start seeing any signs of a stroke, including slurred speech, confusion, and blurred vision.

COVID-19 Doctor Discussion Guide

Symptoms Unique to Ear Infections

Some common symptoms specific to ear infections include:

• Ear pain
• Fullness in the ear
• Fluid drainage from the ear
• Loss of appetite
• Sleep disruption

Other symptoms of an ear infection include:

• Otitis media with effusion: This is also known as secretory otitis media, which refers to fluid buildup in the middle ear. You may experience this after a middle ear infection, while for others it may develop due to a blocked eustachian tube—the passage that connects the back of your nose to your middle ear. When the fluid builds, bacteria can grow and ultimately lead to an ear infection. This can cause mild to moderate hearing loss, cracking sounds when you swallow, and fullness in the ear.
• Chronic ear infections: Chronic otitis media may mean you experience a repetition of symptoms and a repeat infection if, for example, you develop a cold. This can be disruptive to your daily life, with chronic, ongoing bouts of headaches, drainage from the ear, hearing loss, and fatigue.

Ear Infection Causes

An ear infection is caused by a virus or bacteria. It may start out as a seemingly benign cold or a respiratory infection.

The virus or bacteria can then travel up through the eustachian tube to the middle ear, and the tube can become inflamed as a result. This inflammation and swelling can result in blockage in the tube, with fluid retained in the middle ear rather than draining out.

Can COVID Cause Ear Infections?

Ear infections have not been found to be a common symptom of COVID-19. However, more research is showing how COVID-19 can affect the human ear.

Hearing impairment and symptoms like severe gastric upsets and blood clots that result in gangrene are among some of the more serious symptoms being reported in some people who contracted the Delta variant of COVID-19 in India.

Some research has also pointed to COVID-19 being detected in the middle ear. A July 2020 study found that the autopsies of two people who died with COVID-19 tested positive for the virus in the middle ear.

The authors of the study wrote that this does "not necessarily imply current or future otologic symptomatology" in people who have COVID-19 infection present in their middle ear. More research needs to be done to better understand the effects of COVID-19 in the human ear.

Ear Infection Diagnosis

Your medical provider will examine your ear with an instrument called an otoscope. As they are testing your ear, they will assess whether it's a healthy eardrum, which will be pinkish grey and clear, or one that has an infection. An infected eardrum might look reddish in color, swollen, and puffy with inflammation.

A pneumatic otoscope is a device that blows air into the eardrum, causing it to move back and forth. This is to assess if the fluid retention is in the middle ear. The eardrum won't move back and forth with ease if fluid has built up.

Tympanometry may also be employed. It is a test that uses air pressure to check for fluid retention in the middle ear.

These tests do not examine hearing quality. If your provider thinks it is necessary, they will have a separate hearing test performed by an audiologist to see if you have hearing loss. This would be important if you have chronic ear infections or fluid that refuses to drain away.

Ear Infection Treatment

A range of treatments are available for ear infections. They vary depending on the severity of the infection, symptoms, age of the person being treated, and amount of fluid retention. If the infection is mild, your provider may ask you to wait a few days to see if the infection goes away on its own. If not, they may prescribe treatments to help with your symptoms.

Ear Infections Doctor Discussion Guide

Medications

You may be prescribed antibiotic medications to treat an ear infection. In general, your provider will assess your medical history, interactions with other medications, and age before prescribing a medication to treat your ear infection.

The American Academy of Pediatrics outlines the following recommendations for treating children:

• Children 6 months or older who have an ear infection in one or both ears should be prescribed an antibiotic if symptoms are moderate to severe for at least 48 hours or their temperature is 102.2 F or higher.
• An antibiotic will be prescribed to a child 6 to 23 months old if an infection is in both ears and they have shown mild symptoms for less than 48 hours and a fever of less than 102.2 F.
• Children 6 to 23 months with an infection in one ear with mild symptoms for less than 48 hours and a fever of less than 102.2 F should receive an antibiotic or be observed, unless their symptoms don't improve within 48 to 72 hours.
• Children 24 months or older with an infection in one or both ears who possess mild symptoms for less than 48 hours and a fever of less than 102.2 F are recommended to either be observed or treated with an antibiotic. If observed, they should be given medication if their symptoms don't improve within 48 to 72 hours.

Amoxicillin is generally the common antibiotic of choice to treat an ear infection that won't go away after observation. If you or your child has an allergy to penicillin, you will want to consult with your provider about an alternate medication. Ear drops with a topical anesthetic may also be prescribed.

Home Treatment and Procedures

You may use over-the-counter (OTC) medications to relieve the pain that comes with an ear infection. These include ibuprofen (Advil or Motrin) or acetaminophen (Tylenol). Always follow the instructions from your provider about the best way to go about taking OTC treatments and review what would be the best dosage and course of treatment for you or your child.

Chronic ear infections that recur often or that present consistent fluid buildup in the middle ear may require treatment with ear tubes, which are small cylinders that are positioned through the eardrum to allow easy passage of air into the middle ear. They are inserted during an outpatient surgical procedure known as a myringotomy.

Summary

COVID-19 and ear infections cause similar symptoms like headaches and fevers, but they also have different symptoms. For example, COVID-19 causes shortness of breath, while ear infections do not. If you have any symptoms of COVID-19, it's important for you to get tested and make sure you don't spread it to others. Ear infections may go away on their own, but if they don't, you will need antibiotics and other treatments from your healthcare provider.

A Word From Verywell

The COVID-19 pandemic is an ever-evolving public health crisis, and as time goes on, more is being learned about how the virus affects our health. Symptoms of COVID-19 can resemble those of other common conditions like ear infections.

If you find yourself experiencing symptoms of either COVID-19 or an ear infection, consult your medical provider right away.

It is important that you be tested for COVID-19 to prevent the spread of the virus. An ear infection that doesn't go away on its own and is left untreated can result in pain and hearing problems.

If your symptoms become more extreme, seek medical attention right away.

Frequently Asked Questions

Can COVID-19 cause ear pain?

Ear pain is not one of the common symptoms of COVID-19. However, research has shown that COVID-19 has presented itself in the human ear in a few specific cases.

Is tinnitus a symptom of COVID-19?

While there have been some reports of people who had COVID-19 experiencing tinnitus in the ears, these cases are not enough to substantiate a link between the two. There's not enough research out there right now to determine whether COVID-19 can cause tinnitus.

Do any coronavirus variants cause ear infections?

There are no conclusive studies at the moment showing that COVID-19 and its developing variants directly cause ear infections. That being said, a recent report out of India showed some cases of hearing loss among some people who contracted the Delta variant. More research needs to be conducted, but right now COVID-19 is not associated with ear infections.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

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