Dizziness in Post COVID-19 Patients

Background: Dizziness is a popular vestibular symptom, which depicted a domain of sensations like lightheadedness, confusion and being out of balance. A wide variety of viruses are known to cause labyrinthitis and vestibular neuritis manifested by dizziness/vertigo, Covid 19 infection is claimed to be one of them. Objective: This work aimed at evaluating some audio-vestibular functions in dizzy patients after COVID-19 infection, beside searching for possible correlations between vestibular impairment and grade of dyspnea or oxygentaion status in such patients. Patients and methods: The current study is a case control observational study included thirty-three persons with post-COVID-19 dizziness (patients’ group) and equal number of healthy controls (control group) were involved. Audio-vestibular investigations including videonystagmography (VNG) testing plus video head impulse test(vHIT) were implemented for all participants. Results: When comparing both groups, the median of the left ear hearing thresholds at 4000 and 8000 Hz were higher among patients (P = 0.003 and P = 0.011, respectively).Gaze-evoked nystagmus was found in 9.1% of patients, while pursuit tracking was abnormal in only 6.1% of them. Positional nystagmus was significantly evident among patients (21.2%, P=0.011). Five patients (15.2%) had evidence of benign paroxysmal positional vertigo (BPPV). Both right and left weaknesses were significantly obvious among patients (P<0.001).All vHIT results were significantly lower in patients than controls. A significant positive correlation was found between vHIT right posterior gain and O2 saturation% (r=0.409, P=0.018). Conclusion: Dizziness in post COVID-19 patients was due to vestibular dysfunction which may be of central or peripheral origin. Abnormal VNG test results and reduced vHIT gain were detected in post COVID-19 patients.