Unraveling the Mechanisms of Hearing Loss in Lassa Fever: A Pathophysiological and Clinical Perspective

Lassa fever is a viral hemorrhagic illness endemic to West Africa that poses a significant public health burden. One of its most debilitating complications is sensorineural hearing loss (SNHL), which affects up to 30% of survivors, regardless of the severity of its acute phase. The pathophysiological mechanisms underlying hearing loss in Lassa fever are not yet fully understood. In this review, we explore four potential mechanisms: direct viral damage to cochlear structures, immune-mediated cochleitis, cochlear neuritis, and vascular compromise. The neurotropic properties of Lassa fever may allow it to directly invade cochlear structures or trigger immune responses that damage auditory tissues. Cochlear inflammation and ischemic damage due to systemic inflammatory response and vascular dysfunction in Lassa fever also contribute to hearing loss. Despite these insights, gaps remain in understanding the exact mechanisms, and further studies are needed to elucidate the molecular and immune profiles associated with hearing loss in Lassa fever. Clinically, early detection and intervention, including routine auditory assessments and timely treatment, are crucial to improve the quality of life for survivors. Further research is needed to develop targeted therapies and implement public health measures to address this neglected complication in endemic regions.