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Ear Pain And COVID: What To Know

There are common signs and symptoms of COVID-19. However, some people with the illness have also been known to experience additional symptoms such as sore throat and ear pain, also called otalgia.

Ear pain is not a common symptom of COVID, but researchers have suggested connections between the pain and the illness. Here's what you need to know about earaches and COVID.

Getty Images / AdobeStock It can be. One study, including data from 2,247 participants, found that some people with COVID presented with ear pain around the ear or within the ear canal. Redness, swelling, or heat did not accompany the pain. Earaches aren't a common symptom of COVID, but it's not unheard of, Amesh A. Adalja, MD, a senior scholar at Johns Hopkins Bloomberg School of Public Health's Center for Health Security, told Health. COVID as a Possible Ear Pain Cause Researchers have tried to determine if COVID might cause earache in someone sick with the virus. One small study suggested that SARS-CoV-2 can infect inner ear cells. The researchers found that the patients with COVID experienced: Hearing loss Ringing in one or both ears A sudden spinning sensation called vertigo Still, research is ongoing regarding the connection between ear pain and COVID. Ear Pain Prevalence With COVID Not everyone who has COVID will experience problems with their ears. Researchers of one study found that 19% of individuals with the illness experienced otalgia. An earache might be more common with the variants of SARS-CoV-2, including Delta and Omicron, as it seems like they have more upper respiratory tract symptoms, Taylor Heald-Sargent, MD, an assistant professor of pediatrics specializing in infectious diseases at Northwestern University Feinberg School of Medicine, told Health. There's not a lot of research concerning the causes of ear pain in cases of COVID. However, some researchers hypothesized one reason for COVID-related ear pain. They suggested it was nerve pain due to viral effects on the trigeminal and greater auricular nerves. Both nerves are sensory nerves, but the trigeminal nerve is the primary head and face sensory nerve. Another cause may be the fact that COVID is a respiratory infection. "Many respiratory infections, especially those that cause sore throats, can sometimes also cause earaches," said Dr. Adalja. Even sore throats alone may lead to ear pain. When a person has an upper respiratory infection—which can be triggered by viruses like SARS-CoV-2, which causes COVID—the nasal passages can drain mucus into the throat. The throat can send fluid into the eustachian tube, which connects the ears and the throat. The tube can then get clogged and interfere with the ears' ability to drain fluid, ultimately causing an earache. Risk Factors Ear pain during any respiratory illness can happen to anyone. Still, it's prevalent in young children, whose eustachian tubes are smaller and more easily obstructed, Ellen Wald, MD, an infectious disease physician at the University of Wisconsin School of Medicine and Public Health, told Health. In addition to children being more at risk, people who smoke are also at a higher risk of developing problems with their eustachian tubes. Smoking can damage the hairs in the nose that clear mucus, which can cause mucus to build up. According to Dr. Adalja, in some cases, fluid in the ear during a bout of COVID could also result in an ear infection—but in that case, the ear isn't infected with SARS-CoV-2. "Inflammation in the ear can cause secondary bacterial ear infections, just like we see commonly with influenza," said Dr. Adalja. Dr. Heald-Sargent also explained that when fluid is stagnant in the ears, it can become infected with bacteria already in the body. In this case, a healthcare provider may prescribe antibiotics to stave off the bacteria—though it's worth noting that antibiotics don't help with viral illnesses, including COVID, influenza, and the common cold. Seek medical attention if you experience severe ear pain that stops suddenly or experience pain, fever, or irritability that worsens or doesn't improve after 24 to 48 hours. If you believe you have COVID, get tested and adhere to isolation guidance after confirmation of a positive test. Get emergency care for the following symptoms related to COVID: Blue-colored, gray, or pale skin, lips, or nail beds Difficulty breathing Inability to remain awake or wake up New confusion Persistent chest pain or pressure It is possible to experience an earache if you are diagnosed with COVID. COVID itself may cause earache, or it could be due to the combination of respiratory symptoms you may be experiencing. If you experience an earache associated with other respiratory symptoms, such as a runny or congested nose, a headache, cough, or a sore throat—along with any other potential signs of the virus—it's worth getting checked out by a healthcare provider and tested for COVID as soon as possible. The information in this story is accurate as of press time. However, as the situation surrounding COVID continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

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Persistent Sore Throat 'can Be Cancer Sign'

GPs with patients who have a persistent sore throat, combined with shortness of breath, trouble swallowing or earache, should consider cancer as the cause, according to new research.

Currently, it is recommended patients with persistent hoarseness or an unexplained neck lump are investigated for throat or laryngeal cancer.

However, Cancer Research UK's Weilin Wu said patients should not be alarmed.

"A sore throat on its own wasn't linked to laryngeal cancer," he said.

"But importantly, this study also provides the best evidence to date to support the current recommendation to refer older patients with persistent hoarseness."

The larynx is part of the throat found at the entrance of the windpipe that helps you breathe and speak.

In the UK, there are around 2,000 new cases of laryngeal cancer each year.

The research, led by the University of Exeter, looked at patient records from more than 600 GP practices and studied 806 patients diagnosed with cancer of the larynx and 3,559 control patients. It is published in the British Journal of General Practice.

Lead author Dr Elizabeth Shephard said it was the first real look at all the symptoms that might be important for laryngeal cancer.

"The significance of the study really is that we've found that hoarseness is important for laryngeal cancer, but significantly the risk of having laryngeal cancer greatly increases when it's combined with a recurrent sore throat," she said.

Laryngeal cancer

More common in men

Strongly linked to tobacco and alcohol use

Early diagnosis improves outcomes

Radiotherapy, surgery and chemotherapy are the main treatments

If the cancer is advanced, the patient may have to have surgery to remove part or all of the larynx

These patients will no longer be able to speak or breathe in the usual way

They will breathe through a permanent hole in their neck (stoma) and will need additional treatment to help restore their voice

This may include a throat implant or an electrical device you hold against your throat to produce sound

One of the study authors, Prof Willie Hamilton, was the clinical lead for the current guidelines from The National Institute for Health and Care Excellence (NICE).

He said their research is important because it "has shown the potential severity of some symptom combinations previously thought to be low risk."

"When NICE guidance for cancer investigation was published, there was no evidence from GP practices to guide this - nor to inform GPs," he said.

Smoking can increase the risk of cancer of the larynx

But he points out they are not talking about just any sore throat - "the sore throat has to be significant enough to go to the GP".

"We're all used to sore throats, but the sore throats that are reported to GPs are already unusual because it's gone outside the patient's norms."

And it is the combination of persistent symptoms - sore throat, hoarseness and breathing or swallowing problems - that could be a warning sign, he said.

Dr Shephard said the study will feed into the NICE guidelines when they are updated.

"It's vital for selecting the right patients for referral. If we get people earlier we can then diagnose the cancer at an earlier stage and they will have access to the right treatment."

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Sore Throat Could Be Covid XEC Strain, Strep Throat Or Something Else - How To Tell

His advice comes as the NHS has warned of the potential for a "quademic" in the UK, with rising cases of flu, norovirus, respiratory syncytial virus (RSV), and Covid expected to hit the UK. A sore throat could be a sign of Covid, especially if accompanied by four other symptoms (

Image: Getty)

An expert has highlighted the difference between a sore throat caused by Covid, strep throat and other infections as coronavirus rates remain high in the UK. Around this time of year it is very common to come down with some sort of seasonal illness.

The cold weather coupled with the fact we spend more time indoors with other people makes us especially vulnerable to these kinds of viruses. However, with so many types of illnesses going around at the moment it can be hard to know exactly what is wrong.

According to data from the UK Health Security Agency (UKHSA), cases of COVID-19 remain relatively high with 1,081 confirmed cases in the week up to December 4. There were also 122 deaths linked to Covid in the seven days up to November 22.

And the most up to date figures on hospital admissions caused by Covid increased with 1,085 in the week up to November 30, a 1.5 percent rise on the week before. Health experts had previously linked a rise in Covid cases with the emergence of the XEC strain.

The variant, which was first discovered in Germany, is thought to be highly transmissible due to a number of mutations it carries. More recently, the NHS has also warned of the potential for a "quademic" in the UK, with cases of flu, norovirus, respiratory syncytial virus (RSV), and Covid expected to affect large swathes of the population this winter.

Experts believe the XEC Covid strain is highly transmissible (

Image:

Getty)

With this in mind, an expert shared how to tell what your sore throat could be caused by - including other telltale symptoms to be wary of. Phil Day, superintendent pharmacist at Pharmacy2U, explained more.

Covid

If your sore throat is accompanied by four other symptoms it could mean you have the XEC variant of Covid, he said. Phil said: "The XEC variant of COVID-19 has added another layer of complexity to the sore throat diagnosis.

"In many cases, a sore throat is one of the initial symptoms, often accompanied by a dry cough, fatigue, fever, and sometimes a loss of taste or smell. While most mild cases can be managed with rest and over-the-counter remedies, it's crucial to assess whether COVID-19 could be the cause of your symptoms."

If you think you have Covid, the NHS advice is to try to stay at home and avoid contact with other people until you feel better.

Strep throat

Strep throat is a bacterial infection that presents with more severe symptoms. Phil continued: "These include a sudden onset of sharp throat pain, difficulty swallowing, swollen glands, and white streaks or spots on the tonsils."

He warned it could also cause a high fever, general fatigue and potentially tonsillitis. "It's important to recognise that unlike a viral sore throat, strep throat requires antibiotics to prevent complications like rheumatic fever," he said. "This means a GP consultation is necessary for proper diagnosis and prescription, as antibiotics cannot be issued without a confirmed bacterial cause."

But a sore throat could also signal strep throat, tonsillitis or laryngitis (

Image:

Getty) Tonsillitis

Tonsillitis can be viral or bacterial, and it's often characterised by red, swollen tonsils, a fever, and pain when swallowing. "It may also cause bad breath, swollen lymph nodes, and even ear pain," Phil said.

"Viral tonsillitis is generally managed with supportive care, much like treating a sore throat—rest, hydration, and over-the-counter treatments. However, bacterial tonsillitis, particularly when caused by strep bacteria, requires antibiotic treatment."

Laryngitis

Laryngitis affects the voice box and can lead to hoarseness, a sore throat, or even a complete loss of voice. Phil added: "This condition is commonly triggered by viral infections, overuse of the voice, or exposure to irritants like smoke.

"While laryngitis typically clears up on its own within a week or two, the discomfort can be bothersome. Pharmacists can offer advice on how to soothe the throat during recovery, such as staying hydrated, using throat lozenges, and resting the voice. Avoiding irritants like smoking and maintaining a humid environment can also help speed up recovery."

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