Why Is My Ear Ringing After COVID?
If you’ve recovered from COVID-19 and now have a ringing, buzzing, or humming in your ears that wasn’t there before, it’s natural to feel alarmed. You might be wondering whether this is connected to your illness, whether it will go away, and whether you need to see a doctor. These are the right questions to ask, and there are real answers.
This article covers how common tinnitus after COVID actually is, why the infection can affect your hearing, and what the evidence says about recovery. The short version: COVID tinnitus is a documented, recognised phenomenon. Whether it resolves depends in part on how severe it is at onset, and that distinction matters for what you do next.
Can COVID-19 Cause Tinnitus?
Yes. COVID-19 is associated with new-onset tinnitus and the worsening of pre-existing tinnitus. Depending on the study and the population examined, somewhere between roughly 5% and 28% of people who have had COVID-19 report tinnitus afterwards.
The range is wide because it reflects genuine differences in study design. A 2022 meta-analysis of 12 studies found a pooled tinnitus rate of around 4.5% across largely hospital-based acute-phase cohorts (Jafari et al., 2022). A larger cross-sectional survey of 1,331 post-COVID respondents found a prevalence of 27.9% (Mao et al., 2024). A 2026 meta-analysis of cohort studies using physician-diagnosed outcomes found no statistically significant pooled association overall (Liu et al., 2026), which shows how much the answer depends on who is studied and how tinnitus is measured.
COVID-19 can trigger new-onset tinnitus in a meaningful proportion of survivors. Estimates vary widely across studies — from around 5% to 28% — depending on whether researchers studied hospitalised patients, mild-case survivors, or long-COVID clinic populations. The figure is real, even if the exact number is uncertain.
What is consistent across studies is that the association is real and that it affects people across the spectrum of COVID severity, not just those who were seriously ill. Worsening of pre-existing tinnitus is also well-documented.
When Does COVID Tinnitus Start — and Why Does Timing Matter?
Not everyone who develops tinnitus after COVID notices it at the same point in their illness. Research points to three distinct onset windows, and understanding which applies to you can help clarify what is likely driving it.
During the acute illness phase. Some people notice tinnitus while they are still actively sick — during the first one to two weeks of infection. This most likely reflects direct cochlear involvement: inflammation, reduced blood flow, or early viral effects on the inner ear during the height of the immune response.
During treatment. A subset of cases appear to begin during COVID treatment rather than from the infection itself. Corticosteroids, sometimes prescribed for COVID, are among the medications that can independently affect tinnitus perception. Separating drug effects from viral effects in this window is genuinely difficult, and the research doesn’t fully resolve it.
After recovery — delayed onset. Some people develop tinnitus days or weeks after they have otherwise recovered. One audiometric study found that tinnitus onset averaged around 30 days after the initial COVID symptoms. This delayed pattern may reflect a different underlying process: post-inflammatory changes in the central auditory system, or ongoing immune activation rather than the direct cochlear effects more likely in the acute phase.
The timing matters clinically because it shapes how you understand the likely cause. Tinnitus appearing during acute illness suggests peripheral (inner ear) involvement. Tinnitus appearing weeks after recovery, without any other hearing change, is more likely to involve central auditory pathways — a distinction that affects how the condition is managed.
Why Does COVID Affect Your Hearing? The Biology in Plain Language
Your cochlea — the spiral-shaped structure in your inner ear that converts sound into nerve signals — contains cells that carry a protein on their surface called ACE2. This is the same receptor that SARS-CoV-2 uses to enter cells throughout the body. Animal studies have confirmed that ACE2, along with related proteins that help the virus enter cells, is present in cochlear hair cells, the stria vascularis, and the spiral ganglion (Uranaka et al., 2021). This establishes the biological plausibility that the virus can, in principle, directly affect the inner ear.
Here is the chain of events researchers believe may occur:
Viral or inflammatory damage to cochlear hair cells. Hair cells are the sensory cells that detect sound vibrations. They do not regenerate once lost. If the virus or the immune response triggered by it damages these cells, the cochlea sends fewer signals to the brain.
The brain compensates by turning up its internal volume. When the brain receives less input from the ear, it tends to amplify its own activity to compensate. This process — called central gain upregulation — can produce phantom sounds that feel just as real as external noise. That is tinnitus.
Auditory pathway involvement beyond the cochlea. Objective audiometric testing of long-COVID patients found significantly prolonged signal transmission times through the brainstem auditory pathway, suggesting that nerve damage extends beyond the inner ear itself (Dorobisz et al., 2023).
Mechanical causes from the upper airway. Eustachian tube dysfunction — common during and after any upper respiratory infection — can cause ear fullness and muffled hearing that temporarily triggers or worsens tinnitus through a simpler mechanical route, without any cochlear damage at all.
No single mechanism has been confirmed as the primary cause of COVID-related tinnitus, and it likely varies between individuals. Anxiety and poor sleep — both common during and after COVID illness — can independently intensify tinnitus perception regardless of the underlying cause. Some COVID medications may also play a role.
If your tinnitus started during COVID or shortly after, you are not imagining it and you are not alone. The biological pathways described above are plausible and supported by evidence, even though researchers are still working out exactly which pathway dominates in different cases.
Will COVID Tinnitus Go Away? What the Research Actually Shows
This is the question most people searching this topic most want answered. The honest answer is: it depends on how severe it is.
The most detailed evidence on this comes from Mao et al. (2024), whose survey of 1,331 post-COVID respondents found a clear severity gradient in outcomes. Mild (Grade I) tinnitus had notably higher rates of spontaneous resolution. Severe tinnitus — classified as Grade IV — had low spontaneous resolution rates and a strong association with long-term hearing loss and anxiety disorders. Grade IV was also the most common severity grade reported, representing 33.2% of all tinnitus cases in the survey.
This matters for what you do next. If your tinnitus is mild and fading, watchful waiting with good sleep and stress management is reasonable. If it is severe, intrusive, or has not improved after several weeks, waiting longer is unlikely to help and may delay treatment that could.
A smaller audiometric study of long-COVID patients with hearing complaints found that, at around 259 days post-infection, 7 out of 21 patients who had presented with tinnitus showed full recovery; 14 had only partial recovery or none at all (Dorobisz et al., 2023). This is a small sample and cannot be generalised widely, but it is consistent with the pattern from Mao et al.: a substantial proportion of cases do not resolve without support.
Hospitalisation history is also a relevant predictor. Research has found that patients who were hospitalised during their COVID illness tend to have worse tinnitus outcomes than those with milder acute illness, with severity correlating significantly with hospitalisation status.
Severe or persistent tinnitus after COVID is not likely to resolve on its own without support. If your tinnitus has lasted more than a few weeks after your COVID illness and is significantly affecting your daily life or sleep, seek an audiological evaluation rather than waiting indefinitely.
Importantly, this does not mean severe cases are untreatable. Standard tinnitus management approaches — including cognitive behavioural therapy, sound therapy, and audiological support — can reduce distress and improve function even when spontaneous resolution does not occur. Severity at onset is the best available predictor of whether the tinnitus will resolve on its own; it does not determine whether you can get better with the right support.
COVID Tinnitus vs. Long COVID Tinnitus: Is There a Difference?
You may have heard the term “long COVID” and wondered whether it applies to you. Under NICE guidance, long COVID (formally called post-COVID-19 syndrome) is defined as symptoms that develop during or after COVID infection, persist for more than 12 weeks, and cannot be explained by another diagnosis. Tinnitus is explicitly listed as a recognised ENT symptom of long COVID under these guidelines (NICE/SIGN/RCGP, 2024).
The clinical categories break down like this:
- Acute COVID: symptoms lasting up to 4 weeks
- Ongoing symptomatic COVID: symptoms lasting 4 to 12 weeks
- Post-COVID-19 syndrome (long COVID): symptoms lasting 12 weeks or more
If your tinnitus has persisted beyond three months after your COVID illness, it qualifies as a recognised long COVID symptom — which matters because it entitles you to appropriate clinical assessment and support rather than being dismissed as something unrelated.
Long COVID tinnitus may involve a somewhat different biological dynamic than tinnitus that resolves in the acute phase. Persistent systemic inflammation, central sensitisation, and possible autoimmune mechanisms are all proposed contributors. A 2025 narrative review found that approximately 1 in 5 long-COVID patients reports tinnitus (Guntinas-Lichius et al., 2025). Self-reported rates in long-COVID populations are often higher.
None of this means long COVID tinnitus is untreatable. It does mean it is less likely to resolve without some form of structured support, and more likely to respond well if you seek it.
What Can You Do If You Have COVID Tinnitus?
There is no treatment that specifically targets COVID tinnitus as a separate category — the same evidence-based approaches used for tinnitus from any cause apply here (Guntinas-Lichius et al., 2025). The practical steps below are grounded in what the research supports.
See a GP or ENT if tinnitus has lasted more than a few weeks. Do not wait indefinitely. Ask for a referral for audiological evaluation to check for underlying hearing loss, which may accompany the tinnitus and is worth detecting early.
Manage the things that make tinnitus louder. Anxiety, poor sleep, and sustained stress are known amplifiers of tinnitus perception — and all three are common during post-COVID recovery. Improving sleep quality and managing anxiety are not just general wellness advice; they have a direct effect on how tinnitus is perceived.
Standard tinnitus therapies apply. Cognitive behavioural therapy for tinnitus has strong evidence for reducing tinnitus-related distress. Sound therapy and audiological counselling are also established options. Your GP or an audiologist can help you access these.
If you had tinnitus before COVID and it has worsened, this is also documented and worth raising with a clinician. A small controlled study found that COVID infection itself — not just pandemic stress — significantly worsened tinnitus severity and quality of life in people with pre-existing tinnitus, even without changes in hearing thresholds (Aydogan et al., 2025). You are not imagining a deterioration.
What This Means for You
If you came to this article worried about a new ringing in your ears after COVID, here is what the evidence actually shows.
First, COVID tinnitus is real. It is documented across multiple large studies, officially recognised in clinical guidelines, and not imagined or exaggerated. You are not the only person dealing with this.
Second, the prognosis is genuinely variable, and severity at onset is the most useful guide. Mild tinnitus that appeared during or shortly after COVID illness often improves over weeks to months. Severe tinnitus — particularly the intrusive, high-grade kind that affects sleep and daily functioning — is less likely to resolve on its own and more likely to need active management. Waiting without seeking help is rarely the right approach if tinnitus is severe or has persisted for weeks.
Third, this is not an untreatable condition. There is no special “COVID tinnitus treatment,” but there are effective management approaches that work for post-COVID cases just as they do for other forms of tinnitus. Getting an audiological assessment is the right starting point — not because something is necessarily seriously wrong, but because knowing what you are dealing with puts you in a better position to manage it.
The uncertainty can be hard to sit with. But understanding what is happening, and knowing when to seek support, is a meaningful first step.
