Dizziness is a recognized symptom of COVID-19, occurring during the acute phase and sometimes persisting long after recovery. This sensation is generally described as feeling faint, unsteady, or experiencing a spinning sensation, known as vertigo. Studies suggest that up to one-fifth of patients experience some form of dizziness during their infection. This symptom can significantly affect a person’s quality of life and balance.
Dizziness as an Acute COVID Symptom
Dizziness often manifests during the active infection phase of COVID-19, sometimes appearing before typical respiratory issues. Approximately 16.6% of patients report new-onset dizziness while sick with the virus. This symptom commonly accompanies other systemic complaints, such as fatigue, headache, and body aches.
The term “dizziness” covers multiple sensations, with lightheadedness being the most common type reported in acute cases. Lightheadedness, or pre-syncope, is the feeling of nearly fainting and is often linked to systemic factors like blood pressure fluctuations. Vertigo, a true spinning sensation, is less frequent but indicates a specific disruption of the body’s balance system.
The presence of dizziness, particularly vertigo, highlights the virus’s potential to affect more than just the respiratory tract. Researchers now include dizziness among the main symptoms of COVID-19. For some individuals, the symptom can be severe enough to cause difficulty with walking or maintaining equilibrium.
Biological Causes of Dizziness During Infection
The physiological reasons for dizziness during acute COVID-19 infection are complex and involve several overlapping mechanisms. A general systemic effect often contributes to lightheadedness, particularly dehydration caused by fever, poor fluid intake, or gastrointestinal symptoms. Dehydration can lead to temporary drops in blood pressure, resulting in faintness, especially when quickly changing positions.
The body’s intense inflammatory response, often referred to as a cytokine storm, can also disrupt the central nervous system. These inflammatory markers can affect the brain’s balance centers, leading to disequilibrium and unsteadiness. The virus exhibits neurotropism, meaning it can affect the nervous system by potentially entering the central nervous system through pathways like the Angiotensin-Converting Enzyme 2 (ACE2) receptors.
In cases of true vertigo, the cause is often localized to the inner ear, which houses the vestibular system responsible for balance. The virus may directly or indirectly trigger conditions like labyrinthitis or vestibular neuritis, involving inflammation of the inner ear structures or the connecting nerve. This inflammation sends confusing signals to the brain about the body’s position, causing the sensation that the world is spinning. The virus can also affect the inner ear’s blood flow, which is highly sensitive to changes and can lead to balance disorders.
Persistent Dizziness After Recovery
For a significant number of individuals, dizziness does not resolve after the acute infection clears and becomes a component of Post-Acute Sequelae of COVID-19, often called Long COVID. This persistent dizziness can last for weeks or months and is linked to lingering physiological changes. The condition often manifests as chronic unsteadiness, disequilibrium, or recurrent lightheadedness.
One of the most studied causes is Postural Orthostatic Tachycardia Syndrome (POTS), a disorder of the autonomic nervous system. The autonomic system regulates involuntary functions like heart rate and blood pressure. Dysfunction here can cause chronic dizziness, particularly when moving from lying down to standing. This orthostatic intolerance results from inadequate control of blood flow, which leads to reduced blood supply to the brain upon standing.
Persistent dizziness may also stem from chronic vestibular dysfunction, where inner ear structures failed to fully recover from the initial viral insult or inflammation. This can manifest as ongoing balance problems or heightened sensitivity to motion. The cognitive symptoms of Long COVID, often described as “brain fog” or chronic fatigue, can also contribute to unsteadiness and difficulty maintaining balance.
Relief Measures and Medical Red Flags
Managing dizziness during or after a COVID-19 infection often begins with simple self-care measures. Ensuring adequate hydration is important, as many acute cases of lightheadedness are exacerbated by fluid loss due to fever or poor intake. Slowly transitioning between positions, such as pausing on the edge of the bed before standing, can help the body’s blood pressure regulate and prevent sudden drops.
For persistent symptoms, specialized treatment like vestibular rehabilitation therapy may be recommended. This involves targeted exercises to help the brain compensate for inner ear dysfunction. Over-the-counter medications, such as antihistamines or anti-nausea drugs, can sometimes provide temporary relief from vertigo. A healthcare provider may also evaluate if the dizziness relates to autonomic dysfunction and recommend strategies like increased salt intake or compression garments.
It is important to recognize symptoms that require immediate medical attention, as dizziness can occasionally signal a more serious underlying issue. Seek urgent care if dizziness is accompanied by:
- Sudden, severe headache
- Chest pain
- Shortness of breath
- New difficulty speaking
- Facial drooping
- Weakness or numbness on one side of the body
- Loss of consciousness