The initial symptoms of COVID-19 are commonly recognized as fever, cough, and fatigue, but the virus can affect the body in less obvious ways. Many individuals who contract the SARS-CoV-2 virus report experiencing clogged or full ears. This feeling, known medically as aural fullness, is a recognized manifestation of the infection that can cause discomfort and muffled hearing.
The Link Between COVID-19 and Aural Symptoms
Clinical observations confirm that ear-related issues are a component of a COVID-19 infection. The most common auditory complaint is the feeling of pressure or blockage in one or both ears, often occurring alongside upper respiratory symptoms like nasal congestion or sore throat. Ear symptoms, including pressure, ear pain, and ringing (tinnitus), can appear during the acute phase of the illness or sometimes persist into the post-COVID period. Though not listed among the most common symptoms, ear congestion is a recognized secondary effect of the body’s reaction to the virus.
Biological Mechanisms Causing Ear Congestion
The sensation of a clogged ear in the context of a COVID-19 infection is primarily caused by Eustachian tube dysfunction (ETD). The Eustachian tube is a narrow passage that connects the middle ear to the nasopharynx, which is the upper part of the throat behind the nose. Its function is to equalize pressure between the middle ear and the outside environment, as well as to drain fluid from the middle ear space.
The SARS-CoV-2 virus, like other respiratory pathogens, triggers an inflammatory response in the upper respiratory tract. This inflammation causes the mucous membranes lining the nasal passages and the nasopharynx to swell. Since the opening of the Eustachian tube is located in the nasopharynx, this swelling can easily block or impair its function. When the tube is blocked, middle ear pressure cannot equalize, leading to a vacuum effect that pulls the eardrum inward and causes the sensation of fullness or pressure.
This dysfunction can also lead to a buildup of fluid in the middle ear space, creating an environment susceptible to secondary infections. In rare cases, the virus may directly infect cells within the inner ear, such as the hair cells responsible for hearing and balance. However, for most people experiencing a clogged sensation, the issue is an indirect result of congestion in the surrounding tissues.
Managing Ear Congestion at Home
Since this congestion often stems from pressure imbalances, several simple techniques can help relieve the feeling of fullness. One common method is the Valsalva maneuver, which involves gently blowing air out while pinching the nostrils shut and keeping the mouth closed to force air into the Eustachian tubes. Yawning, chewing gum, or swallowing repeatedly can also help activate the small muscles that open the tubes, assisting with pressure equalization.
Using steam or humidity can help thin the mucus contributing to the blockage. Inhaling steam from hot water or taking a warm shower provides relief to the nasal passages. Over-the-counter decongestants or steroid nasal sprays can also reduce swelling, improving Eustachian tube function. Decongestant nasal sprays should only be used for a few days to avoid rebound congestion. Staying well-hydrated is also beneficial, as it helps keep the mucus thin.
Warning Signs and When to Consult a Doctor
While most cases of ear congestion related to a respiratory infection resolve on their own, certain signs indicate a need for professional medical attention. Severe or unrelenting ear pain that does not improve with over-the-counter pain relievers can signal a developing middle ear infection. The presence of any fluid drainage from the ear canal, especially if it is bloody or pus-like, is a clear warning sign that requires immediate evaluation.
Other red flags include the sudden onset of significant hearing loss, which requires urgent assessment by a healthcare provider. Persistent dizziness or vertigo, a sensation of spinning or unsteadiness, may suggest the inner ear or balance system has been affected. If the feeling of clogged ears or pressure lingers long after other COVID-19 symptoms have cleared, a consultation is warranted to rule out lingering Eustachian tube dysfunction or other complications.