Long COVID: Dizziness

Dizziness

Dizziness is a general term that’s used to describe several different sensations. It is non-specific, meaning it’s not associated with one cause or one condition. 

It may be difficult for you to describe the sensation of dizziness since it is something only you can explain. You may describe it as:

  • Feeling as if you're in motion when you’re not moving

  • Spinning, tilting, swaying, whirling, or floating

  • Feeling like you’re going to fall or off-balance

  • Lightheadedness or feeling as if you’re going to faint

One type of dizziness is called vertigo. It’s the type described in the first and second bullets above. You feel as if you’re moving or the area around you is moving, as if you’re spinning, tilting, swaying, whirling, or floating.

Dizziness and Long COVID

Dizziness is one of many symptoms of long COVID. It is common and can be very uncomfortable and challenging, causing difficulties in daily activities.

It is one of the neurological symptoms - i.e it affects the nervous system, of long COVID. Some of the other neurological symptoms are headache, trouble sleeping, loss of taste and smell, brain fog (trouble with memory, concentration, and attention), etc.

Studies of the number of people with various long COVID symptoms, including dizziness, are ongoing. As an example of dizziness, 3 out of 5 patients in Mount Sinai Hospital’s COVID-19 Precision Recovery Program (PRP) reported dizziness as a symptom. 

Cause of Dizziness in Long COVID

The way by which SARS-CoV-2, the virus that causes COVID, produces neurological symptoms is not well understood. Similar viruses have caused neurological symptoms like dizziness, hearing loss, ringing in the ears.

There are several theories of the cause of dizziness in long COVID. They include invasion of the nervous system by the virus, localized inflammation of the nervous system caused by the virus, hyperactivation or overactivity of the immune system, low levels of oxygen in the blood, increased blood clotting, etc.

The Audiovestibular System

It may help you to understand dizziness and vertigo, and some of the other symptoms (e.g. hearing loss, ringing in the ears (tinnitus), etc. of long COVID if you know a little bit about the structure and function of the audiovestibular system.

The audiovestibular system is part of the nervous system. It’s responsible for hearing and balance. It’s located in the inner ear (also called the labyrinth). The main parts are the:

  • Semicircular canals - regulate coordination and balance

  • Cochlea - converts vibrations into impulses; conveys to the brain via the auditory nerve

  • Cranial nerve VIII - a combination of the vestibular and cochlear nerves. The vestibular nerve controls balance and eye movement and the cochlear nerve controls hearing.

Dizziness in Long COVID

Dizziness or vertigo in long COVID is usually due to a problem with the inner ear. For example, there may be:

  • Inflammation of the inner ear or labyrinth - acute labyrinthitis

  • Changes in the semicircular canals - benign paroxysmal positional vertigo or BPPV

  • Inflammation of the vestibular nerve - vestibular neuritis

Dizziness may also be from other conditions, like a middle ear infection.

Benign paroxysmal positional vertigo (BPPV)

One type of vertigo is called benign paroxysmal positional vertigo (BPPV). Although there are other types in long COVID, BPPV is a common one. 

BPPV is a problem with the semicircular canals in the inner ear.

  • It’s benign -   it isn’t serious, although the symptoms can be severe

  • It’s paroxysmal - it occurs in sudden, brief episodes (usually lasting seconds to minutes)

  • It feels as if you’re in motion - vertigo

  • It’s positional - a change in body position triggers it 

Some people with BPPV also have nausea and vomiting, trouble with balance, or other symptoms. Following the episode of intense vertigo, you may continue to have mild dizziness and other symptoms.

Is There Anything I Can Do for My Long COVID Dizziness?

While there isn’t a cure for long COVID dizziness and vertigo, there are strategies and treatments based on vertigo in other conditions. Over a period of time, vertigo usually goes away without treatment.

General Strategies

Make sure you stay well-hydrated by drinking water throughout the day. Lack of fluids, dehydration, may cause dizziness.

Avoid alcohol since it may cause you to feel dizzy and unstable.

Talk with your doctor about the medications you’re taking. Some have dizziness or drowsiness as side effects.

Avoiding Triggers

Try to avoid positions and movements that trigger your symptoms. Moving your head too quickly to talk with someone, getting out of bed, standing up, or bending while showering are some examples that may trigger your vertigo. When you do change positions, make sure to move slowly. 

Safety

Vertigo increases the risk of falling, even after an episode, when you still may have milder symptoms. You should use the handrail on stairs, you might have a friend go for a walk with you, etc.

Do not drive or take part in other activities that may result in accidents or injury. For example, something as simple as reaching for something on a high shelf may trigger your symptoms.

When Should I See My Doctor for My Long COVID Dizziness?

Since you have dizziness, you should see your doctor for a physical exam. They will check you for less common, but serious causes of dizziness, such as a stroke. 

If your dizziness is due to BPPV, they can also treat it with specific maneuvers that involve moving your head in certain patterns.

Talk with your Goodpath coach if you have questions about your dizziness.