Long Covid Land Toolbox

SARS-CoV-2 directly infects the inner ear and causes hearing dysfunction

April 28, 2026

Coronavirus disease 2019 (COVID-19) results from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus.¹^,²^,³ Population epidemiological studies have shown that SARS-CoV-2 virus infection can be associated with sudden sensorineural hearing loss (SSNHL). Kim et al.⁴ suggest a heightened risk of hearing loss and SSNHL in young adults following SARS-CoV-2 infection. This hearing impairment may result from SARS-CoV-2 damaging the auditory-vestibular system.⁵ Additionally, some patients progress to permanent hearing loss, which may be considered a phenotype of long COVID within the broader category of post-acute sequelae of SARS-CoV-2 infection.⁶^,⁷^,⁸^,⁹^,¹⁰^,¹¹^,¹²^,¹³ In clinical practice, hearing loss associated with SARS-CoV-2 infection is typically addressed using treatment protocols established for sudden deafness, which commonly involve using glucocorticoids to mitigate the inflammatory response in the inner ear. However, the efficacy has been disappointing due to limited research on the impact of SARS-CoV-2 on auditory function.¹⁴ Consequently, it is of vital importance to explore the impact of SARS-CoV-2 infection on the inner ear and the underlying mechanisms.

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Overview and Pathophysiology of Long COVID

March 18, 2026
By Elisa Perrgo

Long COVID is the disease entity triggered and potentially driven by SARS-CoV-2 infection. It is an heterogeneous condition characterized by dozens of different symptoms, signs and sequelae, which can affect all organs and body systems and evolve over the disease course. Clinical manifestations of Long COVID can vary from individual to individual and across the broader patient population. Pathology can range from asymptomatic and subclinical manifestations to fatal outcomes. Over 400 million people worldwide are estimated to suffer, or have suffered, from Long COVID, making the sequelae of SARS-CoV-2 infection one of the greatest public health challenges of the 21st century. This article provides an updated overview of epidemiology, definitions, main concepts and terminology for Long COVID. It also summarizes key evidence of pathology and disease mechanisms in major organs and body systems, such as the immune system, cardiovascular system, endothelium, heart, lungs, central nervous system, peripheral nervous system, gastrointestinal system, hapatobiliary system, pancreas and kidney. Heterogeneity in manifestations, potential risk of death and the degree of disability in several disease subsets call for timely diagnosis of each Long COVID types and a fuller understanding of their pathophysiological underpinnings. Further research is recommended to better understand pathobiology, develop effective clinical trials, and identify treatments and scalable biomarkers.

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Covid for Doctors Part 2

March 11, 2026

Does Covid cause long-term harm? This presentation explores the recent, peer-reviewed literature through the lens of the Bradford Hill Criteria for Causation. Full list of references available at covidfordoctors.org

Long Covid Knowledge Hub

Long Covid: Symptoms, Management and Real-Life Understanding

Long covid symptoms can be complex, fluctuating, and difficult to understand. Living with long covid rarely follows a clear pattern, and symptoms are not always visible in standard tests or routine investigations.

LongCovidJourney is an independent patient-led, evidence-informed long covid knowledge hub built from lived experience and supported by current research and clinical understanding. The site explores long covid symptoms, post-exertional malaise (PEM), dysautonomia, brain fog, autonomic dysfunction, fatigue, pacing, invisible illness, and the real-world impact of post-viral conditions on daily life.

This site exists to explain what living with long covid actually feels like, how symptoms behave in real life, and why many people remain unwell despite normal scans, blood tests, or medical investigations.

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Why Covid-19 is “a vascular disease masquerading
as a respiratory one”

February 2026

Covid-19 is not just a respiratory infection. Cardiovascular symptoms are seen in both acute and long covid. Katharine Lang reports on what we’ve learnt since the onset of the pandemic

Cardiovascular complications from covid-19 have been seen widely since the early days of the pandemic, when a small study in Wuhan reported myocardial injury in several patients.1 Soon after, studies found that up to 30% of those admitted to intensive care units showed myocardial injury.2 3

“In many respects covid-19 is a vascular disease masquerading as a respiratory one,” says Andy Benest, vascular biologist at the University of Nottingham.

Although covid is transmitted through the respiratory system, much of the pathology unfolds in the vascular system, with microvascular damage, thromboinflammation, and dysregulated perfusion underpinning the cardiac, pulmonary, and neurological manifestations of severe disease.

“The virus enters through the airways but exerts its systemic effects through the vasculature, the common denominator in the lungs, heart, kidneys, and brain,” Benest tells The BMJ.

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