Vestibular Dysfunction Secondary to Reactivation of the Neurotropic Virus VZV After COVID-19: A Case Study

BACKGROUND The novel coronavirus COVID-19 infection, caused by the SARS-CoV-2 virus, was declared a global pandemic by the World Health Organization (WHO) in March 2020. As of April 14, 2021, the virus has impacted the lives of over 138 million lives globally, with hundreds of thousands more impacted each day. COVID-19 has resulted in a multitude of clinical manifestations such as respiratory pathology, cardiovascular complications, and neurological dysfunction, and recent evidence points to potential changes in vestibular function secondary to COVID-19 infection. CASE REPORT We present the case of a 67-year-old female patient presenting with vertigo, hearing loss, tinnitus, aural dullness, dizziness, and imbalance following a diagnosis of shingles after contracting COVID-19. Results of a comprehensive balance evaluation were suggestive of a right peripheral vestibulopathy, otolith dysfunction, and a right-sided sensorineural hearing loss. The patient's subjective and objective data may support the claim that COVID-19 can lead to an increase in cases of vestibular dysfunction after reactivation of neurotropic viruses. CONCLUSIONS Our study and others suggest the possibility of vestibular deficits following the reactivation of VZV following a period of immunosuppression in conjunction with the lowered cell-mediated immunity caused by COVID-19. Additionally, vestibular interventions such as advanced vestibular treatment could be used to improve vestibular function in a linear manner.