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

Xiaozhou Liu1, Yanjun Zong1, Kunpeng Liu2

  • 1Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

Cell Reports
|April 5, 2026
PubMed

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) directly infects inner ear neurons, causing cell death and potential hearing loss. This occurs via spike protein-induced stress granule dysregulation, independent of inflammation.

Area of Science:

  • Neuroscience
  • Virology
  • Otolaryngology

Background:

  • Epidemiological studies link SARS-CoV-2 infection to auditory dysfunction.
  • The precise mechanisms of SARS-CoV-2-induced hearing loss remain incompletely understood.

Purpose of the Study:

  • To investigate the direct impact of SARS-CoV-2 on the inner ear.
  • To elucidate the cellular mechanisms underlying SARS-CoV-2-associated auditory dysfunction.

Main Methods:

  • Intranasal infection of K18-ACE2 mice with four SARS-CoV-2 strains.
  • Analysis of inner ear tissues, specifically targeting spiral ganglion neurons (SGNs).
  • Investigation of spike protein interactions and stress granule formation (G3BP1).

Main Results:

  • SARS-CoV-2 directly invades and infects SGNs in the inner ear.
  • Viral infection leads to increased phase separation and apoptosis in SGNs.
  • Spike protein overexpression inhibits mTOR signaling, causing G3BP1-positive stress granule aggregation and neuronal apoptosis.

Conclusions:

  • SARS-CoV-2 infection directly targets SGNs, causing neuronal cell death and potentially hearing loss.
  • An inflammation-independent pathway involving spike protein-driven stress granule dysregulation is identified.
  • Findings provide a foundation for developing targeted therapies for SARS-CoV-2-related hearing impairment.
Keywords:
CP: immunologyCP: neuroscienceSARS-CoV-2cochleahearinginner ear

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