الفهرس 
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Abstract
Several studies regarding COVID-19 has been shown to affect the ear and has led to hearing deficits, tinnitus, and vertigo. The post COVID – 19 audiovestibular symptoms were seen in 52%of subjects. The current study aimed to assess the vestibular system in post COVID- 19 dizzy patient.
The study was performed on two groups: a study group consisted of 30 post COVID-19 patients 15 days post diagnosis and complaining of dizziness with mean age of 37.10± 7.95 years and a control group consisted of 30 volunteers with no history of any previous balance or hearing problems before COVID-19 infection or systemic diseases known to affect the vestibular system. Their mean age was 34.93± 8.17 years. Both study and control groups underwent PTA, acoustic immitancemetry, acoustic reflex, vestibular evaluation (Arabic version of dizziness handicapped inventory, bedside test for vestibular and balance impairment, video Head Impulse Test (vHIT) cervical Vestibular Evoked Myogenic Potential Test (cVEMP))
In the present study, pure tone audiometry showed normal hearing in 25 (83.3%) patients of the study group, documented bilateral high frequency sensorineural hearing loss in 5 (16.67%) patients.
Dizziness Handicapped Inventory score was assessed among study. Less than half cases (46.7%) had mild impairment, 43.3% of them had moderate impairment while 3 (10%) cases had severe impairment.
Positional nystagmus was found in 14 (46.7%) of patients and 3 patients (10%) presented with positive Dix hall pike test.
Absent waves in cVEMP were found in 8 (26.7%) patients either unilateral or bilateral, while 5 (1.7%) patients were found with prolonged latencies. In VHIT, nine patients (30%) showed abnormal vHIT results in the form of abnormal saccades with or without gain reduction, five patient had a combined canal affection.
A number of hypotheses are discussed and based on knowledge of the disease progresses which cause audiovestibular manifestation. Among those hypotheses, direct damage of the structures of the inner ear or cochleovestibular nerve via a direct viral effect or indirect route by an autoimmune-mediated process (Almishaal & Alrushaidan, 2022).
Finally, SARS-COV2 may have deleterious effects on the audiovestibular system. COVID-19 virus mainly affects peripheral vestibular end organ (semicircular canals, saccule, superior and inferior vestibular nerves) but central affection should be considered.