There is strong evidence for viral infection as a cause of idiopathic SSNHL. Proposed mechanisms include direct viral invasion of the labyrinth or cochlear nerve, reactivation of a latent virus within the spiral ganglion, and immune-mediated mechanism in a systemic viral infection (8,12). Though the fluctuating SNHL seen in the patient's right ear is atypical for classic SSNHL, it is characteristic in pathology such as Menière's disease. Since viral infection has been advocated as a potential cause of Menière's disease (13,14), this presentation still implicates the SARS-CoV-2 virus as a potential cause of her SSNHL.
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