Post-Covid dizziness disability
Reviewed by Victor Osei-Lah

An estimated 750 million people worldwide were affected by Covid-19. A significant proportion have been left with long-term symptoms for which the World Health Organization has proposed the term ‘post-Covid condition’ (PCC). Dizziness is but one of the symptoms. Dizziness is also a symptom in several neurological, autonomic and psychological conditions associated with both Covid-19 and PCC. In this study, the authors explored the “severity of dizziness-related disability in individuals with post COVID condition, and how it is manifested in daily life”. Data were collected between October 2021 and February 2022. Of the 887 who responded to the survey, 524 fulfilled the study criteria. The main outcome measure was the Dizziness Handicap Inventory (DHI). The three commonly used cut points in the DHI scores are mild (0–30 points), moderate (31–60 points) and severe (61–100 points), subdivided into functional, physical and emotional subscales. But in this study, the subscales were modified to physical manifestations, emotional impact and catastrophic impact. The most common PCC symptoms reported were tiredness (88.7%), musculoskeletal pain (53.2%) and breathing difficulties (43.5%). A majority (71.4%) also experienced other symptoms, for example sore throat, nausea, and cognitive impairment. Forty eight percent had mild DHI disability and the majority – 52% – had moderate to severe DHI disability. Within the three modified subscales to assess the impact on daily lives, physical manifestation was reported by 48%. Emotional impact and catastrophic impact were reported by 36% and 17%, respectively. Unsurprisingly, the physical impact related to movements when bending forward, head shaking or doing strenuous physical activities or household chores. As seen in many chronic illnesses, frustration, restriction of social activities, travelling and work also scored highly. The authors appeared to imply that the dizziness was an indication for vestibular impairment and, on that basis, recommended vestibular rehabilitation. Although vestibular rehabilitation is not unreasonable, no evidence was offered to support the implied vestibular pathology. To their credit, they concluded that “future research should continue to explore the potential causal pathways of dizziness in PCC”.

Dizziness-related disability in persons with post-COVID condition: A cross sectional study.
Ostlinda E, Ekstranda E, Axen I, et al.
J VESTIB RES
2024;34(4):185–93.