Ear abnormalities in chronic fatigue syndrome (CFS), fibromyalgia (FM), Coronavirus-19 infectious disease (COVID) and long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/inflammatory syndrome induced by adjuvants (ASIA): A systematic review.

Why It Matters

This systematic review consolidates evidence that ear-related symptoms are widespread across a cluster of immune-mediated conditions including ME/CFS, highlighting a potentially underrecognized symptom domain. For ME/CFS patients experiencing hearing or balance problems, this work validates these symptoms as part of the disease spectrum and suggests clinical evaluation pathways. It also proposes shared pathophysiologic mechanisms that may advance understanding of these overlapping conditions.

What This Study Does Not Prove

This review does not establish causation or the relative prevalence of ear symptoms in ME/CFS specifically—findings are aggregated across heterogeneous populations with variable case definitions and symptom assessment methods. The study cannot determine which proposed mechanisms (viral, autoimmune, vascular, epigenetic) are primary versus secondary or most relevant to any individual condition. It also does not provide controlled comparison between ME/CFS and healthy populations or establish prognostic or treatment implications.

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