Case Presentation:
A 31 y/o otherwise healthy male suffered rapidly onset severe non-positional vertigo, disequilibrium, and nystagmus associated with nausea and vomiting, which were followed in a few hours with high fever, diarrhea, and generalized fatigue. He and his wife were then both tested positive for SARS CoV-2 by PCR. He denied having other common COVID-19 symptoms. All his systemic symptoms resolved in 2 weeks after treatments. However, he remained having persistent severe and subjectively progressive vertigo and disequilibrium upon the first office encounter 2 months later. Symptoms were enhanced by head pitching and were reduced by maintaining head stationary in supine position with eyes closed. Examination was unremarkable except the findings of slight left-sided peripheral vestibular weakness and mild deviation with Fukuda stepping. Further vestibular studies showed normal water caloric irrigation, impaired vertical gaze holding, abnormal subjective visual vertical testing, and delayed bilateral vestibular evoked myogenic potentials. COVID-19 infection-related peripheral and central vestibular complications were suspected. The patient was referred to vestibular rehabilitation.