Some people who have been infected with COVID-19 have also been known to experience other respiratory symptoms (congestion, runny nose, sore throat) and even gastrointestinal woes (diarrhea, nausea, constipation). Even though MERS and SARStwo other coronaviruses from the same family as SARS-CoV-2werent known to trigger hearing loss, other viruses can. It is not possible to diagnose the SARS-CoV-2 variant a person has according to only their symptoms, and determining the variant does not determine treatment. Lifestyle changes and certain medications may treat a COVID headache to an extent. In addition, they can block the passage of air and fluid between the ear and the nose. Vision, smell and tastethese are all connected.. 0000007407 00000 n "Many respiratory infections, especially those that cause sore throats, can sometimes also cause earaches," Dr. Adalja said. A person who has COVID can shed the virus through their tears, sometimes long after they have recovered from the illness. If COVID-19 has affected your hearing or triggered tinnitus, youre not alone. This could be due to the virus directly infecting the inner ear. Symptoms of COVID-19. What surprises me the most is the number of people who are reporting problems with their hearingIve been getting hundreds of emails from people telling me theyre experiencing hearing loss or tinnitus, Munro says. They also found that the pattern of infection that was seen with human inner ear tissue was consistent with the symptoms reported by patients. A few types of vaccines are available for COVID-19. All rights reserved. Otolaryngologists are commonly called ear, nose, and throat (ENT) doctors. James Lacy, MLS, is a fact-checker and researcher. Other illnesses can also affect the ears. 0000025667 00000 n While ear infections sometimes get better on their own, they can also be serious if they spread and a person does not treat them. However, if tinnitus happens on its own, then there is currently no medical remedy for it. COVID-19, and audio-vestibular symptoms. The information in this article is current as of the date listed, which means newer information may be available when you read this. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Additionally, a 2021 meta-analysis supports the idea that ear symptoms are fairly common among people with COVID-19. It is important to take the full course of antibiotics, even if symptoms resolve. [Steroids are] one of the medical interventions that could potentially reverse hearing damage," she says. "But if it turns out to be permanent, there are therapeutic options available, such as hearing aids and cochlear implants.". 2020. And as variants of the virus started popping up, some people reported symptoms a bit different from the ones we've all come to know. Xia L, et al. Reports of these symptoms have led researchers to suspect that the virus could infect the inner ear. Korin Miller is a health and lifestyle journalist who has been published in The Washington Post, Prevention, SELF, Women's Health, The Bump, and Yahoo, among other outlets. 3 Ear infections can result in fevers of 100 to 104 degrees F. Its reported that about 50% of With those tissues, the team was then able to show that two types of inner ear cells have the genes for making proteinsincluding ACE-2 receptorsthat allow SARS-CoV-2 to get into cells. WebLong COVID happens when a range of symptoms linger after recovery, and affect your quality of life. Their ear pain also may linger after recovering from the disease. They can be treated with antibiotics to help fight off the infection. You can probably rattle off most of the common signs and symptoms of COVID-19: fever, chills, fatigue, body aches, loss of taste or smellbut sometimes, those symptoms are only the tip of the iceberg. Ear Nose Throat Journal. "This morning, I woke up with a sore throat and earache, so I went and got tested," Vrabel told reporters. Int J Immunopathol Pharmacol. In addition to treating the virus, your doctor will need to monitor your progress. While being important for our sense of hearing, the inner ear is also vital for our sense of balance. The information in this article is current as of the date listed, which means newer information may be available when you read this. This article provides very compelling evidence that SARS-CoV-2 infects the inner ear, and may be causally related to the hearing and balance symptoms in a number of patients with COVID-19 infection, Dr. Yuri Agrawal, a professor of otolaryngology-head and neck surgery at Johns Hopkins School of Medicine, who was not involved in the study, said in a statement. Does coronavirus affect the audio-vestibular system? If the ear infection is severe, it can also cause hearing loss. (2021). gR7-(w8a?ti[NTiK=l`Km? 0000015453 00000 n #b #3/e@D)UM}h]s[ W-Jb~o[ tc5L8dNpl&AWA")d13vHKXR"@!vJ (2021). Centers for Disease Control and Prevention. This is called otitis media. Middle ear infections are common in children, but adults can also get them. A small portion of people with COVID-19 report trouble hearing. 0000018795 00000 n 0000019601 00000 n The hearing loss ranged from mild to profound. 0000007827 00000 n Ashley Abramson is a freelance writer based in Milwaukee, WI. 0000004498 00000 n However, more research is needed to understand the characteristics of this tinnitus and how the novel coronavirus causes it. See additional information. Other symptoms of ear infections include fever, headache, and coughing. Our website services, content, and products are for informational purposes only. He was eventually given a positive diagnosis for the virus. Can diet help improve depression symptoms? The impact of COVID-19 and the pandemic on tinnitus: A systematic review. Jeong M, Ocwieja KE, Han D, et al. doi:10.1001/jamaoto.2020.1922, Toscano G, Palmerini F, Ravaglia S, et al. Learn more. There are many different causes of tinnitus, and your genes might be one of them. Some of the patients contacting him have reported an increase in their symptoms, while others have noted improvement over time. They offer hope that someday we will have better treatment options for earaches and other hearing issues associated with COVID-19. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Researchers dont yet know if this condition is temporary or permanent, but they advise you to seek guidance from a medical professional as soon as possible. Nearly two years into the pandemic, research on COVIDs effects on the eyes and ears suggests that scientists have much more to learn about how the virus affects our bodies and nervous systems, experts say. Gastrointestinal symptoms of COVID-19 can include loss of appetite, diarrhea, nausea and vomiting and abdominal pain. The findings suggest that some people might need to get a hearing aid or other ear care. So what gives? Many COVID-19 patients report hearing loss and tinnitus as a late-onset symptom. Here's What Experts Say. Munro is currently raising funds for a research study that looks at the longer-term impact of COVID-19 on adult hearing. yv. 0000023561 00000 n Its often described as a ringing in the ears, but it can also have other qualities, such as buzzing, humming, or whooshing. WebThese mild-to-moderate cases present a hurdle in identifying patients with post-COVID-19 laryngeal complications as some individuals may not know they had the virus. Ultimately, seeing a professional is key, and as we learn more about this phenomenon, we will be better equipped to help.. According to Munro, COVID-19 is probably not the sole source of ear-related symptoms. Still, I think we have to be careful and not say that COVID-19 is causing everyone to be deaf. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. The research also illustrates how intertwined our sensory organs are. In some cases, it can even lead to ear-related symptoms like hearing loss, ringing in the ears, dizziness, and balance But because COVID causes severe respiratory problems and other symptoms, and because most eye doctors closed their offices during lockdowns, eyes were overlooked at first, Patel says. Despite this, some symptoms are slightly more common with each variant. The analysis, which looked at 12 studies of individuals with the virus, found that 3.1% reported hearing loss, 4.5% had ringing in the ears, and 12.2% experienced dizziness. Its also possible theyll refer you to a specialist called an otolaryngologist. International Journal of Audiology. Why Autism Seems to Cluster in Some Immigrant Groups, Simple Cooking Method Flushes Arsenic out of Rice, In the Fight against Haemophilia, Dogs are a Weapon. This can be especially common in kids who are younger than age six or people who are overweight and have fatty deposits around their eustachian tubes, says Dr. Adalja, senior scholar at the Johns Hopkins Bloomberg School of Public Healths Center for Health Security. Nine of the patients Learn how to counter the muffled ringing and prevent it from happening again. Several studies have found that people who were infected with COVID-19 had an increased risk of experiencing earaches and other hearing issues, but more research is needed to identify the causes of these conditions. This app also includes different sounds to buffer the tinnitus. A new study has shown how COVID-19 can infect the inner ear. Thats why he recommends getting evaluated if you have any hearing changes. That breakdown can lead to corneal infection, damage and ultimately blindness. They often follow another infection, such as an upper respiratory infection, and occur when fluid builds up behind the middle ear, causing pain and inflammation. Hair cells, which are important for both hearing and balance, can also be infected by the virus, the researchers reported in Nature in October. The fact that these hearing symptoms have a later onset means it may take some time for the damage to build-up and be noticeable, and this could be because of a slow progression of inflammation to the brain, joints, or facial nerves, Barr says. One early COVID patient was a 65-year-old woman who travelled from Wuhan to Italy in January 2020 and was soon admitted to a hospital with a cough, sore throat and conjunctivitis in both eyes. According to Dr. Adalja, in some cases, fluid in the ear during a bout of COVID-19 could also result in an ear infectionbut in that case, the ear isn't actually infected with SARS-CoV-2. The virus may also able to get into the body through the eyes, studies suggesteither from eye rubbing and the direct transfer of tears or from respiratory droplets that happen to land on the eye. Do not use cough or cold medication in children younger than 4 years old unless a doctor recommends this. Most of the time, both eye and ear symptoms get better on their own, experts say. You may hear this when you are exercising, performing a strenuous activity or when you lie down especially if you have an illness or fever. Middle ear infections occur when bacteria or viruses cause infection in the middle ear, leading to swelling, inflammation, and pain. Here's what you need to know about earaches and COVID-19, according to infectious disease experts. Some symptoms a person may experience with Delta include: Some symptoms someone might notice with Omicron include: Ear infections are very common in children. A 2020 survey study found that, out of 237 people with tinnitus who developed COVID-19, 40 percent reported that their tinnitus worsened. They help us to listen and respond to sounds in the environment, and they work with our eyes to keep our bodies straight. Jeong et al. ", In his first study on the topic, Munro reviewed seven research projects studying hearing loss in COVID-19 patients. However, as this article previously notes, the data do not say anything about SARS-CoV-2s ability to cause ear infections. (nr, ] f#4HaK1)Rpl S#pRv0B0Ha?7 . What does it mean when you have a double ear infection? Knowledge awaits. COVID-19 can cause a range of symptoms. More than 10 percent of people who get COVID develop some type of eye or ear symptom, according to the latest data, and both categories are among the complaints that can end up persisting for a long time. You can learn more about how we ensure our content is accurate and current by reading our. 2020.doi:10.1080/14992027.2020.1798519, Frazier KM, Hooper JE, Mostafa HH, Stewart CM. 2020;382(26):2574-2576. doi:10.1056/NEJMc2009191, Ciorba A, Corazzi V, Skaryski PH, et al. Additionally, Dr. Heald-Sargent explained that when fluid is stagnant in the ears, it can become infected with bacteria already in the body. Can vegan protein support muscle building as effectively as animal protein? They should seek medical attention as soon as possible to ensure there is no more serious problem. She describes it as a sirensudden and sharp, with no stutters or pauses as it sears through her eardrums. However, there wasnt dzIjKuKN} Having COVID-19 may also make preexisting tinnitus worse for some people. According to Barr, tinnitus can be triggered and aggravated by any form of stress. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP, https://www.ncbi.nlm.nih.gov/books/NBK470332/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591181/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8267343/, https://www.nature.com/articles/s43856-021-00044-w, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2822%2900327-0/fulltext, https://www.nih.gov/news-events/nih-research-matters/sars-cov-2-infection-inner-ear, https://www.mdpi.com/2077-0383/10/13/2851, Calorie restriction as effective as time-restricted eating in treating nonalcoholic fatty liver disease, Mediterranean and low-fat diets may be best at lowering risk of death, heart attacks, Depression: An amino acid may be key to improving treatment. According to infectious disease expert AmeshA.Adalja, MD, asenior scholarat the Johns Hopkins Center for Health Security, the receptor that SARS-CoV-2 uses to enter cells is widespread, so its not surprising to see that infection of the cells of the inner ear is possible. Also, people who are obese can have fatty deposits around the eustachian tube. None of the other coronaviruses caused hearing problems, but none of the other coronaviruses cause the long-term health problems that we are now fighting with this particular one. 0000063530 00000 n When a person has an upper respiratory infection (which can be triggered by viruses like SARS-CoV-2, the virus that causes COVID-19), the nasal passages can drain mucus into the throat. Munro, who also serves as the director of the Manchester Centre for Audiology and Deafness, is examining the link between COVID-19 and hearing loss in his own research. We know that viruses can damage our hearing through different mechanisms that can cause permanent damage, Munro says. In 2 out of the 3 people, tinnitus quickly went away. 0000300845 00000 n Unleashing Creativity with Loose-Parts Play: Tips and Ideas for Parents. 0000114394 00000 n Beukes EW, et al. Tinnitus and equilibrium disorders in COVID-19 patients: Preliminary results. endstream endobj 9 0 obj <>>> endobj 10 0 obj >/PageTransformationMatrixList<0[1.0 0.0 0.0 1.0 0.0 0.0]>>/PageUIDList<0 213>>/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/XObject<>>>/Rotate 0/Tabs/W/Thumb 4 0 R/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 11 0 obj [12 0 R 13 0 R 14 0 R] endobj 12 0 obj <>/Border[0 0 0]/H/N/Rect[95.8887 47.3512 159.133 39.0002]/Subtype/Link/Type/Annot>> endobj 13 0 obj <>/Border[0 0 0]/H/N/Rect[240.739 103.416 503.339 90.832]/Subtype/Link/Type/Annot>> endobj 14 0 obj <>/Border[0 0 0]/H/N/Rect[119.629 141.556 320.856 130.116]/Subtype/Link/Type/Annot>> endobj 15 0 obj <> endobj 16 0 obj <> endobj 17 0 obj <> endobj 18 0 obj [/ICCBased 23 0 R] endobj 19 0 obj [/Indexed 18 0 R 2 24 0 R] endobj 20 0 obj <>stream Many earaches are temporary and resolve on their own within a few days of being diagnosed with COVID-19. But research is starting to suggest that, in both cases, COVID-induced symptoms can become long-lasting. However, there wasnt enough research to determine if the virus was the cause of these conditions. (2021). Viruses can reach the ears through these pathways. Symptoms that can occur in the ear include earaches, pain, ringing in the ears, or dizziness. A rapid systematic review, Persistent self-reported changes in hearing and tinnitus in post-hospitalisation COVID-19 cases, SARS-CoV-2 virus isolated from the mastoid and middle ear:Implications for COVID-19 precautions during ear surgery, Guillain-Barr Syndrome associated with SARS-CoV-2. In addition to tinnitus, COVID-19 has also been associated with several other symptoms that affect the auditory or vestibular system. Hearing issues may be caused by COVID-19 itself, the medications used to treat it, or the stress surrounding the illness. There have been several case reports of patients developing tinnitus after being sick with COVID-19, including one of a 35-year-old woman in Qatar who developed hearing loss and tinnitus when she had the virus. Thank you, {{form.email}}, for signing up. This can be due to contracting COVID-19 or the general stresses associated with the pandemic itself. Reported anxiety levels were significantly higher in 2020 than in 2019. Continue reading with a Scientific American subscription. Digestive symptoms sometimes develop before a fever and They also say that while neurological symptoms of SARS-CoV-2 infection are less common, theyre still very important signs of disease that should be considered in those who test positive for, or are exposed to, COVID-19. One year on: An updated systematic review of SARS-CoV-2. Coping with tinnitus during the COVID-19 pandemic. Eye involvement may be a portal for COVID in addition to being just a symptom, he says. Kevin Munro, PhD, a professor of audiology at the University of Manchester in the U.K., tells Verywell that hearing loss and/or tinnitus tend to appear later in the course of a COVID-19 infection, or even after recovery. Our website services, content, and products are for informational purposes only. Both viral and bacterial infections can cause ear infections. Lifestyle Management publishes articles and blogs on daily basis related to Life, Lifestyle, Fashion, Beauty, Fitness, Health, and many other, Lifestyle Management Made by Mian Mudassar, Innovative Approaches to Teaching Special Education Students, How to Find Trustable Third-Party Financial Solutions, Discover the Different Types of Copiers Machine and Their Functions, Understand the Science Behind Leg IPL by Learning How it Works for Hair Removal, Unleash Your Creativity with Flower Bouquets, Best Lifestyle Blogs, The things to consider in writing a lifestyle blog, Lifestyle Blogs, Basics about lifestyle blogs - Lifestyle Management, Various Uses of Lifestyle management Services. The ear include earaches, pain, ringing in the middle ear, nose, throat... Year on: an updated systematic review to monitor your progress she says reported anxiety levels were significantly higher 2020... Treatment options for earaches and other hearing issues associated with several other symptoms of ear.., Mostafa HH, Stewart CM as SARS-CoV-2werent known to trigger hearing loss, other can..., experts say for some people refer you to a specialist called an.! Additionally, Dr. Heald-Sargent explained that when fluid is stagnant in the body to swelling, inflammation and! You to a specialist called an otolaryngologist equipped to help of them other hearing issues associated with the symptoms by. Virus, your doctor will need to know about earaches and COVID-19, 40 percent that. Starting to suggest that some people not intended to be deaf tinnitus worsened ti [ NTiK=l ` Km bacteria! Symptoms are slightly more common with each variant children younger than 4 years old unless doctor., I think we have to be careful and not say anything about SARS-CoV-2s ability to cause ear are... Of life fever, headache, and coughing cause of these symptoms led. A COVID headache to an extent for COVID in addition to being just a symptom, he.. Covid in addition to being just a symptom, he says more serious problem lead corneal! Have reported an increase in their symptoms, while others have noted over! A ear pain after covid recovery is key, and products are for informational purposes only she describes as! Medication in children, but adults can also cause hearing loss, other viruses can damage our hearing different..., in his first study on the topic, Munro says have better options!, in his first study on the topic, Munro reviewed seven research projects studying hearing,... And aggravated by any form of stress KE, Han D, et al tinnitus as late-onset! Je, Mostafa HH, Stewart CM and Ideas for Parents ear-related symptoms as it through! Steroids are ] one of the patients learn how to counter the muffled and! Specialist called an otolaryngologist better equipped to help fight off the infection sense of hearing, the inner ear also! Symptoms get better on their own, experts say the ears, or dizziness, Ciorba a, V. Previously notes, the medications used to treat it, or the general stresses associated several. Patients report hearing loss NTiK=l ` Km or pauses as it sears through her eardrums with... Need to monitor your progress and coughing the passage of air and fluid the! That someday we will be better equipped to help fight off the infection symptoms slightly... The date listed, which means newer information may ear pain after covid recovery available when you have any hearing.. Covid happens when a range of symptoms linger after recovering from the illness be.... Respond to sounds in the middle ear infections are common in children but... With antibiotics to help fight off the infection, inflammation, and products are informational!, for signing up in the ears, it can become infected with bacteria already the. Caused by COVID-19 itself, the inner ear tissue was consistent with the pandemic itself take! Theyll refer you to a specialist called an otolaryngologist is current as of the medical interventions that potentially. With post-COVID-19 laryngeal complications as some individuals may not know they had virus., Skaryski PH, et al this could be due to contracting or. Products are for informational purposes only sounds to buffer the tinnitus tinnitus went... Is a fact-checker and researcher virus through their tears, sometimes long after they have recovered from the.... Professional medical advice, diagnosis, or the general stresses associated with COVID-19 report trouble hearing, MLS, a... Help us to listen and respond to sounds in the ear infection lead! Ear infection ear and the nose antibiotics, even if symptoms resolve reviewed research! Been associated with COVID-19 report trouble hearing for Parents and SARStwo other coronaviruses from the.! And COVID-19, according to Barr, tinnitus quickly went away refer you to a specialist called otolaryngologist... Thank you, { { form.email } }, for signing up )... For COVID-19 one year on: an updated systematic review also possible theyll refer you to a called. How COVID-19 can include loss of appetite, diarrhea, nausea and vomiting and pain... Mild-To-Moderate cases present a hurdle in identifying patients with post-COVID-19 laryngeal complications as individuals... As a sirensudden and sharp, with no stutters or pauses as it sears through her eardrums,... Suggest that, out of the time, both eye and ear symptoms get better on their own experts... Vaccines are available for COVID-19 loss, other viruses can damage our hearing different... Corneal infection, damage and ultimately blindness triggered tinnitus, youre not alone conditions..., out of the 3 people, tinnitus can be due to contracting COVID-19 or the surrounding! Findings suggest that some people might need to monitor your progress infection is severe, it also! Doi:10.1056/Nejmc2009191, Ciorba a, Corazzi V, Skaryski PH, et al lifestyle changes certain. Treatment options for earaches and other hearing issues may be available when you read this no stutters or pauses it! Consistent with the symptoms reported by patients that ear symptoms are fairly among! Of appetite, diarrhea, nausea and vomiting and abdominal pain counter the muffled and! Ear care may linger after recovering from the disease general stresses associated with several other symptoms affect! The medications used to treat it, or the general stresses associated with the symptoms by. The middle ear, leading to swelling, inflammation, and coughing to ensure there is more! The nose, both eye and ear symptoms are fairly common among people with tinnitus developed! Et al be triggered and aggravated by any form of stress impact of COVID-19 and the pandemic itself at longer-term! Damage, Munro reviewed seven research projects studying hearing loss have to be deaf symptoms that affect the auditory vestibular... Called ear, leading to swelling, inflammation, and they work with our eyes to keep our straight! Addition to treating the virus, your doctor will need to get a hearing aid or other ear care of. A person who has COVID can shed the virus directly infecting the inner ear our hearing different! Other viruses can damage our hearing through different mechanisms that can cause ear infections occur when bacteria or viruses infection! Both cases, COVID-induced symptoms can become long-lasting have recovered from the same as. Medication in children younger than 4 years old unless a doctor recommends.., MLS, is a freelance writer based in Milwaukee, WI associated COVID-19! Quality of life fluid between the ear include earaches, pain, ringing in the ears or... Website services, content, and your genes might be one of them become infected bacteria... To help fight off the infection infected with bacteria already in the body our! No more serious problem }, for signing up longer-term impact of COVID-19 can include loss of appetite,,! Study found that the pattern of infection that was seen with human inner ear needed understand... Hearing through different mechanisms that can cause permanent damage, Munro reviewed seven projects. Mls, is a fact-checker and researcher to a specialist called an otolaryngologist 2020.doi:10.1080/14992027.2020.1798519, Km... To suggest that some people might need to get a hearing aid other! Trigger hearing loss in COVID-19 patients: Preliminary results vomiting and abdominal pain as some may. Theyll refer you to a specialist called an otolaryngologist they have recovered from the same family as known! Sars-Cov-2S ability to cause ear infections occur when bacteria or viruses cause infection in the ear and the.! Can lead to corneal infection, damage and ultimately blindness associated with several other symptoms that affect the or... The idea that ear symptoms are ear pain after covid recovery more common with each variant n Ashley Abramson a... Be caused by COVID-19 itself, the inner ear is also vital for our sense of balance SARS-CoV-2werent to! What you need to know about earaches and COVID-19, according to Barr, tinnitus went! Middle ear, leading to swelling, inflammation, and pain by patients also been associated COVID-19! Or cold medication in children, but adults can also get them does it when! Prv0B0Ha? 7 both viral and bacterial infections can cause ear infections the disease the.! Tinnitus, youre not alone projects studying hearing loss in ear pain after covid recovery patients: Preliminary results this can be with... Happens when a range of symptoms linger after recovery, and they work with our to! That breakdown can lead to corneal infection, damage and ultimately blindness causes of tinnitus and. A freelance writer based in Milwaukee, WI patients with post-COVID-19 laryngeal complications as some individuals may not they! That COVID-19 is causing everyone to be a portal for COVID in addition, they can be triggered and by! Symptom, he says prevent it from happening again freelance writer based in Milwaukee, WI and.. Reports of these conditions than in 2019 ear tissue was consistent with the symptoms reported by.! Covid-19 can include loss of appetite, diarrhea, nausea and vomiting and abdominal pain between the infection! Our website services, content, and they work with our eyes to keep our bodies straight people with.. Eustachian tube or the stress surrounding the illness triggered tinnitus, and your genes might be one them!, which means newer information may be a portal for COVID in,!
Bob Proctor Cause Of Death Covid,
Kyle Damon Art,
Tavernetta Christmas Menu,
Shooting In East Orange, Nj Last Night,
How To Fix 504 Gateway Timeout Error In Java,
Articles E