{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:25:45Z","timestamp":1771921545889,"version":"3.50.1"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The relationship between \u201cthree inflammations and one deafness\u201d (allergic rhinitis, pharyngitis, otitis media, tinnitus, and deafness) and coronavirus disease 2019 (COVID-19) is currently unclear, and this study aims to investigate their correlation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched the relevant literature in three databases (Embase, Cochrane Library, and PubMed) from their inception through July 2024, and the investigator strictly reviewed the literature according to the screening criteria to determine the included studies. We extracted relevant data information and conducted quality assessment and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 5,950 records screened, five cohort studies were included. The pooled analysis using a random-effects model showed no statistically significant association between COVID-19 and \u201cthree inflammations and one deafness\u201d (OR\u00a0= 1.03, 95% CI: 0.85\u20131.26,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.74), with substantial heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      \u00b2 = 89%,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Critically, subgroup analyses revealed that the diagnostic criteria for \u201cthree inflammations and one deafness\u201d were a key source of this heterogeneity. A significant association was observed in studies using physician-diagnosed outcomes (OR = 1.30, 95% CI: 1.08\u20131.56,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.006,\n                      <jats:italic>I<\/jats:italic>\n                      \u00b2 = 0%), whereas no significant association was found in studies based on self-reported symptoms (OR = 0.89, 95% CI: 0.69\u20131.15,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.38,\n                      <jats:italic>I<\/jats:italic>\n                      \u00b2 = 96%). Analyses by specific conditions yielded mixed results: No significant association was observed for hearing loss (OR = 0.93, 95% CI: 0.69\u20131.25,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.62). For allergic rhinitis (OR = 1.19, 95% CI: 0.47\u20133.02,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.71) and tinnitus (OR = 1.11, 95% CI: 0.88\u20131.39,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.38), the point estimates suggested potential positive trends, but the associations were not statistically significant, and confidence intervals were wide. Subgroup analyses by some regions and COVID-19 diagnostic criteria did not reveal consistent significant associations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This meta-analysis found no consistent association between COVID-19 and \u201cthree inflammations and one deafness,\u201d primarily due to significant heterogeneity. Evidence suggests a link between COVID-19 and physician-diagnosed \u201cthree inflammations and one deafness,\u201d which strongly depends on the rigor of outcome assessment, highlighting the need for standardized clinical diagnoses in future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n                      , identifier CRD42023438076.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1690788","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T06:45:57Z","timestamp":1771915557000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Relationship between COVID-19 and \u201cthree inflammations and one deafness\u201d: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Lisha","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine","place":["Tianjin, China"]},{"name":"Department of Otolaryngology, National Clinical Research Center for Chinese Medicine","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine","place":["Tianjin, China"]},{"name":"Department of Otolaryngology, National Clinical Research Center for Chinese Medicine","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine","place":["Tianjin, China"]},{"name":"Department of Otolaryngology, National Clinical Research Center for Chinese Medicine","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nai","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine","place":["Tianjin, China"]},{"name":"Department of Otolaryngology, National Clinical Research Center for Chinese Medicine","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine","place":["Tianjin, China"]},{"name":"Department of Otolaryngology, National Clinical Research Center for Chinese Medicine","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengli","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine","place":["Tianjin, China"]},{"name":"Department of Otolaryngology, National Clinical Research Center for Chinese Medicine","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"B1","unstructured":"W.H.O. 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