{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:35:30Z","timestamp":1753893330144,"version":"3.41.2"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"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. Surg."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study investigates the characteristics of Otitis Media with Effusion (OME) secondary to the SARS-CoV-2 pandemic, and examines whether SARS-CoV-2 is present in middle ear effusions (MEE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed patients diagnosed with SARS-CoV-2 who presented with ear fullness between December 15, 2022, and January 20, 2023. After obtaining a detailed medical history and conducting audiometric assessments, we confirmed OME and performed tympanocentesis to test for SARS-CoV-2 in the MEE following informed consent. Post-procedure, patients received nasal decongestants and oral\/nasal corticosteroids. Follow-up consultations, tympanic membrane examinations, and audiometric evaluations were conducted 2\u20134 weeks later, with a final assessment at three months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our clinic recorded 311 OME cases during the study period, accounting for 9.5% of all patients\u2014a significant increase from 2.2% the previous year and 2.5% the following year. The peak incidence occurred one week post-infection. Among the 311 patients, 52 underwent tympanocentesis (33 males, 19 females). 20 patients had bilateral onset, while 32 had unilateral onset. 31 patients were cured after a single tympanocentesis, whereas 21 required two or more procedures. 17 patients tested positive for SARS-CoV-2 in the MEE, but only one simultaneously tested positive in nasal secretions. At the three-month follow-up, 59.6% of patients were cured, 30.8% showed improvement without full recovery, and 9.6% had no improvement. Factors such as poor mastoid pneumatization, nasopharyngeal obstruction, and comorbidities (hypertension, diabetes) affected treatment efficacy. Among the 52 patients, 37 had conductive hearing loss (CHL), and 15 had mixed hearing loss (MHL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SARS-CoV-2 contributes to OME, primarily affecting one ear. The virus persists longer in MEE than in the upper respiratory tract, suggesting slower viral clearance in the middle ear compared to the nasopharynx. Conductive hearing loss (CHL) is the most common type post-infection, but mixed hearing loss (MHL) can also occur, particularly in older patients, with less favorable outcomes compared to CHL.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1515724","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T05:39:42Z","timestamp":1747028382000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Analyzing the characteristics of Otitis media with effusion following SARS-CoV-2 infection in China"],"prefix":"10.3389","volume":"12","author":[{"given":"Xinxin","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanfang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minxing","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuanfu","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Asad","family":"Iqbal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guochang","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e0171049","DOI":"10.1371\/journal.pone.0171049","article-title":"The pathogens profile in children with otitis media with effusion and adenoid hypertrophy","volume":"12","author":"Buzatto","year":"2017","journal-title":"PLoS One"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1097\/AUD.0000000000001038","article-title":"Audiologic profiles of children with otitis media with effusion","volume":"42","author":"Al-Salim","year":"2021","journal-title":"Ear Hear"},{"key":"B3","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1136\/archdischild-2024-327454","article-title":"Modifiable risk factors for developing otitis media with effusion in children under 12 years in high-income countries: a systematic review","volume":"110","author":"Paing","year":"2025","journal-title":"Arch Dis Child"},{"key":"B4","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1038\/s41586-020-2008-3","article-title":"A new coronavirus associated with human respiratory disease in China","volume":"579","author":"Wu","year":"2020","journal-title":"Nature"},{"key":"B5","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1002\/jmv.25678","article-title":"Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle","volume":"92","author":"Lu","year":"2020","journal-title":"J Med Virol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1177\/00034894241241889","article-title":"Changes in Otitis media during COVID-19","volume":"133","author":"Cho","year":"2024","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s13005-024-00429-x","article-title":"Effect of COVID-19 on the characteristics and outcome of patients who have otitis media with effusion: a case-control study","volume":"20","author":"Fan","year":"2024","journal-title":"Head Face Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1097\/MAO.0000000000004158","article-title":"Clinical observation of Otitis Media secretory during COVID-19","volume":"45","author":"Liang","year":"2024","journal-title":"Otol Neurotol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e0297100","DOI":"10.1371\/journal.pone.0297100","article-title":"Analysis of characteristics of and risk factors for otological symptoms after COVID-19 infection","volume":"19","author":"Wang","year":"2024","journal-title":"PLoS One"},{"key":"B10","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1177\/00034894231188855","article-title":"The prevalence and association of biofilms with otitis media with effusion: a systematic review and meta-analysis","volume":"133","author":"Elzayat","year":"2024","journal-title":"Ann Otol Rhinol Laryng"},{"key":"B11","doi-asserted-by":"publisher","first-page":"104229","DOI":"10.1016\/j.amjoto.2024.104229","article-title":"The silent reservoir? SARS-CoV-2 detection in the middle ear effusion of patients with Otitis media with effusion after omicron infection","volume":"45","author":"Han","year":"2024","journal-title":"Am J Otolaryngol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.17305\/bb.2024.10239","article-title":"Clinical manifestations and outcomes of otitis media with effusion in adult patients following omicron infection in China","volume":"24","author":"Meng","year":"2024","journal-title":"Biomol Biomed"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1488","DOI":"10.1001\/jama.2020.3204","article-title":"Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore","volume":"323","author":"Young","year":"2020","journal-title":"JAMA"},{"key":"B14","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1002\/jmv.25725","article-title":"Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection","volume":"92","author":"Xia","year":"2020","journal-title":"J Med Virol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1843","DOI":"10.1001\/jama.2020.3786","article-title":"Detection of SARS-CoV-2 in different types of clinical specimens","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA"},{"key":"B16","doi-asserted-by":"crossref","DOI":"10.1101\/2020.02.11.20022228","article-title":"Single-cell RNA expression profiling of ACE2, the putative receptor of Wuhan 2019-nCoV, in the nasal tissue","volume-title":"MedRxiv","author":"Wu","year":""},{"key":"B17","doi-asserted-by":"publisher","first-page":"280","DOI":"10.34172\/hpp.2023.33","article-title":"A review on the impacts of COVID-19 on the auditory system: implications for public health promotion research","volume":"13","author":"Shibafar","year":"2023","journal-title":"Health Promot Perspect"},{"key":"B18","doi-asserted-by":"publisher","first-page":"905","DOI":"10.3390\/jpm13060905","article-title":"SARS-CoV-2 in the middle ear-CovEar: a prospective pilot study","volume":"13","author":"Rubicz","year":"2023","journal-title":"J Pers Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e29545","DOI":"10.1002\/jmv.29545","article-title":"Detection of SARS-CoV-2 virus in middle ear effusions and its association with otitis media with effusion","volume":"96","author":"Fu","year":"2024","journal-title":"J Med Virol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1017\/S0022215122000093","article-title":"Middle-ear effusion in children with cleft palate: congenital or acquired?","volume":"136","author":"Kraus","year":"2022","journal-title":"J Laryngol Otol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"910","DOI":"10.4102\/sajcd.v69i2.910","article-title":"Middle ear status\u2013structure, function and pathology: a scoping review on middle ear status of COVID-19 positive patients","volume":"69","author":"Sebothoma","year":"2022","journal-title":"S Afr J Commun Disord"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e47798","DOI":"10.7759\/cureus.47798","article-title":"Successful treatment of eosinophilic chronic rhinosinusitis and secretory otitis media in refractory asthma with thymic stromal lymphopoietin (TSLP) receptor monoclonal antibody","volume":"15","author":"Kawashima","year":"2023","journal-title":"Cureus"},{"key":"B23","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1177\/0194599820919741","article-title":"A commentary on safety precautions for otologic surgery during the COVID-19 pandemic","volume":"162","author":"Saadi","year":"2020","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e10","DOI":"10.1097\/MAO.0000000000002860","article-title":"Bilateral sudden sensorineural hearing loss and intralabyrinthine hemorrhage in a patient with COVID-19","volume":"42","author":"Chern","year":"2021","journal-title":"Otol Neurotol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"58","DOI":"10.5339\/qmj.2021.58","article-title":"COVID-19-related sudden sensorineural hearing loss","volume":"2021","author":"Yaseen","year":"2021","journal-title":"Qatar Med J"},{"key":"B26","doi-asserted-by":"publisher","first-page":"313","DOI":"10.3390\/audiolres11030029","article-title":"Sudden sensorineural hearing loss in mild COVID-19: case series and analysis of the literature","volume":"11","author":"Ricciardiello","year":"2021","journal-title":"Audiol Res"},{"key":"B27","doi-asserted-by":"publisher","first-page":"768377","DOI":"10.3389\/fcimb.2021.768377","article-title":"A strong decline in the incidence of childhood otitis media during the COVID-19 pandemic in The Netherlands","volume":"11","author":"Hullegie","year":"2021","journal-title":"Front Cell Infect Microbiol"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1515724\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T05:39:42Z","timestamp":1747028382000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1515724\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,12]]},"references-count":27,"alternative-id":["10.3389\/fsurg.2025.1515724"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1515724","relation":{},"ISSN":["2296-875X"],"issn-type":[{"type":"electronic","value":"2296-875X"}],"subject":[],"published":{"date-parts":[[2025,5,12]]},"article-number":"1515724"}}