Objective We investigated the role of middle ear effusion and serum cytokines in the pathogenesis of acute secretory otitis media caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection in adults.Methods Forty-five adult patients with acute secretory otitis media after SARS-CoV-2 infection were enrolled in this study.All patients had been infected with SARS-CoV-2 within the past 4 weeks.Blood samples were collected for cytokine analyses,and cytokines and SARS-CoV-2 nucleic acid were detected by ear effusion after tympanocentesis,to analyze changes in serum and middle ear effusion cytokines.Results The expression of cytokines IL-5,IL-6,IL-8,and IL-10 in middle ear effusions was significantly elevated relative to their levels in serum(P＜0.05);IL-2,IFN-α,IFN-γ and TNF-α expression was not significantly different between serum and middle ear effusion(P＞0.05).IL-5,IL-6,IL-8,and IL-10 expression level in middle ear effusion displayed no significant difference between SARS-CoV-2 positive individuals(including suspected positive individuals)and negative individuals(P＞0.05).Individuals with mixed hearing loss exhibited significantly elevated IL-6 and IL-8 expression in middle ear effusion than individuals with conductive hearing loss(P＜0.05).Conclusion SARS-CoV-2 can infect the middle ear through the eustachian tube and induce middle ear im-mune cells to produce high levels of cytokines,promoting secretory otitis media.IL-5,IL-6,IL-8,and IL-10 were the main inflam-matory cytokines that promoted adult acute secretory otitis media caused by the novel coronavirus.IL-6 and IL-8 can be used as pri-mary indicators to predict the severity of impairment of sensory nerve function in patients.
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