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COVID-19-related secretory otitis media in the omicron era: a case series

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Increased numbers of patients with secretory otitis media appeared in outpatient clinics after the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Omicron pandemic; however, the relationship between SARS-CoV-2 Omicron variant infection and secretory otitis media is uncertain.


We performed tympanocentesis and used reverse transcription-polymerase chain reaction (RT-PCR) testing to examine middle ear effusion (MEE) and nasopharyngeal secretions from 30 patients with secretory otitis media associated with SARS-CoV-2 infection. RT-PCR was performed using the open reading frame 1ab and nucleocapsid protein gene kit from Shanghai Berger Medical Technology Co., Ltd., as the sole assay method, in accordance with the manufacturer's instructions.


MEEs from 5 of the 30 patients tested positive for SARS-CoV-2, including one patient with positive results for both the nasopharyngeal secretion and MEE. We report and discuss the medical records of six patients, including these five MEE-positive patients and a MEE-negative patient.


SARS-CoV-2 RNA can be detected in MEE caused by coronavirus disease 2019-related secretory otitis media even when a patient’s nasopharyngeal secretion tests PCR-negative for SARS-CoV-2. The virus can remain in the MEE for a long time after SARS-CoV-2 infection.

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The authors thank all patients for their participation. The authors also thank the Department of Laboratory Medicine of the Third Hospital of Hebei Medical University for its support of this study.


This work was supported by Hebei Science and Technology Department, Health innovation Project (Grant no. 22377762D), and Key Scientific and Technological Research Plan of Hebei Province Medical Science Research Project (Grant nos. 20220975 and 20221200).

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Correspondence to Zhanchi Zhang or Feng Luan.

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The authors have no relevant financial or non-financial interests to disclose.

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This study was performed in line with the principles of the Declaration of Helsinki. And it was approved by the Ethics Committee of the Third Hospital of Hebei Medical University.

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Informed consent was obtained from all individual participants included in the study.

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Zhang, Y., Liu, J., Yang, F. et al. COVID-19-related secretory otitis media in the omicron era: a case series. Eur Arch Otorhinolaryngol 280, 4697–4700 (2023).

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