Dalian Medical University, Dalian, China.
Department of Otolaryngology-Head and Neck Surgery, The Second People's Hospital of Yibin City, Yibin, China.
Immun Inflamm Dis. 2023 Oct;11(10):e1055. doi: 10.1002/iid3.1055.
The etiology and pathophysiological mechanisms of sudden sensorineural hearing loss (SSNHL) remain unclear, but it is generally believed to be associated with viral infections, vascular diseases, and autoimmune disorders. Considering that coronavirus disease 2019 (COVID-19) is promising candidates for SSNHL, we studied the immune cells changes by COVID-19 in patients with SSNHL.
We collected data from 47 patients with SSNHL and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive. Patients were divided into ineffective or effective groups based on the degree of hearing recovery at discharge. Clinical information was collected and processed for both groups. Logistic regression models were used to determine the risk factors for an unfavorable prognosis in COVID-19-related SSNHL. Receiver operating characteristic (ROC) curves were used to estimate the predictive value.
There was statistically significant difference in C-reactive protein (CRP), auditory curve, degree decline, pretreatment hearing, posttreatment hearing, systolic blood pressure, diastolic blood pressure, total bilirubin, neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), indirect-bilirubin and platelet count between groups (p < 0.05). In the logistic regression model, high levels of SII and NLR were associated with treatment ineffectiveness, pre- and postcorrectively (both, p < 0.05). And ROC curve analysis showed higher AUC of 0.765 for SII, 0.697 for NLR,0.681 for CRP, and 0.553 for platelet-to-lymphocyte ratio (PLR) in predicting treatment outcomes.
The prognosis of COVID-19-related SSNHL was associated with inflammation. SII, NLR and CRP could serve as predictive markers of unfavorable outcomes in COVID-19-related SSNHL. SII may be considered an independent risk factor for poor prognosis in COVID-19-related SSNHL.
突发性聋（SSNHL）的病因和病理生理机制尚不清楚，但一般认为与病毒感染、血管疾病和自身免疫性疾病有关。鉴于 2019 年冠状病毒病（COVID-19）是 SSNHL 的潜在候选因素，我们研究了 COVID-19 患者中 SSNHL 的免疫细胞变化。
我们收集了 47 例 SSNHL 患者和 SARS-CoV-2 阳性患者的数据。根据出院时听力恢复程度，将患者分为有效组和无效组。对两组患者的临床资料进行收集和处理。采用逻辑回归模型确定 COVID-19 相关 SSNHL 不良预后的危险因素。采用受试者工作特征（ROC）曲线评估预测价值。
两组间 C 反应蛋白（CRP）、听力曲线、下降程度、治疗前听力、治疗后听力、收缩压、舒张压、总胆红素、中性粒细胞与淋巴细胞比值（NLR）、系统免疫炎症指数（SII）、间接胆红素和血小板计数差异均有统计学意义（p＜0.05）。在逻辑回归模型中，SII 和 NLR 水平与治疗效果呈正相关（均 p＜0.05）。ROC 曲线分析显示，SII 的 AUC 为 0.765，NLR 的 AUC 为 0.697，CRP 的 AUC 为 0.681，血小板与淋巴细胞比值（PLR）的 AUC 为 0.553，预测治疗结局的效果更佳。
COVID-19 相关 SSNHL 的预后与炎症有关。SII、NLR 和 CRP 可作为 COVID-19 相关 SSNHL 不良结局的预测标志物。SII 可能是 COVID-19 相关 SSNHL 不良预后的独立危险因素。
