Weng Chien-Hsiang, Lin Jun-Fu, Wang Jing-Jie
Department of Family Medicine, Brown University Warren Alpert Medical School, Providence, RI 02903, USA.
Brown Health Medical Group Primary Care, Brown University Health, Providence, RI 02903, USA.
Diagnostics (Basel). 2025 Jun 9;15(12):1462. doi: 10.3390/diagnostics15121462.
Sudden sensorineural hearing loss (SSNHL) is an acute condition with unclear etiology, commonly hypothesized to be associated with viral infections. Acute respiratory tract infections (RTIs), particularly those of viral origin, have been implicated in SSNHL through proposed mechanisms such as cochlear invasion and immune-mediated damage. However, robust large-scale epidemiological evidence examining this association remains limited. This study aimed to investigate the potential association between acute RTIs and subsequent risk of developing SSNHL across diverse populations. We conducted a multinational retrospective cohort study using data from the TriNetX Global Collaborative Network. Adults diagnosed with acute RTIs between 1 January 2012 and 30 June 2023 were compared to matched controls without RTI exposure. Patients with predisposing conditions for SSNHL were excluded. Propensity score matching (1:1) was performed by age and sex. SSNHL diagnoses within 60 days post index were analyzed using Cox proportional hazards models. Subgroup and sensitivity analyses were conducted by race, sex, and age strata. Among 37 million patients analyzed, individuals with acute RTIs had a lower incidence of SSNHL compared to matched controls. Hazard ratios (HRs) for SSNHL were significantly reduced across all racial groups: Whites (HR: 0.572), Blacks (HR: 0.563), and Asians (HR: 0.409). Subgroup analyses revealed stronger inverse associations in males and younger age groups, particularly those aged 18-25 years. Contrary to prior assumptions, acute RTIs were associated with a lower incidence of SSNHL in a large, diverse cohort. While the findings raise the possibility of immunological or physiological factors influencing this association, the results should be interpreted with caution due to unmeasured confounding and the observational nature of the study.
突发性感音神经性听力损失（SSNHL）是一种病因不明的急性病症，通常被认为与病毒感染有关。急性呼吸道感染（RTIs），尤其是病毒源性感染，通过耳蜗侵袭和免疫介导损伤等机制被认为与SSNHL有关。然而，检验这种关联的有力大规模流行病学证据仍然有限。本研究旨在调查不同人群中急性RTIs与随后发生SSNHL风险之间的潜在关联。我们使用TriNetX全球合作网络的数据进行了一项多国回顾性队列研究。将2012年1月1日至2023年6月30日期间被诊断为急性RTIs的成年人与未接触RTIs的匹配对照组进行比较。排除有SSNHL易感因素的患者。按年龄和性别进行倾向评分匹配（1:1）。使用Cox比例风险模型分析索引后60天内的SSNHL诊断情况。按种族、性别和年龄层进行亚组和敏感性分析。在分析的3700万患者中，与匹配对照组相比，急性RTIs患者的SSNHL发病率较低。所有种族组的SSNHL风险比（HRs）均显著降低：白人（HR：0.572）、黑人（HR：0.563）和亚洲人（HR：0.409）。亚组分析显示，男性和较年轻年龄组，特别是18 - 25岁年龄组的反向关联更强。与先前的假设相反，在一个大型、多样化的队列中，急性RTIs与较低的SSNHL发病率相关。虽然这些发现提出了免疫或生理因素影响这种关联的可能性，但由于存在未测量的混杂因素以及研究的观察性性质，结果应谨慎解释。
