Lower socioeconomic status strengthens the risk of otitis media with effusion after COVID-19 infection: a case-crossover study in Northeast China

Abstract

Abstract To investigate the associations of otitis media with effusion (OME) with different socioeconomic status (SES) before during and after the coronavirus disease 2019 (COVID-19) outbreak in Northeast China. Three cross-sectional data on daily emergency and outpatient were included pre, during and post COVID-19 epidemic. We recorded the number of OME and symptoms and confirmed SARS-Cov-2 infection in patients with OME. We used logistic regression to evaluate the odds ratio (OR) for OME with COVID-19 infection, and employed an interrupted time series analysis to quantify the effect of COVID-19 outbreak on OME, and a time-stratified case-crossover analysis to evaluate the association of OME with SES before, during and after the COVID-19 outbreak, especially in the two months following the COVID-19 outbreak. During COVID-19 outbreak, the OME significantly increased by 50% (RR: 1.563, 95% CI 1.256–1.942) compared to the same period in other years, low SES was associated with an increased risk of OME, but this low SES-related risk elevation significantly increased during the outbreak of COVID-19, especially in the first month after COVID-19 infection. Individuals under 50 years old were still vulnerable to SES after COVID-19 infection in Liaoning. Lower SES might aggravate OME and greater efforts are needed to improve SES in post-COVID-19.