Abstract Text: The association between COVID-19 and its effect on autoimmune inner ear disease (AIED) has not been explored. We investigated the exacerbation of sensorineural hearing loss (SNHL) after COVID -19 infection and COVID-19 vaccination in these patients. Our prior research in AIED demonstrated that peripheral blood mononuclear cell (PBMC) from corticosteroid-resistant AIED patients had increased interleukin-1β (IL-1β) and IL-6 levels. In this study, we compared IL-1β, IL-1Ra and IL-6 mRNA production and release between AIED patients with worsening SNHL after COVID-19 vaccination or infection (Covid (+)) (n= 7) with AIED patients with worsening SNHL unrelated to Covid (Covid (-)) (n=7). In these two groups, we treated isolated PBMCs with increasing dose of SARS-CoV-2 spike protein and compared responses to stimulation with myelin basic protein (MBP), and LPS samples. In Covid (+) AIED patients, their PBMCs exposed to 12 ug/ml spike protein had almost 5-fold greater release of IL-6 as compared to Covid (-) AIED patients, and 4-fold greater for 12ng/ml and 12pg/ml of spike protein. In Covid (-) AIED patients, a greater induction of IL-1RA was observed in response to all concentrations of spike protein as compared with Covid (+) AIED patients, suggesting a stronger anti-inflammatory effect. Minimal differences were observed for IL-1 β release with spike protein. Notably, no sequence homology is observed between spike protein and cochin, the inner ear protein implicated in AIED. Further studies are underway to get more definitive answer to understand the relationship between the COVID-19 infection or COVID-19 vaccination and SNHL.
