Efficacy Measures Used in Alzheimer Disease Clinical Trials Between 2015 and 2025: A Systematic Review.

The coronavirus disease 2019 (COVID-19) initially occurred in Wuhan (China) in December 2019. Until January 2024, COVID-19 has infected over 774 million people and caused over 7.0 million deaths globally. The COVID-19 pandemic became public health emergency of international concern caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in March 2020. SARS-CoV-2 continued to mutate, with a new mutant strain Omicron becoming the main prevalent strain in China since October 2022. Omicron mainly causes changes in clinical manifestations, including a decrease in pneumonia symptoms and an increase in upper respiratory tract infections, especially the eustachian tube infection. Upper respiratory tract infections often lead to middle ear infections. SARS-CoV-2 is found in the middle ear fluid (MEF) of patients with otitis media with effusion (OME). The OME patients were previously COVID-19-positive, OME symptoms may still appear even after the second or third COVID-19 infection. Thus, SARS-CoV-2 infection may be a cause of OME, and OME is a possible symptom of COVID19. OME has the characteristic of high prevalence in winter and spring, and is more common in children, mainly due to the anatomic and functional immaturity of the eustachian tube in children compared to adults, but forced isolation of children at home during SARS-CoV-2 pandemic cut down the incidence of OME in children. As China has previously taken comprehensive closure measures, the lifting of COVID-19 restrictions started from December 7, 2022. The change led to a unique phenomenon in the world, that is, almost people has been COVID-19 positive during followed 2 months. The number of positive people reached its peak on December 22 (6.94 million/day) in China, But, as the northeast region of China, all residential areas of Shenyang city were fully unsealed on December 14, 2022. Recently, two systematical reviews have underscored the need for standardized diagnostic protocols and large-scale multicenter research to clarify pathophysiology and optimized management of COVID-19-related otologic and neurologic manifestations. They clearly indicate that olfactory dysfunction in COVID-19 often precedes or accompanies other symptoms, with objective testing revealing higher prevalence than self-report, especially for female predominance with an incidence of 34–68%, and sudden sensorineural hearing loss (SSNHL) in COVID-19 often accompanies tinnitus symptoms with an incidence of 61%, which is related to the impaired audio-vestibular system by SARS-CoV-2. Glucocorticoids remain the mainstay of treatment. Also, from December 2022 to March 2023, the OME incidence in our emergency and outpatient department increased significantly compared with the incidence in the same month before the epidemic. COVID-19 infection may increase severity of mental pressure among survivors, . But, since Chinese people experienced the baptism of SARS in 2003, and Chinese government took full closure measures when facing COVID-19. Individuals with COVID-19 infection were isolated and actively treated. The severity of the epidemic has brought little physiological and psychological pressure among Chinese people, but the severity of isolated closure may mainly induce mental stress from home and work.