On the contrary, ACE2 and TMPRSS2 gene expressions are upregulated by Th1 cytokines such as interferon-γ and tumor necrosis factor α (TNF-α), increasing the susceptibilities of nECRS patients to COVID-19 and further inflammation in OM and OD (Chen et al., 2020; Kawasumi et al., 2022). This evidence concerns the gene TNF and COVID-19.