No Inherent Increased COVID-19 Infection Risk in Patients with Chronic Rhinosinusitis

by Linda Kossoff •

Do patients with chronic rhinosinusitis (CRS) exhibit elevated rates of COVID-19 infection?

BOTTOM LINE

Patients with CRS are likely not inherently more vulnerable to COVID-19 infection at a rate above that of the general population.

BACKGROUND: Since the pandemic’s onset, many groups at increased risk for COVID-19 infection or more severe forms of infection have been identified. Patients with CRS often ask if they are more susceptible to contracting COVID-19 given their underlying inflammatory mucosal disease and potential use of topical steroid sprays or rinses.

STUDY DESIGN: Matched cohort study.

SETTING: Department of Otolaryngology, Harvard Medical School, Boston.

SYNOPSIS: Researchers identified a case group of 12,282 adult patients (55.4% female, mean age 53.0 years) with a clinical diagnosis of CRS given by an otolaryngologist between June 1, 2020, and January 31, 2021 (pre-vaccine utilization). This group was successfully matched 1:1 to a control patient group. Despite a significantly higher COVID-19 testing rate among the CRS group (3,381/27.5%) versus the control group (1,880/15.3%), the overall COVID-19 contraction rates for both were the same at 1.4%. Among the CRS group, researchers did not find significantly different contraction rates when comparing age, sex, race, and comorbidity in matched controls. Authors note that although patients with CRS are commonly concerned that steroid treatments may predispose them to coronavirus infection due to a local immunosuppressive effect, this study’s findings would suggest that there’s nothing inherent about the upper airway inflammatory environment in CRS that would make these patients more susceptible. Study limitations included not examining relative disease severity among those who did contract COVID-19 and a possible lower susceptibility rate among CRS patients because they might be more cautious about avoiding COVID-19 exposure.

CITATION: Workman AD, Bhattacharyya N. Do patients with chronic rhinosinusitis exhibit elevated rates of COVID-19 infection? Laryngoscope. 2022;132:257-258