Can chronic rhinosinusitis increase the risk of SARS-CoV-2 infection and severe COVID-19 illness?

Published online: June 2021

Owing to the upper airway inflammatory condition, epithelial barrier dysfunction, and high expression levels of viral entry genes, chronic rhinosinusitis may increase COVID-19 infectivity or severity. While basic studies suggest that SARS-CoV-2 infection can affect chronic rhinosinusitis, real-world evidence on the association of chronic rhinosinusitis with COVID-19 infectivity or severity has not been obtained.

In an article recently published in The Journal of Allergy and Clinical Immunology: In Practice, Lee and colleagues aimed to determine whether chronic rhinosinusitis is associated with increased risk for SARS-CoV-2 infection and severe COVID-19. Altogether, 219,959 adult patients who were tested for SARS-CoV-2 were identified in the large-scale, population-based nationwide cohort in South Korea.

The authors found that patients with chronic rhinosinusitis had an increased risk for SARS-CoV-2 infection and COVID-19 severity compared with people without chronic rhinosinusitis. In particular, chronic rhinosinusitis patients with an absence of nasal polyps, prior intranasal corticosteroid use, or nonatopic type had a greater risk for SARS-CoV-2 infection and severe COVID-19 outcomes. This is the first real-world study to investigate potential associations between chronic rhinosinusitis and COVID-19.

Based on their results, the authors suggest that clinicians should be cautious in assessing the prognosis and determining care for patients with chronic rhinosinusitis amid the COVID-19 pandemic.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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