Chronic rhinosinusitis is associated with increased risk of COVID-19 hospitalization

Sbeih, Firas; Martín-Gutiérrez, Jorge; Saieed, George; Chaaban, Mohamad R.

doi:10.1016/j.amjoto.2022.103469

Cited by 4 publications

(8 citation statements)

References 57 publications

(53 reference statements)

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“…A total of seven studies, including five cross-sectional ( 13 , 15 – 17 , 20 ) and two cohort studies ( 18 , 21 ), were finally retrieved. The included studies’ sample size remarkably varied, ranging from 52 to 12323 in the CRS group and 942 to 207636 in the control group.…”

Section: Resultsmentioning

confidence: 99%

“…Around one-fifth (20.8%; 95%CI: 3.7-84) of CRS patients with COVID-19 required hospitalization ( Table 2 ). Moreover, COVID-19 hospitalization rates were significantly higher in CRS patients than in controls (38.46% versus 25.82%; p = 0.03) ( 17 ).…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, it has been suggested that the condition might have a protective role against COVID-19 (12-16). On the other hand, other studies demonstrated that CRS increases the risk of hospitalization in COVID-19 patients (17,18). Increased susceptibility to COVID-19 and increased risk of severe disease with CRS might be attributed to the high expression levels of viral entry genes, epithelial barrier dysfunction, and induced upper airway inflammatory condition.…”

Section: Introductionmentioning

confidence: 97%

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The impact of chronic rhinosinusitis on COVID-19 risk and outcomes: A systematic review and meta-analysis

et al. 2023

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BackgroundThe impact of chronic rhinosinusitis (CRS) and subsequent steroid therapy on acquiring COVID-19 and severe outcomes remains controversial. Therefore, we conducted this systematic review and meta-analysis to provide cumulative evidence regarding the risk of COVID-19 and the impact of steroid therapy, length of hospital stay, mechanical ventilation, and mortality among CRC patients.MethodsWe conducted a comprehensive electronic search strategy using the relevant keywords. The outcomes and risk factors of COVID-19 in CRS patients was estimated and compared to a healthy control group when applicable.ResultsA total of seven studies were included, with an estimated prevalence of 6.5% (95% confidence interval (CI): 2.5-15.7) for COVID-19 in the CRS group. COVID-19 prevalence did not differ between CRS and controls (odds ratio (OR): 0.92; 95%CI: 0.84-1.01; p = 0.08). Moreover, using steroid/immunosuppressive therapy did not significantly increase the risk of acquiring COVID-19 in CRS patients compared to the control group (OR: 3.31; 95%CI: 0.72-15.26; p = 0.12). Length of hospital stay, mechanical ventilation, and mortality rates were comparable between the two groups. Furthermore, we found that male sex, cardiovascular morbidity, renal diseases, and hypertension were inversely associated with COVID-19 infection (p < 0.01).ConclusionCRS had a neutral effect on acquiring COVID-19 and developing severe outcomes. However, further studies are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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The impact of chronic rhinosinusitis on COVID-19 risk and outcomes: A systematic review and meta-analysis

et al. 2023

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“… However, this study had several limitations, such as assessing the CRS through self-reported telephonic interviews and excluding the fatal cases. Sbeih F et al 13 Retrospective cohort study COVID – 19 positive patients = 998 COVID – 19 Negative patients – 996 COVID – 19 positive patients with CRS had significantly more risk of hospitalization than those without CRS (AOR = 3.19, 95% CI = 1.12–10.68) Workman AD et al 14 Matched cohort CRS Patients – 12,000 Controls – 12, 000 No statistical significance in contracting COVID – 19 infections among the patients with and without CRS Miller LE et al 15 Historical cohort 1707 CRS patients (197 – Received oral corticosteroids 1510 – Did not receive oral corticosteroids) There was no statistically significant difference in COVID – 19 positive results between the CRS patients who received oral corticosteroids with the CRS patients who did not receive them. Note : Data presented in this table is authors, study design, sample size, and important findings with the level of evidence.…”

Section: Covid-19 and Chronic Sinusitismentioning

confidence: 99%

“…Therefore, their data might not have been adequately represented. A retrospective study conducted by Sbeih et al 13 showed that chronic rhinosinusitis was significantly associated with an increased risk of hospital admission in COVID-19 patients (AOR = 3.19, 95% CI = 1.12–10.68). However, they also reported that this risk was not associated with an increased risk of mortality, mechanical ventilation, or admission to the ICU.…”

Section: Covid-19 and Chronic Sinusitismentioning

confidence: 99%

Epidemiological Characteristics, Pathogenesis and Clinical Implications of Sinusitis in the Era of COVID-19: A Narrative Review

Alrasheedi

Alotaibi

Alshalan

et al. 2023

JAA

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Sinusitis is a common condition with various forms and different etiologies. In the era of COVID-19, a large number of studies covered the association between sinusitis and COVID-19, while others reported the impact of COVID-19 on the development of acute invasive fungal rhinosinusitis (AIFR), together with the most commonly associated predisposing factors. Fungal sinusitis, particularly AIFR, can be life-threatening. It is important to dissect this association and improve current evidence and management. Therefore, we conducted this literature review to highlight the association between COVID-19 and sinusitis based on evidence from the available studies in the literature. Evidence shows that chronic sinusitis might have a negative impact on COVID-19 outcomes. However, current results are conflicting, and further studies are needed. On the other hand, COVID-19 can also cause olfactory dysfunction, which is usually temporary. In addition, we found several studies that indicated the association between COVID-19 and AIFR. The condition is usually associated with severe morbidities, as affected patients are usually immunocompromised, including those with uncontrolled diabetes, malignancy, immunosuppression, AIDS, the administration of chemotherapy and other immunosuppressive drugs, and COVID-19.

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A RELATION BETWEEN CHRONIC RHINOSINUSITIS WITH NASAL POLYPS (CRSwNP) AND COVID-19 COURSE

Lyubimova,

Savlevich,

Zurochka

et al. 2024

Russian Journal of Infection and Immunity

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The data on impact of chronic rhinosinusitis (CRS) on SARS-CoV-2 virus susceptibility and COVID-19 course were reviewed. CRS heterogeneity is determined by different types of inflammatory response. A heterogeneous CRS is divided into CRS without polyps and with nasal polyps (CRSwNP) is accounted for by diverse underlying immune responses. Hypersecretion of interleukins (IL)-4, IL-5, IL-13 in eosinophilic CRSwNP downmodulates angiotensin-converting enzyme (ACE)-2 receptor expression that should reduce SARS-CoV-2 infection risk because ACE2 is a main cellular tropism factor for SARS-CoV-2. In neutrophilic CRS type 1 immune response predominates, with activation of Th-1 cells, hypersecretion of interferon (IFN)-γ and tumor necrosis factor (TNF)-α to increase ACE2 expression. However, another data also show that hypoxemia level and pulmonary system damage did not differ between patients with CRS and CRS without polyps. Literature contradictions may be related to differences in availability of medical care, treatment of bronchial asthma (BA) as well as coverage of PCR testing. Regarding use of local or systemic glucocorticosteroids (GCS) effect on SARS-CoV-2 infection risk, some authors believe that GCS may increase COVID-19 severity and mortality, probably by downmodulating local innate immune response factors. According to other data, GCS may reduce ACE2 expression, or there is no relationship between previous GCS use, the incidence of COVID-19 and the frequency of treatment in the intensive care unit. Biological therapy of CRSwNP and BA with monoclonal antibodies did not aggravate COVID-19 severity and mortality risk. Although such data are currently limited, authors recommend not to interrupt such treatment during the epidemic, as well as continue taking leukotriene receptor blockers that can further inhibit major protease (Mpro) of the SARS-CoV-2 virus. However, according to international guidelines on COVID-19 treatment, using CRSwNP and asthma biological therapy should be discontinued until the patients recover completely. Allergen-specific immunotherapy (ASIT) should be interrupted in the case of confirmed COVID-19 due to a probability of developing severe COVID-19. After COVID-19, disturbances in the immune system may persist and possibly change the course of CRS, therefore requiring to modify therapeutic approaches for such patients. At the same time, the worldwide literature has been gradually accumulating information on pathogenesis underlying alterations in such patients including those with CRS, which requires development of new therapeutic approaches.

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Chronic rhinosinusitis is associated with increased risk of COVID-19 hospitalization

Cited by 4 publications

References 57 publications

The impact of chronic rhinosinusitis on COVID-19 risk and outcomes: A systematic review and meta-analysis

The impact of chronic rhinosinusitis on COVID-19 risk and outcomes: A systematic review and meta-analysis

Epidemiological Characteristics, Pathogenesis and Clinical Implications of Sinusitis in the Era of COVID-19: A Narrative Review

A RELATION BETWEEN CHRONIC RHINOSINUSITIS WITH NASAL POLYPS (CRSwNP) AND COVID-19 COURSE

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