Effect of post-COVID syndrome on the quality of life of patients with allergic rhinitis and eosinophilic phenotype of chronic polyposis rhinosinusitis

Korkmazov, Musos Yu.; Lengina, Maria A.; Korkmazov, Arsen M.; Kravchenko, Anna Yu.

doi:10.17816/medjrf472079

Medical Journal of the Russian Federation

2023

DOI: 10.17816/medjrf472079

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Effect of post-COVID syndrome on the quality of life of patients with allergic rhinitis and eosinophilic phenotype of chronic polyposis rhinosinusitis

Musos Yu. Korkmazov,

Maria A. Lengina,

Arsen M. Korkmazov

et al.

Abstract: BACKGROUND.An urgent issue of modern medicine is the study of the quality of life of people with post-COVID syndrome.Particular emphasis is placed on patients with various forms of allergic rhinitis associated with comorbid conditions such as polyposis rhinosinusitis.These diseases are still common and tend to increase.In this context, the study of the effect of conservative methods of treatment of allergic rhinitis and polyposis rhinosinus on the quality of life of patients will improve the effectiveness of t… Show more

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Cited by 4 publications

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Cytokine profile of nasal polyps and clinical characteristics of patients with polypous rhinosinisitis at different degree of therapeutic control and disease severity

Savlevich,

Lyubimova,

Zurochka

et al. 2023

Med. immunol.

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The issues of recurrencies in chronic rhinosinusitis with nasal polyps (CRSwNP) still remain unresolved. Therefore, detection patients with uncontrolled clinical course of CRSwNP is required.The aim of the present study was to assess cytokine profile in nasal polyps as well as clinical characteristics of patients with CRSwNP at varying levels of therapeutic control.The study included 99 patients with chronic rhinosinusitis. The contents of interferon IFNγ, interleukin IL- 1β, IL-4, IL-5, IL-13, tumor necrosis factor TNFα, transforming growth factors TGF-β1, TGF-β2, TGF-β3 were measured in polyp tissue samples by means of multiplex analysis. The patients were treated according to a stepwise СRSwNP therapeutic algorithm [9]. Following observation for 5 years, all patients were divided into groups, as based on medical control degree. Group 1 included patients with mild CRSwNP, who mainly received stage I and II treatment for the entire observation period. Group 2 was presented by moderate- severity CRSwNP, with stage II or III therapy according to the referred algorithm. Group 3 included the patients with severe CRSwNP who received one or more stage IV courses. The patients underwent repeated SNOT-22 questionnaire, endoscopic examination, clinical assessment. In case of bronchial asthma (BA), ACQ-7 was repeated. Initial cytokine profile of nasal polyps was analyzed by the mentioned clinical groups.Results:After 5 years of observations in group 1 (mild CRSwNP), we found a minimal decrease in quality of life (SNOT-22), severity of nasal congestion, or smell impairment. Bronchial asthma duration in these patients was significantly lower compared to group 3, the patients had better asthma control level. Cytokine profile of nasal polyps was characterized by the highest IL-4 concentration, average values IL-1β, TNFα, IFNγ and minimal TGF-β1 values.In group 2 (moderate CRSwNP), we noted more pronouced impairment of smell, nasal congestion and quality of life. Bronchial asthma was less controlled than in group 1. The maximal concentrations of IFNγ, IL-1β, TNFα, IL-5, TGF-β1, TGF-β2 were registered.In group 3 with poor CRSwNP control, the highest SNOT-22 scores, severity of difficulty in nasal breathing, impaired sense of smell were revealed. Duration of bronchial asthma was longer, with lowest levels of medical control. In nasal polyps, minimal levels of IFNγ, IL-1β, TNFα, IL-4, IL-5, TGF-β2, TGF-β3 were noted.Treatment of patients depending on the clinical phenotypes of CRSwNP in the presence/absence of allergic rhinitis or bronchial asthma may improve control and reduce incidence of relapses in CRSwNP.

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Cytokine profile of nasal polyps and clinical characteristics of patients with polypous rhinosinisitis at different degree of therapeutic control and disease severity

Savlevich,

Lyubimova,

Zurochka

et al. 2023

Med. immunol.

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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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Incidence of coronavirus disease (COVID-19) in patients with different degrees of chronic rhinosinusitis with nasal polyps

Lyubimova,

Savlevich,

Zurochka

et al. 2024

Medicinskij sovet

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Introduction. Chronic rhinosinusitis with nasal polyps (CRSwNP) pathogenesis is based on inadequate local immune response, additional SARS-CoV-2 infection can alter CRSwNP pathological process.Aim. To effect of COVID-19 on CRSwNP course in patients with different drug control degree.Materials and methods. 99 patients with bilateral CRSwNP (48 men, 51 women, 58.37 ± 14.43 years), were divided into 3 groups based on CRSwNP medical control degree for 5 years [17]. Group 1 (n = 34) – patients with mild CRSwNP received treatment according to treatment algorithm stages I and II. Group 2 (n = 32) – moderate severity CRSwNP, therapy corresponded to algorithm stage II or III. Group 3 (n = 33) – patients with severe CRSwNP received stage IV treatment 1 or more times. All data about vaccination against coronavirus infection and confirmed COVID-19 episodes with an analysis of its severity were recorded,Results. 63 people had COVID-19 (63.64%, 62.5 ± 13.1 years), of which 62.5% people were vaccinated before infection. COVID-19 was mild in 84.1% (54.70 ± 13.83 years), moderate COVID-19 – in 12.7% (63.1 ± 15.38 years), and severe – in 3.2% (age – 40 years). 36% people (62.5 ± 13.1 years) did not infected with coronavirus. In group 1 mild COVID-19 was observed in 35.29%, moderate severity – in 5.88%. In group 2 all patients who had COVID-19 (87.5%) had mild course. In group 3 39.39% patients had mild COVID-19, 18.18% had moderate COVID-19. Severe COVID-19 was observed in 2 people from this group.Conclusions. COVID-19 was mild in most cases in CRSwNP patients. In 84.1% patients were treated as outpatients. CRSwNP patients had frequent swabs to detect SARS-CoV-2 RNA due to complaints of hyposmia and raised coronavirus infection suspicion.

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Effect of post-COVID syndrome on the quality of life of patients with allergic rhinitis and eosinophilic phenotype of chronic polyposis rhinosinusitis

Cited by 4 publications

References 31 publications

Cytokine profile of nasal polyps and clinical characteristics of patients with polypous rhinosinisitis at different degree of therapeutic control and disease severity

Cytokine profile of nasal polyps and clinical characteristics of patients with polypous rhinosinisitis at different degree of therapeutic control and disease severity

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

Incidence of coronavirus disease (COVID-19) in patients with different degrees of chronic rhinosinusitis with nasal polyps

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