tetano
Editor, Senior Moderator
J Allergy Clin Immunol Pract
. 2021 Apr 27;S2213-2198(21)00430-X.
doi: 10.1016/j.jaip.2021.03.044. Online ahead of print.
Estimating COVID-19 Infection and Severity Risks in Patients with Chronic Rhinosinusitis: A Korean Nationwide Cohort Study
Seung Won Lee[SUP] 1 [/SUP], So Young Kim[SUP] 2 [/SUP], Sung Yong Moon[SUP] 1 [/SUP], Jee Myung Yang[SUP] 3 [/SUP], Eun Kyo Ha[SUP] 4 [/SUP], Hye Mi Jee[SUP] 5 [/SUP], Jae Il Shin[SUP] 6 [/SUP], Seong Ho Cho[SUP] 7 [/SUP], Dong Keon Yon[SUP] 8 [/SUP], Dong In Suh[SUP] 9 [/SUP]
Affiliations
Abstract
Background: Basic studies suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can affect chronic rhinosinusitis (CRS), but there is unclear real-world evidence regarding the association of underlying CRS with the risk for SARS-CoV-2 infection and severe coronavirus disease 19 (COVID-19).
Objective: We aimed to determine whether CRS is associated with increased risk for SARS-CoV-2 infection and severe COVID-19.
Methods: Altogether, 219,959 adult patients who tested for SARS-CoV-2 in South Korea from January 1 to May 15, 2020 (excluding self-referral) were identified in this nested case-control study with propensity score matching. Data on SARS-CoV-2 test results and COVID-19 worsened outcomes (ie, the need for oxygen therapy, intensive care, or mechanical ventilation, and death) were obtained from the Health Insurance Review and Assessment Service of Korea.
Results: In this matched cohort, 380 of 12,217 patients with CRS (3.1%) tested positive for SARS-CoV-2 infection, compared with 310 patients without CRS (2.5%; adjusted odds ratio = 1.22; 95% confidence interval, 1.04-1.42). Moreover, 60 of 286 COVID-19 patients with CRS (21.0%) had severe COVID-19 outcomes, compared with 38 without CRS (13.3%; adjusted odds ratio = 1.71; 95% confidence interval, 1.09-2.71). Subgroup analysis identified that CRS 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.
Conclusions: In patients with CRS, prior intranasal corticosteroid use, the absence of nasal polyps, or nonatopic type was associated with increased risk for SARS-CoV-2 infection and severe COVID-19 in the Korean nationwide cohort. Clinicians should be cautious in determining prognosis and care for patients with CRS amid the COVID-19 pandemic.
Keywords: COVID-19; Chronic rhinosinusitis; Intranasal corticosteroids; Nasal polyp; Severe acute respiratory syndrome 2.
. 2021 Apr 27;S2213-2198(21)00430-X.
doi: 10.1016/j.jaip.2021.03.044. Online ahead of print.
Estimating COVID-19 Infection and Severity Risks in Patients with Chronic Rhinosinusitis: A Korean Nationwide Cohort Study
Seung Won Lee[SUP] 1 [/SUP], So Young Kim[SUP] 2 [/SUP], Sung Yong Moon[SUP] 1 [/SUP], Jee Myung Yang[SUP] 3 [/SUP], Eun Kyo Ha[SUP] 4 [/SUP], Hye Mi Jee[SUP] 5 [/SUP], Jae Il Shin[SUP] 6 [/SUP], Seong Ho Cho[SUP] 7 [/SUP], Dong Keon Yon[SUP] 8 [/SUP], Dong In Suh[SUP] 9 [/SUP]
Affiliations
- PMID: 33931377
- DOI: 10.1016/j.jaip.2021.03.044
Abstract
Background: Basic studies suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can affect chronic rhinosinusitis (CRS), but there is unclear real-world evidence regarding the association of underlying CRS with the risk for SARS-CoV-2 infection and severe coronavirus disease 19 (COVID-19).
Objective: We aimed to determine whether CRS is associated with increased risk for SARS-CoV-2 infection and severe COVID-19.
Methods: Altogether, 219,959 adult patients who tested for SARS-CoV-2 in South Korea from January 1 to May 15, 2020 (excluding self-referral) were identified in this nested case-control study with propensity score matching. Data on SARS-CoV-2 test results and COVID-19 worsened outcomes (ie, the need for oxygen therapy, intensive care, or mechanical ventilation, and death) were obtained from the Health Insurance Review and Assessment Service of Korea.
Results: In this matched cohort, 380 of 12,217 patients with CRS (3.1%) tested positive for SARS-CoV-2 infection, compared with 310 patients without CRS (2.5%; adjusted odds ratio = 1.22; 95% confidence interval, 1.04-1.42). Moreover, 60 of 286 COVID-19 patients with CRS (21.0%) had severe COVID-19 outcomes, compared with 38 without CRS (13.3%; adjusted odds ratio = 1.71; 95% confidence interval, 1.09-2.71). Subgroup analysis identified that CRS 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.
Conclusions: In patients with CRS, prior intranasal corticosteroid use, the absence of nasal polyps, or nonatopic type was associated with increased risk for SARS-CoV-2 infection and severe COVID-19 in the Korean nationwide cohort. Clinicians should be cautious in determining prognosis and care for patients with CRS amid the COVID-19 pandemic.
Keywords: COVID-19; Chronic rhinosinusitis; Intranasal corticosteroids; Nasal polyp; Severe acute respiratory syndrome 2.