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Estimating COVID-19 Infection and Severity Risks in Patients with Chronic Rhinosinusitis: A Korean Nationwide Cohort Study

Authors
 Seung Won Lee   ;   So Young Kim   ;   Sung Yong Moon   ;   Jee Myung Yang   ;   Eun Kyo Ha   ;   Hye Mi Jee   ;   Jae Il Shin   ;   Seong Ho Cho   ;   Dong Keon Yon   ;   Dong In Suh  
Citation
 JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, Vol.9(6) : 2262-2271, 2021-06 
Journal Title
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
ISSN
 2213-2198 
Issue Date
2021-06
MeSH
Adult ; COVID-19* ; Case-Control Studies ; Cohort Studies ; Humans ; Pandemics* ; Republic of Korea / epidemiology ; SARS-CoV-2
Keywords
COVID-19 ; Chronic rhinosinusitis ; Intranasal corticosteroids ; Nasal polyp ; Severe acute respiratory syndrome 2.
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.
Files in This Item:
T202124588.pdf Download
DOI
10.1016/j.jaip.2021.03.044
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187375
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