COVID ‐19 Infection Increases the Risk of Subsequent Diagnosis of Chronic Rhinosinusitis

OBJECTIVES: To analyze the impact of COVID-19 infection on the diagnosis of chronic rhinosinusitis (CRS). METHODS: TriNetX, a large international database of anonymized health records, was queried for adults with either positive or negative SARS-CoV-2 polymerase chain reaction (PCR) tests between March 1, 2020 and December 31, 2024. Patients with cancer or immunodeficiency before the COVID-19 diagnosis were excluded. Propensity score matching was used to create comparable exposure and control groups. Relative risk ratios and Cox proportional hazards regression analysis of CRS diagnosis were calculated 3 months after PCR testing. Sub-analyses were completed to investigate the effects of prior COVID-19 infection on subsequent CRS development stratified by prior vaccination status and by variant-dominant time periods (pre-Delta, Delta, and Omicron). RESULTS: Propensity score-matched COVID-19+ and COVID-19- cohorts each consisted of 2,135,446 patients. Rate of diagnosis of CRS increased following a positive COVID-19 PCR test (RR = 2.13, 95% CI [2.10-2.16]) and varied across variant-dominant periods, with risk ratios of 1.44 (95% CI [1.41-1.47]) during pre-Delta, 1.20 (95% CI [1.15-1.25]) during Delta, and 2.10 (95% CI [2.07-2.13]) during Omicron. Prior COVID-19 vaccination did not modify the risk of CRS among patients with a positive COVID-19 PCR (RR = 0.98, 95% CI [0.92-1.05]). CONCLUSIONS: COVID-19 infection was found to increase the risk of subsequent diagnosis of CRS. Further studies are needed to better understand the relationship between COVID-19 and the development of sinonasal inflammatory pathology.