Clinical characteristics of acute rhinosinusitis in COVID-19 - a post-hoc analysis of a longitudinal study

Introduction: Acute rhinosinusitis (ARS) is a common and well-defined disorder, primarily of viral aetiology, with rhinovirus and coronavirus accounting for more than 50% of viral ARS. The fight with COVID-19 pandemic resulted in an increased availability of viral testing, which in turn allowed testing for the presence of SARS-CoV-2 in all patients presenting common cold (or ARS) symptoms. The aim of this study was to assess the clinical characteristics of acute rhinosinusitis in patients diagnosed with COVID-19. Materials and methods: This study is a post-hoc analysis. Patients' symptoms were evaluated using a structured questionnaire twice: directly after a positive SARS-CoV-2 result and 7-12 days following the first evaluation. Subjects were asked about the presence of nasal and systemic symptoms as well as headaches. Results: A total of 130 COVID-19 symptomatic patients were recruited into the study, 58 (45%) patients met EPOS2020 diagnostic criteria for ARS. Of all ARS patients, 72% presented with rhinorrhoea, 69% with pain perceived over paranasal sinuses, 62% with nasal congestion, 52% with cough, 45% with olfactory dysfunction, 38% with fever, 33% with facial pressure, and in 22% pain was exacerbated by sinus palpation. Conclusions: Half of COVID-19 subjects had ARS. The course of SARS-CoV-2 ARS does not seem to differ significantly from ARS of other aetiologies. Since ARS in the course of COVID-19 seems to meet the definition of ARS proposed by EPOS 2020, we hypothesize that substances validated for ARS treatment, such as intranasal corticosteroids could be effective in SARS-CoV-2 ARS.