Chronic rhinosinusitis is associated with prolonged SARS‐CoV‐2 RNA shedding in upper respiratory tract samples: A case‐control study

Background SARS‐CoV‐2, the COVID‐19 causative agent, has infected millions of people and killed over 1.6 million worldwide. A small percentage of cases persist with prolonged positive RT‐PCR on nasopharyngeal swabs. The aim of this study was to determine risk factors for prolonged viral shedding amo...

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Published in:	Journal of internal medicine Vol. 289; no. 6; pp. 921 - 925
Main Authors:	Recalde‐Zamacona, B., Tomás‐Velázquez, A., Campo, A., Satrústegui‐Alzugaray, B., Fernández‐Alonso, M., Iñigo, M., Rodríguez‐Mateos, M., Di Frisco, M., Felgueroso, C., Bertó, J., Marín‐Oto, M., Alcaide, A. B., Zulueta, J. J., Seijo, L., Landecho, M. F.
Format:	Journal Article
Language:	English
Published:	England Blackwell Publishing Ltd 01-06-2021
Subjects:	Atopy Chronic rhinosinusitis Clinical trials Confidence intervals Corticoids Corticosteroids COVID-19 Demographics inhaled corticosteroids Multivariate analysis Pandemics Patients Respiratory tract Rhinitis Rhinosinusitis Risk analysis Risk factors SARS‐CoV‐2 shedding Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Sinusitis upper respiratory tract Viral diseases SARS-CoV-2 shedding atopy Chronic rhinosinusitis upper respiratory tract inhaled corticosteroids
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Summary:	Background SARS‐CoV‐2, the COVID‐19 causative agent, has infected millions of people and killed over 1.6 million worldwide. A small percentage of cases persist with prolonged positive RT‐PCR on nasopharyngeal swabs. The aim of this study was to determine risk factors for prolonged viral shedding amongst patient’s basal clinical conditions. Methods We have evaluated all 513 patients attended in our hospital between 1 March and 1 July. We have selected all 18 patients with prolonged viral shedding and compared them with 36 sex‐matched randomly selected controls. Demographic, treatment and clinical data were systematically collected. Results Global median duration of viral clearance was 25.5 days (n = 54; IQR, 22–39.3 days), 48.5 days in cases (IQR 38.7–54.9 days) and 23 days in controls (IQR 20.2–25.7), respectively. There were not observed differences in demographic, symptoms or treatment data between groups. Chronic rhinosinusitis and atopy were more common in patients with prolonged viral shedding (67%) compared with controls (11% and 25% respectively) (P < 0.001 and P = 0.003). The use of inhaled corticosteroids was also more frequent in case group (P = 0.007). Multivariate analysis indicated that CRS (odds ratio [OR], 18.78; 95% confidence interval [95%CI], 3.89–90.59; P < 0.001) was independently associated with prolonged SARS‐CoV‐2 RNA shedding in URT samples, after adjusting for initial PCR Ct values. Conclusion We found that chronic rhinosinusitis and atopy might be associated with increased risk of prolonged viral shedding. If confirmed in prospective trials, this finding might have clinical implications for quarantine duration due to increased risk of pandemic spread.
Bibliography:	L. Seijo and M.F. Landecho have equally contributed to the development of the document. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0954-6820 1365-2796
DOI:	10.1111/joim.13237