Assessing the Safety of Endoscopic Sinus Surgery After COVID-19 Infection

Area of Science:

• Otolaryngology
• Infectious Disease Epidemiology

Background:

• Chronic rhinosinusitis (CRS) management often involves endoscopic sinus surgery (ESS).
• The impact of prior COVID-19 infection on ESS outcomes requires characterization.

Purpose of the Study:

• To evaluate the effect of recent and distant COVID-19 infection on postoperative outcomes following ESS.
• To assess the risks of complications and healthcare utilization after ESS in patients with a history of COVID-19.

Main Methods:

• Retrospective cohort study using the TriNetX database (2020-2024).
• Patients with CRS undergoing ESS were categorized by COVID-19 infection timing: recent (<2 months), distant (2-12 months), or no infection.
• Propensity score matching (PSM) was used to control for confounding variables.

Main Results:

• Recent COVID-19 infection was associated with increased risks of postoperative epistaxis (RR: 1.236) and nasal congestion (RR: 1.273) within 2 months.
• No significant difference in major postoperative complications was observed across cohorts.
• Analysis included 10,803 patients with recent infection and 3804 with distant infection after PSM.

Conclusions:

• Recent COVID-19 infection may elevate the risk of epistaxis post-ESS.
• Endoscopic sinus surgery appears safe regarding major complications, even after recent COVID-19 infection.
• Consideration of COVID-19 infection timing is important for managing surgical risk and postoperative care in ESS patients.