Climate and sino-nasal symptoms

Patients with sino-nasal issues often believe their symptoms are exacerbated by certain weather conditions, but these relationships are largely anecdotal. Using an extensive archive of patient surveys at the University of Virginia Rhinology Clinic from January 2010-March 2020, we examined whether sino-nasal symptoms were impacted by the weather on, or shortly before, the day of clinic visit. Clinic patients completed the Sino-Nasal Outcome Test (SNOT-22), a 22-question survey related to symptoms and severity, on the day of each visit. Included patients lived in one of 28 zip codes comprising the city of Charlottesville and Albemarle County. The primary exposure variable was the Spatial Synoptic Classification (SSC)-a nominal classification of each day's weather type. The SSC weather type on the day of the clinic visit and up to three days before was used as the exposure variable. Weather on days with poor symptoms (mean daily SNOT-22 score ≥ 50) were compared to all other days via odds ratios (ORs) for lags of 0-3 days, and a multivariate mixed effects logistic regression was employed to examine the association between SSC and symptom severity. A total of 955 SNOT-22 surveys were acquired from 481 patients. Dry, polar days (SSC category "DP") and days with transitional weather (SSC category "TR") had 2.0 times the odds of high SNOT-22 scores compared to all other weather types on the day of clinic visit (OR 2.0 [95% CIs 1.4, 2.8]). Logistic regression results indicate 4.0 times higher odds of high SNOT-22 scores on DP days compared to dry moderate days. Climate's effect on sinus symptoms should be considered when managing and measuring sino-nasal symptoms or treatment outcomes.