Comparing the severity of chronic rhinosinusitis symptoms before versus during the COVID-19 pandemic

Background: COVID-19 measures such as masking, social distancing, and staying indoors may mitigate chronic rhinosinusitis (CRS) symptoms. We evaluate whether these measures correlated with improved symptoms in patients with CRS. Methods: This retrospective study compared SNOT-22 survey data from the Northwestern CRS Registry at the time of enrollment and at years 1–5 of follow-up. The final sample consisted of 1826 SNOT-22 surveys for 598 patients. April 10, 2020 to December 31, 2021 was considered "during the pandemic" and prior to March 11, 2020 was considered "pre-pandemic." Wilcoxon test was used to compare SNOT22 at enrollment pre-pandemic versus during pandemic. Separate linear mixed models were performed to estimate SNOT22 at 1 to 5 years after enrollment pre-pandemic versus during pandemic. Results: Subjects enrolled during the pandemic had worse SNOT22 scores than those enrolled pre-pandemic (53 vs. 42, p =.0024). Total SNOT-22 scores were improved during the pandemic than before the pandemic at 1 year follow-up (18.17 vs. 12.22, p =.001). This effect persists when evaluating the nasal (7.33 vs. 5.13, p =.003), sleep (2.63 vs. 1.39, p =.008), function (1.40 vs. 0.72, p =.015), and emotion (0.77 vs. 0.17, p <.001) domains individually. There was no statistically significant difference in total SNOT-22 score at Years 2–5 of follow-up. Conclusions: Patients with CRS experience a greater reduction in symptom severity in their first year of treatment during the pandemic than before the pandemic, plausibly from measures such as masking and staying indoors. Level of Evidence: 4.