Risk of new-onset and prevalent disease in chronic rhinosinusitis: A prospective cohort study

Background: Chronic rhinosinusitis (CRS) is accompanied by burdensome comorbid conditions. Understanding the relative timing of the onset of these conditions could inform disease prevention, detection, and management. Objective: To evaluate the association between CRS and new-onset and prevalent asthma, noncystic fibrosis bronchiectasis (NCFBE), chronic obstructive pulmonary disease (COPD), gastroesophageal reflux disease (GERD), and obstructive sleep apnea (OSA). Methods: We conducted a prospective cohort study among primary care patients using a detailed medical and symptom questionnaire in 2014 and again in 2020. We used questionnaire and electronic health record (EHR) data to determine CRS status: CRS_SE (moderate to severe symptoms with EHR evidence), CRS_E (limited symptoms with EHR evidence), CRS_S (moderate to severe symptoms without EHR evidence), CRS_neg (limited symptoms and no EHR evidence; reference). We evaluated the association between CRS status and new-onset and prevalent disease using logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: There were 7847 and 4445 respondents to the 2014 and 2020 questionnaires, respectively. CRS_SE (vs CRS_neg) was associated with increased odds of new-onset asthma (OR, 1.74 [CI, 1.09–2.77), NCFBE (OR, 1.87 [CI, 1.12–3.13]), COPD (OR, 1.73 [CI, 1.14–2.68]), GERD (OR, 1.95 [CI, 1.61–2.35]), and OSA (OR, 1.91 [CI, 1.39–2.62]). Similarly, increased odds were observed for associations with the prevalence of these conditions. Conclusion: The findings from the study support further exploration of CRS as a target for the prevention and detection of asthma, NCFBE, COPD, GERD, and OSA.