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

Annemarie G. Hirsch*, Brian S. Schwartz, Cara Nordberg, Bruce Kuang-Huay Tan, Robert P. Schleimer, Robert C Kern, Anju T. Peters, Karen Bandeen-Roche, Ashton E. Lehmann

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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: CRSSE (moderate to severe symptoms with EHR evidence), CRSE (limited symptoms with EHR evidence), CRSS (moderate to severe symptoms without EHR evidence), CRSneg (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. CRSSE (vs CRSneg) 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.

Original languageEnglish (US)
JournalInternational Forum of Allergy and Rhinology
StateAccepted/In press - 2023


  • asthma
  • bronchiectasis
  • chronic obstructive pulmonary disease
  • chronic rhinosinusitis
  • gastroesophageal reflux disease
  • obstructive sleep apnea

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology


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