Management of patients with chronic rhinosinusitis during the COVID‐19 pandemic—An EAACI position paper

• DOI: 10.1111/all.14629
• Publication Date: 2020-10-19T18:41:31Z
• Authors: Ludger Klimek; Marek Jutel; Jean Bousquet; Ioana Agache; Cezmi A. Akdis; Valerie Hox; Philippe Gevaert; Peter Valentin To...; Carmen Rondon; Cemal Cingi; Sanna Toppila‐Salmi; Aspasia Karavelia; Banu Bozkurt; Ulrike Förster‐Ru...; Sven Becker; Adam M. Chaker; Barbara Wollenberg; Ralph Mösges; Tilman Huppertz; Jan Hagemann; Claus Bachert; Wytske Fokkens
• Keywords: Immunology; 610 Medicine & health; 03 medical and health sciences; Nasal Polyps; 0302 clinical medicine; 10183 Swiss Institute of Allergy and Asthma Research; Adrenal Cortex Hormones; Immunology and Allergy; Humans; biologics; Sinusitis; Rhinitis; 2403 Immunology; Biological Products; SARS-CoV-2; chronic rhinosinusitis; COVID-19; CRSwNP; General medicine, internal medicine and other clinical medicine; Asthma; 3. Good health; Chronic rhinosinusitis; Chronic Disease; 2723 Immunology and Allergy

AbstractBackgroundChronic rhinosinusitis is regarded as a chronic airway disease. According to WHO recommendations, it may be a risk factor for COVID‐19 patients. In most CRSwNP cases, the inflammatory changes affecting the nasal and paranasal mucous membranes are type‐2 (T2) inflammation endotypes.MethodsThe current knowledge on COVID‐19 and on treatment options for CRS was analyzed by a literature search in Medline, Pubmed, international guidelines, the Cochrane Library and the Internet.ResultsBased on international literature, on current recommendations by WHO and other international organizations as well as on previous experience, a panel of experts from EAACI and ARIA provided recommendations for the treatment of CRS during the COVID‐19 pandemic.ConclusionIntranasal corticosteroids remain the standard treatment for CRS in patients with SARS‐CoV‐2 infection. Surgical treatments should be reduced to a minimum and surgery preserved for patients with local complications and for those with no other treatment options. Systemic corticosteroids should be avoided. Treatment with biologics can be continued with careful monitoring in noninfected patients and should be temporarily interrupted during the course of the COVID‐19 infection.