Assessing the Safety of Endoscopic Sinus Surgery After COVID-19 Infection.

OBJECTIVE

This study seeks to characterize the impact of COVID-19 infection on endoscopic sinus surgery (ESS) outcomes.

METHODS

The TriNetX database identified patients with chronic rhinosinusitis who underwent ESS from January 1, 2020 to December 31, 2024. Cohorts included patients who had a diagnosis of COVID-19 infection within 2 months before ESS (recent infection), and those who did not. A cohort of those with COVID-19 infection between 2 months and 1 year before ESS (distant infection), was compared to a control without recent or distant infection. Propensity score matching (PSM) controlled for demographics and comorbid conditions. Relative risks (RRs) were calculated to determine risks for postoperative complications and healthcare utilization.

RESULTS

A total of 49,609 patients underwent ESS during the study period. After PSM, there were 10,803 patients with and without recent COVID-19 infection, and 3804 patients with or without distant COVID-19 infection. Recent COVID-19 infection increased the risk of epistaxis [RR: 1.236, 95% CI: (1.036, 1.474)], and nasal congestion [RR: 1.273, 95% CI: (1.016, 1.596)] within 2 months of ESS. There was no difference in risk for major complications identified between any cohort.

CONCLUSION

Recent COVID-19 infection may increase the risk of post-operative epistaxis, but not major complications, highlighting the overall safety of ESS after recent COVID-19 infection and the importance of considering the timing of COVID-19 infection when evaluating surgical risk and postoperative care needs for ESS patients.

LEVEL OF EVIDENCE: Level III.