FEATURES OF VASOMOTOR RHINITIS IN PATIENTS WITH A HISTORY OF COVID-19 INFECTION.

Abstract

Objective: to determine some aspects of the pathogenesis of VMR in patients with a history of COVID-19 infection and to evaluate the therapeutic efficacy of a local antihistamine drug.

Design: Data was collected from patients diagnosed with Vasomotor rhinitis (VMR) (who had COVID-19 more than 6 months ago, group I) and those without COVID-19 (group II). These patients were filtered to seasonal allergens, a history of bronchial asthma and/or bronchial hypersensitivity, chronic rhinosinusitis, nasal polyposis or sensitivity to aspirin, pregnancy, acute phase of COVID-19 infection, and use of anti-inflammatory drugs within the last 6 weeks.

Setting: First University Clinics of Tbilisi State Medical University and the National Centre of Otorhinolaryngology (Tbilisi, Georgia).

Participants: Patients diagnosed with VMR for 6 weeks or more were selected.

Methods: All patients underwent the instrumental (anterior and posterior rhinoscopy, endoscopy, rhinomanometry) examination, the cytological (eosinophils, neutrophils, and leukocytes count), and biochemical investigations of nasal smear (the content of nitric oxide (NO)) and blood serum total antioxidant activity. Patients were treated with intranasal antihistamine spray - 2 sprays 2 times a day for 10 days. All studies were performed on patients before and after treatment.

Results: No statistically reliable difference in the initial insights of the objective and subjective indicators for groups I and II were detected; the cytological examination of nasal smears showed that in patients from group I eosinophils, lymphocytes, an increased number of neutrophils and low-level of NO were revealed compared to corresponding indicators in patients from group II. The level of TAA in the blood serum of patients with VMR was lower than in healthy volunteers (especially in patients of group I).

Conclusions: In patients with VMR previously exposed to COVID-19 infection, the intensity of the oxidative stress and depletion of nasal NO were especially high, causing the abolishment of protective ability, chronic eosinophilic inflammation, and airway hyperresponsiveness. Antihistamine spray is effective for VMR treatment in groups I and II; in patients with VMR who previously had a COVID-19 infection, it is necessary to increase the treatment course duration.