The association between sinonasal and pulmonary symptoms in aspirin-exacerbated respiratory disease (AERD) is not fully established.
To characterize sinonasal and asthma symptomatology, and to determine if reported sinonasal symptoms predict asthma severity.
Prospectively collected data from an AERD registry cohort was included from 2013-18. Sinonasal symptomatology measured by Sino-Nasal Outcomes Test (SNOT) 22-item total scores was used as the predictor variable, with Asthma Control Test (ACT) scores and percent predicted forced expiratory volume in one second (FEV1%) as primary outcomes. All instances of paired data on the same date were used. ACT was also evaluated with FEV1% as the outcome. Mixed effects regression was completed.
From 1065 AERD registry subjects (mean age 48.1y, SD=12.8; 68.0% female, 29.8% male), mean SNOT-22 score was 42.3 (SD=24.12, n=1307 observations from 869 subjects), mean ACT score was 19.4 (SD=5.2, n=1511 observations from 931 subjects), and mean FEV1% was 82.8 (SD=19.6, n=777 observations from 307 subjects). SNOT-22 significantly predicted ACT scores (p<0.0001, 1185 paired observations from 845 subjects) and FEV1% (p=0.018, 485 observations from 246 subjects). Any ten-point increase in SNOT-22 was associated with a 0.87-point decrease in ACT and a 0.75% decrease in FEV1%. Any one-point increase in ACT was associated with a 1.0% increase in FEV1% (p<0.0001, 616 observations from 269 subjects). The most severe SNOT-22 symptoms were sense of smell/taste and blockage/congestion of nose.
SNOT-22 scores significantly predict ACT scores and FEV1%, and ACT scores significantly predict FEV1%. This study demonstrates an association between patient-reported rhinosinusitis and asthma symptom severity and subjective and objective measures of asthma severity.
Copyright © 2020. Published by Elsevier Inc.