Nose and sinus related problems
Outpatient visits and planned surgery for patients with nasal and sinus disease have been cancelled at Guy's Hospital during the COVID-19 pandemic for two main reasons. First of all we wish to protect you from being infected. Secondly, we wish to protect our health care workers from infection as they may transfer the infection to colleagues or other and potential vulnerable patients. We appreciate your understanding.
Below you will find a guidance for rhinology patients during the COVID-19 pandemic with links to supportive videos or websites. Feel free to contact us with any queries. Contact details can be found below.
If you have concerns about ongoing or worsening symptoms related to your nose and/or sinuses, such as:
- increasing and severe nasal obstruction causing sleep disturbance
- severe facial pain or pressure
- new onset (>3 weeks) one sided nasal obstruction or facial pain
- one sided blood-stained nasal discharge
- increasing nosebleeds (if the bleeding is severe and not stopping after 15 minutes of applying pressure to the nose you need to be seen by a doctor immediately).
Please contact us by emailing firstname.lastname@example.org and one of the clinicians will get back to you within 72 hours to provide advice by email or arrange a telephone/video consultation. Please ensure that you include your name, date of birth, Guy's and St Thomas' hospital number in your email if possible, and the best contact number.
If you are unable to use email or if your query is urgent, please call us on 020 7188 8872 from Monday to Friday, 8am-5pm only.
Advice related to patients with chronic rhinosinusitis during the COVID-19 pandemic
If you are already diagnosed with chronic rhinosinusitis, we encourage you to continue with your regular medications. Saline rinses and nasal steroid sprays are available over the counter and you can get repeat prescriptions from your GP. There is no risk related to continue use of topical nasal steroid as they are not absorbed into the body.
For patients with aspirin exacerbated respiratory disease (AERD)/"Samter's triad" who has been desensitised you should continue with your daily aspirin treatment.
If you are on a maintenance dose of oral steroids for chronic rhinosinusitis it may be worth discussing if you should continue this treatment with your ENT or respiratory physician. Reports from China have suggested poorer outcomes if COVID-19 positive patients with severe respiratory distress are treated with systemic steroids. We therefore recommend against new courses of oral steroids.
If you are known with chronic rhinosinusitis and suddenly is experiencing any of the following symptoms:
- severe headache
- swelling and redness around the eyes
- neurological symptoms such as new onset drowsiness, numbness of the cheek, a change in vision or weakness
These may be an indication of complications to chronic rhinosinusitis and you should seek emergency medical care.
Advice related to patients with loss of sense of smell during the COVID-19 pandemic
Loss of sense of smell may be a symptom of COVID-19 infection. However, most COVID-19 positive patients also presents with either fever, chills, fatigue, shortness of breath, chest pain, and stomach problems. If you are worried that you may be infected with COVID-19 you should contact NHS 111 for advice.
If you are known with chronic rhinosinusitis and suddenly lose your sense of smell it may be worth to consider if you are infected with COVID-19, especially if you are not experiencing a simultaneous worsening in nasal obstruction. If you are worried that you may be infected with COVID-19 you should contact NHS 111 for advice.
Advice related to hay fever during the COVID-19 pandemic
Hay fever or seasonal allergic rhinitis is caused by an allergic reaction to pollen. Symptoms include nasal obstruction, a runny nose, sneezing, red eyes, watery eyes, coughing, and itching of the nose, eyes, mouth or throat. Hay fever and COVID-19 infection display overlapping symptomatology; however, fever, chills, fatigue, chest pain, shortness of breath and stomach problems are not typical symptoms of hay fever. If you are worried that you may be infected with COVID-19 you should contact NHS 111 for advice.
In regards to hay fever we encourage you to seek optimal control of your symptoms with oral antihistamines, intranasal antihistamines and nasal steroid sprays, and saline rinses which are all available over the counter. Speak to the pharmacist about the best treatment for you. If you are already using allergy medication it is safe and recommended to continue. Allergen specific immunotherapy can also be sustained, however, it should be paused during a severe COVID-19 infection.
Patients advice in relation to hay fever:
Patients advice in relation to compare COVID-19 with hay fever and
Nasal deformity and nasal obstruction
Please note that we are unable to offer corrective nasal surgery (rhinoplasty) for cosmetic purposes. If you have been referred with breathing problems due to a deviated nasal septum, there is nothing that we can do to advise you without a face to face assessment, which will be arranged as soon as we can.
Useful links and websites