Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, 22# Shuangyong Road, Nanning, Guangxi, 530021, China.
Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, China.
BMC Med. 2024 Oct 14;22(1):460. doi: 10.1186/s12916-024-03587-6.
To investigate the association between surgical removal of tonsils and risk of COVID-19 with different severity.
Through a nested case-control study during January 31st to December 31st 2020, including 58,888 participants of the UK Biobank, we investigated the association of tonsillectomy with the future risk of mild and severe COVID-19, using binomial logistic regression. We further examined the associations of such surgery with blood inflammatory, lipid and metabolic biomarkers to understand potential mechanisms. Finally, we replicated the analysis of severe COVID-19 in the Swedish AMORIS Cohort (n = 451,960).
Tonsillectomy was associated with a lower risk of mild (odds ratio [95% confidence interval]: 0.80 [0.75-0.86]) and severe (0.87 [0.77-0.98]) COVID-19 in the UK Biobank. The associations did not differ substantially by sex, age, Townsend deprivation index, or polygenic risk score for critically ill COVID-19. Levels of blood inflammatory, lipid and metabolic biomarkers did, however, not differ greatly by history of surgical removal of tonsils. An inverse association between tonsillectomy and severe COVID-19 was also observed in the AMORIS Cohort, primarily among older individuals (> 70 years) and those with ≤ 12 years of education.
Surgical removal of tonsils may be associated with a lower risk of COVID-19. This association is unlikely attributed to alterations in common blood inflammatory, lipid and metabolic biomarkers.
为了探究扁桃体切除术与不同严重程度 COVID-19 之间的关联。
通过 2020 年 1 月 31 日至 12 月 31 日期间在英国生物银行开展的一项巢式病例对照研究，我们使用二项逻辑回归分析了扁桃体切除术与未来发生轻症和重症 COVID-19 的风险之间的关系。我们进一步研究了此类手术与血液炎症、脂质和代谢生物标志物之间的关联，以了解潜在的机制。最后，我们在瑞典 AMORIS 队列（n=451960）中复制了重症 COVID-19 的分析。
扁桃体切除术与英国生物银行中轻症 COVID-19（比值比 [95%置信区间]：0.80 [0.75-0.86]）和重症 COVID-19（0.87 [0.77-0.98]）的风险降低相关。这种关联在性别、年龄、汤森贫困指数或危重症 COVID-19 的多基因风险评分方面没有显著差异。然而，血液炎症、脂质和代谢生物标志物的水平在扁桃体切除术后并没有显著差异。在 AMORIS 队列中也观察到扁桃体切除术与重症 COVID-19 呈负相关，主要发生在年龄较大的人群（>70 岁）和受教育程度较低的人群（≤12 年）。
扁桃体切除术可能与 COVID-19 风险降低相关。这种关联不太可能归因于常见血液炎症、脂质和代谢生物标志物的改变。
