International Rhinologic Society Rhinology 0300-0729 2026 04 02 Integration of transcriptomic data identifies CD163 as a key link between chronic rhinosinusitis with nasal polyps and COVID-19 EN B. Yang Department of Otorhinolaryngology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China J-Q. Zhang Department of Otorhinolaryngology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China Y. Yuan Department of Otorhinolaryngology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China M. Gu Department of Otorhinolaryngology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China C. Hong Department of Otorhinolaryngology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China C-Y. Qiu Department of Otorhinolaryngology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China X-Y. Zou Department of Otorhinolaryngology, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, China M-P. Lu Department of Otorhinolaryngology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China L. ChengDepartment of Otorhinolaryngology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China Department of Allergology Journal Article 3408 10.4193/Rhin24.462 BACKGROUND: Emerging evidence has highlighted a potential link between chronic rhinosinusitis with nasal polyps (CRSwNP) and coronavirus disease 2019 (COVID-19). However, the exact mechanism driving this association is not well understood. We aimed to explore the biological pathways and differentially expressed genes (DEGs) involved in CRSwNP and COVID-19 by performing bioinformatic analyses. METHODS: Data from the GEO database was analyzed using the “limma” package to identify DEGs. Techniques like weighted gene co-expression network analysis (WGCNA), protein-protein interaction (PPI) networks, and machine learning were employed to pinpoint key genes. Single-sample gene set enrichment analysis (ssGSEA) was used to assess immune cell infiltration. Key gene expression in macrophages was verified using single-cell analysis and immunofluorescence. Genetranscription factor-microRNA (gene-TF-miRNA) regulatory networks were constructed via NetworkAnalyst. Potential therapeutic agents were identified through DGIdb. Nasal polyps and control nasal tissues were surgically obtained for validation purposes. RESULTS: The findings revealed 19 co-DEGs common to both CRSwNP and COVID-19, which were enriched in pathways related to inflammation and the immune response. Among these genes, CD163 was identified as the key gene. The infiltration of CD163+ macrophages was substantially greater in the nasal tissues of CRSwNP and COVID-19 patients than in those of control subjects. Fluticasone was determined to be a promising drug that targets CD163. CONCLUSION: This study highlights CD163 as a promising diagnostic marker for CRSwNP and COVID-19, suggesting that targeting CD163 may be pivotal in the management of these conditions.