Purpose of Review <p>This review synthesizes current evidence on the bidirectional interactions between COVID-19 and chronic rhinosinusitis (CRS), focusing on how CRS influences SARS-CoV-2 infection risk and clinical outcomes, as well as the impact of COVID-19 on CRS management and prognosis.</p> Recent Findings <p>Recent findings highlight a complex interplay between CRS and COVID-19. Regional studies report mixed results on whether CRS increases SARS-CoV-2 susceptibility, with some cohorts suggesting higher infection risk and others finding no significant association. Subtypes of CRS may influence outcomes, as non-eosinophilic CRS (Non-ECRS) exhibits elevated ACE2/TMPRSS2 expression linked to higher infection risk, while eosinophilic CRS (ECRS) shows ACE2 downregulation that may offer protection. Behavioral changes during the pandemic, such as mask-wearing, reduced CRS incidence and symptom severity. However, SARS-CoV-2 infection, particularly with early variants, exacerbated CRS symptoms, such as nasal congestion, olfactory loss, and prolonged recovery, whereas infections with later variants correlated with milder outcomes. Prolonged or recurrent COVID-19 infections increased CRS exacerbations and secondary infections. Regarding treatment, nasal glucocorticoids remained safe without elevating COVID-19 risk, while surgical interventions required careful risk–benefit assessments due to aerosolization risks. Biological agents showed no adverse effects on COVID-19 outcomes, though long-term data are lacking.</p> Summary <p>The interplay between CRS and COVID-19 is complex and influenced by CRS endotypes, viral variants, and geographic factors. While CRS may modulate COVID-19 susceptibility via inflammatory pathways, pandemic-related behavioral changes paradoxically improved CRS outcomes. Further research is needed to clarify subtype-specific risks, long-term impacts of repeated infections, and optimal treatment strategies in comorbid patients.</p>