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Background Anosmia and ageusia are symptoms commonly associated with COVID-19, but the relationship with disease severity, onset and recovery are unclear. Objective To examine factors associated with anosmia and ageusia and the recovery from these symptoms in an ethnically diverse cohort. Methods Individuals tested for SARS-CoV-2 between March and April 2020 were eligible for the study. Randomly selected participants answered a telephone questionnaire on COVID-19 symptoms with a focus on anosmia and ageusia. Additionally, relevant past medical history and data on the COVID-19 clinical course were obtained from electronic medical records. 486 patients were in the COVID-19 group and 103 were COVID-19-negative. Results Patients who were younger were more likely to report anosmia and/or ageusia (odds ratio (OR) for anosmia per 1-year increase in age: 0·98, 95%CI:0–97-0·99, p = 0·003; for ageusia: 0·98, 95%CI:0·97-0·99, p = 0·005) as were patients with lower eosinophil counts (OR for anosmia per 0.1-K/μL increase in eosinophils: 0·02, 95%CI:0·001-0·46, p = 0·01, for ageusia 0·10, 95%CI:0·01-0·97, p = 0·047). Male gender was independently associated with a lower probability of ageusia (OR:0·56, 95%CI:0·38-0·82, p = 0·003) and earlier sense of taste recovery (HR:1·44, 95%CI:1·05-1·98, p = 0·02). Latinos showed earlier sense of taste recovery than white patients (HR:1·82, 95%CI:1·05-3·18, p = 0·03). Conclusion Anosmia and ageusia were more common among younger patients and those with lower blood eosinophil counts. Ageusia was less commonly reported among men, and time to taste recovery was earlier among both men and Latinos.

Allergen immunotherapy is a rapidly evolving field. Although subcutaneous immunotherapy has been practiced for over a hundred years, improved understanding of the underlying immunological mechanisms has led to the development of new, efficacious and better tolerated allergen-derivatives, adjuvants and encapsulated allergens. Diverse routes of allergen immunotherapy - oral, sublingual, epicutanoeus and intralymphatic - are enabling immunotherapy for anaphylactic food allergies and pollen-food allergy syndrome, while improving the tolerability and effectiveness of aeroallergen immunotherapy. The addition of Anti-IgE therapy decreases adverse effects of subcutaneous and oral immunotherapy.

Introduction DRESS Syndrome can vary in presentation from mild to life threatening. We report a case of suspected DRESS myocarditis presenting with cardiogenic shock. Case Description A 38-year-old man presented to the ED with fever, dizziness, skin rash and facial swelling. Four weeks prior he was treated with amoxicillin/clavulanate for presumed sinusitis which was changed to sulfamethoxazole/trimethoprim and prednisone 30 mg daily 3 weeks later due to lack of improvement. Three days later he developed presenting symptoms. On ED admission, he was febrile (T =102.5F), tachycardic (HR 150 bpm) and hypotensive (BP 80/50 mmHg) with generalized erythematous macular skin rash and submandibular lymphadenopathy. Laboratory investigation revealed mildly elevated liver enzymes and creatinine, metabolic acidosis, hyponatremia and hypocalcemia, thrombocytopenia (125/nL) and absolute eosinophils of 0.30/nL. Chest x-ray was clear. He was hemodynamically stabilized with intramuscular followed by intravenous epinephrine and 6 liters intravenous fluids. Echocardiogram revealed severely reduced ejection fraction of 35% with diffuse hypokinesis. DRESS syndrome with hypersensitivity myocarditis was suspected. Treatment with prednisolone 80mg was initiated and laboratory abnormalities resolved within 5-10 days. A repeat echocardiogram 3 months later showed near normalization of EF (50-55%). Discussion Cardiac involvement in DRESS syndrome has been reported in 4 to 21 %. DRESS was suspected in this patient given regiSCAR and J-SCAR score of 5 in absence of peripheral eosinophilia (likely suppressed due to prior prednisone treatment). Clinicians should have a high suspicion for cardiac involvement in a patient presenting with suspected DRESS syndrome and hemodynamic compromise. Prompt diagnosis is crucial for successful treatment outcome.

Background: Increasing prevalence of allergic disorders has been observed over the last fifty years. The disparate rates of allergic disorders have been well-characterized in several minority groups. However, few studies have reported the distribution of atopic disorders among Asian Americans. Objective: To gain a greater understanding of the prevalence of atopic disorders in Asian Americans presenting to an Allergy Clinic. Methods: A retrospective chart review was performed on 471 Asian American patients receiving treatment in an inner city allergy clinic located in New York. Family history and past medical history of asthma, allergic rhinitis, atopic dermatitis, food allergy, and drug allergy were recorded. The patients were primarily of Chinese, Japanese or Korean origin; 34% male (n=158), 66% female (n=313), with a mean age of 32 ± 12.9 years. Results: Allergic rhinitis (62%) and atopic dermatitis (50%) were more prevalent (P