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Background: The determinants linked to the short- and long-term improvement in lung function in patients with severe eosinophilic asthma (SEA) on biological treatment (BioT) remain elusive. Objective: We sought to identify the predictors of early and late lung function improvement in patients with SEA after BioT. Methods: 140 adult patients with SEA who received mepolizumab, dupilumab, or reslizumab were followed up for 6 months to evaluate improvement in forced expiratory volume in one second (FEV1). Logistic regression was used to determine the association between potential prognostic factors and improved lung function at 1 and 6 months of treatment. Results: More than a third of patients with SEA using BioT showed early and sustained improvements in FEV1 after 1 month. A significant association was found between low baseline FEV1 and high blood eosinophil count and sustained FEV1 improvement after 1 month (0.54 [0.37–0.79] and 1.88 [1.28–2.97] odds ratios and 95% confidence interval, respectively). Meanwhile, among patients who did not experience FEV1 improvement after 1 month, 39% exhibited improvement at 6 months follow-up. A high ACT score measured at this visit was the most reliable predictor of late response after 6 months of treatment (OR and 95% CI 1.75 [1.09–2.98]). Conclusion: Factors predicting the efficacy of biological agents that improve lung function in SEA vary according to the stage of response. [ABSTRACT FROM AUTHOR]

Purpose: The Korean Chronic Cough Registry study was initiated to characterize patients with chronic cough (CC) and investigate their outcomes in real-world clinical practice. This report aims to describe the baseline cohort profile and study protocols. Methods: This multicenter, prospective observational cohort study included newly referred CC patients and those already being treated for refractory or unexplained chronic cough (RUCC). Cough status was assessed using a visual analog scale, the Leicester Cough Questionnaire (LCQ), and the Cough Hypersensitivity Questionnaire (CHQ). Results: A total of 610 patients (66.9% women; median age 59.0 years) were recruited from 18 centers, with 176 being RUCC patients (28.9%). The median age at CC onset was 50.1 years, and 94.4% had adult-onset CC (≥ 19 years). The median cough duration was 4 years. Compared to newly referred CC patients, RUCC patients had a longer cough duration (6.0 years vs. 3.0 years) but had fewer symptoms and signs suggesting asthma, rhinosinusitis, or gastroesophageal acid reflux disease. Subjects with RUCC had lower LCQ scores (10.3 ± 3.3 vs. 11.6 ± 3.6; P < 0.001) and higher CHQ scores (9.1 ± 3.9 vs. 8.4 ± 4.1; P = 0.024). There were no marked differences in the characteristics of cough between refractory chronic cough and unexplained chronic cough. Conclusions: Chronic cough typically develops in adulthood, lasting for years. Cough severity and quality of life impairment indicate the presence of unmet clinical needs and insufficient cough control in real-world clinical practice. Longitudinal follow-up is warranted to investigate the natural history and treatment outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Blood (EOS-B) and sputum (EOS-S) eosinophil counts may contribute differently to asthma pathogenesis. We compared the impact of the baseline EOS-B and EOS-S levels on lung function, asthma control, and exacerbation in Korean asthma patients. Methods: Asthma patients with baseline EOS-B (n = 4257) and EOS-S (n = 1049) levels from a multicenter cohort (COREA) were included. Pulmonary function test (%FEV1 predicted), asthma control test (ACT), and asthma exacerbation incidence were followed-up every 3 months for one year. Linear mixed-effect models and survival analyses were used to examine the association between eosinophilic groups defined by EOS-B or EOS-S and outcomes. Results: High eosinophilic groups were associated with a low baseline value and a high improvement in the %FEV1 predicted and ACT scores over time. The magnitude of group difference in %FEV1 predicted was twofold higher in the EOS-S versus EOS-B classification [mean and 95% CI: 4.7 (0.6–8.8) versus 2.0 (0.2–3.7) for the baseline value and − 1.5 (− 2.3 to − 0.8) versus − 0.8(− 1.1 to -0.4) for the slope of change], whereas it was identical in ACT score. The magnitude of the impact increased linearly with the elevation of the cut-off level for the EOS-B but remained stable for the EOS-S classification. Patients with an elevation of both their EOS-B and EOS-S showed a higher increment in the %FEV1 predicted and ACT over time. Neither the EOS-B nor EOS-S was associated with asthma exacerbation. Conclusion: EOS-S and EOS-B contribute differently to the clinical outcomes and should be taken into account independently to improve asthma care. [ABSTRACT FROM AUTHOR]

Purpose: Routinely collected data (RCD) from electronic health records (EHR) are useful for studying disease epidemiology in the real world. We examined cough presentation and cough-related healthcare utilization using an academic institutional EHR database in Korea. Methods: In this retrospective cohort study, patients with subacute (3–8 weeks) or chronic cough (> 8 weeks in duration) referred to allergy and asthma clinics were studied. Cases were identified using the search term "cough" or "coughing," which is the chief complaint, in the data fields. Structured data, including demographics, medical history, symptoms, and diagnostic tests, were analyzed. Healthcare utilization was assessed for drug prescriptions, additional tests, or outpatient visits for 1 year. Results: Cough was the chief complaint in 13,223 cases (46.7%) among 28,312 new referrals for 8 years. A total of 3810 subacute and 7150 chronic cough patients were analyzed. The common demographic profile was middle-aged woman (mean age 52.1 years), reported in 63% of the cases. Cough was frequently accompanied by anterior nasal (about 50%), lower airway (30%), or acid reflux disease symptoms (20%), and by test abnormalities in chest X-rays (14%), spirometry (23%), or T2 inflammation markers (40%). Chronic cough patients frequently required additional tests (chest CT scan: 24%), drug prescriptions (codeine: 21.5% and oral steroids: 9.9%), and long-term healthcare utilization (16.0%) for 1 year. Conclusions: Cough is a common chief complaint at allergy and asthma clinics, but the clinical presentation may be heterogeneous. Further studies are needed to understand long-term outcomes and reduce the disease burden. [ABSTRACT FROM AUTHOR]

Background: Targeted therapies have broadened the available treatment options for patients with severe eosinophilic asthma (SEA). However, differences in the magnitude of treatment responses among patients indicate the presence of various underlying pathophysiological processes and patient subgroups. Objectives: We aimed to describe the characteristics of SEA and identify its patient subgroups. Methods: Clinical data from the Cohort for Reality and Evolution of Adult Asthma in Korea were analyzed. Cluster analysis was performed among those with SEA using 5 variables, namely, prebronchodilator forced expiratory volume in 1 s, body mass index, age at symptom onset, smoking amount, and blood eosinophil counts. Results: Patients with SEA showed prevalent sensitization to aeroallergens, decreased lung function, and poor asthma control status. Cluster analysis revealed 3 distinctive subgroups among patients with SEA. Cluster 1 (n = 177) consisted of patients reporting the lowest blood eosinophils (median, 346.8 cells/μL) and modest severe asthma with preserved lung function during the 12-month treatment period. Cluster 2 (n = 42) predominantly included smoking males with severe persistent airway obstruction and moderate eosinophilia (median, 451.8 cells/μL). Lastly, cluster 3 (n = 95) included patients with the most severe asthma, the highest eosinophil levels (median, 817.5 cells/μL), and good treatment response in terms of improved lung function and control status. Conclusions: Three subgroups were identified in SEA through the cluster analysis. The distinctive features of each cluster may help physicians predict patients who will respond to biologics with greater magnitude of clinical improvement. Further research regarding the underlying pathophysiology and clinical importance of each subgroup is warranted. [ABSTRACT FROM AUTHOR]

Optical diffraction tomography (ODT), an emerging imaging technique that does not require fluorescent staining, can measure the three-dimensional distribution of the refractive index (RI) of organelles. In this study, we used ODT to characterize the pathological characteristics of human eosinophils derived from asthma patients presenting with eosinophilia. In addition to morphological information about organelles appearing in eosinophils, including the cytoplasm, nucleus, and vacuole, we succeeded in imaging specific granules and quantifying the RI values of the granules. Interestingly, ODT analysis showed that the RI (i.e., molecular density) of granules was significantly different between eosinophils from asthma patients and healthy individuals without eosinophilia, and that vacuoles were frequently found in the cells of asthma patients. Our results suggest that the physicochemical properties of eosinophils derived from patients with asthma can be quantitatively distinguished from those of healthy individuals. The method will provide insight into efficient evaluation of the characteristics of eosinophils at the organelle level for various diseases with eosinophilia. [Display omitted] • By using label-free 3D tomography, eosinophil granules were successfully imaged. • Eosinophil granules are highly dynamic, constantly repeating fusion and fission. • Granule molecular density is higher in asthma patients than in healthy individuals. [ABSTRACT FROM AUTHOR]

This article discusses a study that aimed to classify the progression of asthma by analyzing longitudinal data on lung function, eosinophilic status, and steroid use. The study utilized electronic medical record data from 350 adults with asthma over a 5-year period. The researchers identified six clusters based on the trajectories of these factors and found significant differences in exacerbation risk among the clusters. The study suggests that this multi-trajectory analysis may be a useful method for studying the complex progression of asthma over time. [Extracted from the article]

Keywords: allergic asthma; biomarker; inhaled corticosteroid; MRGPRX2; prognosis EN allergic asthma biomarker inhaled corticosteroid MRGPRX2 prognosis 959 962 4 04/23/20 20200401 NES 200401 To the Editor, Allergic asthma, the most common phenotype of asthma, is clinically defined by the presence of allergic sensitization and a correlation between asthma symptoms and allergen exposure.[[1]] Although several biomarkers for allergic asthma have been proposed, their role in reflecting treatment efficacy is controversial.[[3]] Mas-related G protein-coupled receptor-X2 (MRGPRX2), expressed in mast cells, is an endogenous receptor associated with IgE-independent activation of mast cells. Serum MRGPRX2 levels in allergic asthma patients according to (B) required ICS dose, and (C) asthma control status according to ICS response. Additionally, high levels of MRGPRX2 were significantly associated with allergic asthma requiring moderate-to-high ICS doses and those with good responses (well-controlled) to ICS for the 12-month follow-up period (especially those with MRGPRX2 value >= 100 ng/mL). [Extracted from the article]

A new Y-type polyurethane (4) containing nitrothiazolylazoresorcinoxy groups as NLO chromophores, which are components of the polymer backbone was prepared. Polyurethane4is soluble in common organic solvents such asN,N-dimethylformamide and dimethylsulfoxide. It shows a thermal stability up to 240°C from thermogravimetric analysis with glass-transition temperature (Tg) obtained from differential scanning calorimetry near 126°C. The second harmonic generation (SHG) coefficient (d33) of poled polymer films at the 1064 nm fundamental wavelength is around 9.02 × 10−9esu. The dipole alignment exhibits a thermal stability even at 4°C higher thanTg, and no SHG decay was observed below 130°C due to the partial main-chain character of polymer structure, which is acceptable for NLO device applications. [ABSTRACT FROM AUTHOR]

A new X-type polyester (4) containing nitrophenylazonitroresorcinoxy groups as NLO chromophores, which are components of the polymer backbone was prepared. Polyester4is soluble in common organic solvents such asN,N-dimethylformamide and dimethylsulfoxide. It shows a thermal stability up to 280°C from thermogravimetric analysis with glass-transition temperature (Tg) obtained from differential scanning calorimetry near 120°C. The second harmonic generation (SHG) coefficient (d33) of poled polymer films at the 1064 nm fundamental wavelength is around 5.08 × 10−9esu. The dipole alignment exhibits a thermal stability even at 5°C higher thanTg, and no SHG decay was observed below 125°C due to the partial main-chain character of polymer structure, which is acceptable for NLO device applications. [ABSTRACT FROM AUTHOR]

New X-type polyester ( 4 ) containing nitrophenylazonitroresorcinoxy groups as NLO chromophores, which are components of the polymer backbone, was prepared and characterized. Polyester 4 is soluble in common organic solvents such as acetone and N , N -dimethylformamide. It shows a thermal stability up to 280 °C in thermogravimetric analysis with glass-transition temperature ( T g ) obtained from differential scanning calorimetry near 120 °C. The second harmonic generation (SHG) coefficient ( d 33 ) of poled polymer film at the 1064 nm fundamental wavelength is around 2.13 pm/V. The dipole alignment exhibits a thermal stability even at 5 °C higher than T g , and there is no SHG decay below 125 °C due to the partial main-chain character of polymer structure, which is acceptable for NLO device applications. [ABSTRACT FROM AUTHOR]

Novel X-type polyurethane 5 containing 4-(2′,2′-dicyanovinyl)-5-nitrocatecholic groups as nonlinear optical chromophores, which constitute parts of the polymer backbone, was prepared and characterized. Polyurethane 5 is soluble in common organic solvents such as acetone and N, N-dimethylformamide. It shows thermal stability up to 270 °C from thermogravimetric analysis with a glass-transition temperature obtained from differential scanning calorimetry thermogram of around 113 °C. The second harmonic generation (SHG) coefficient ( d) of poled polymer film at 1,064 nm fundamental wavelength is around 5.72 × 10 esu. The dipole alignment exhibits a thermal stability even at 7 °C higher than glass-transition temperature, and there was no SHG decay below 120 °C due to the partial main-chain character of the polymer structure, which is acceptable for nonlinear optical device applications. [ABSTRACT FROM AUTHOR]

Novel X-type polyurethane5containing 4-(2′-carbomethoxy-2′-cyano)vinyl-6-nitroresorcinoxy groups as nonlinear optical (NLO) chromophores, which constitute part of the polymer backbone, was prepared and characterized. Polyurethane5is soluble in common organic solvents such as acetone and N,N-dimethylformamide. It shows thermal stabilities up to 260°C from thermogravimetric analysis with glass transition temperature obtained from differential scanning calorimetry near 108°C. The second harmonic generation (SHG) coefficient (d33) of poled polymer film at 1064 nm fundamental wavelength is 9.83 × 10−9esu. Polymer5exhibits a high thermal stability even at 2°C higher thanTg, and no significant SHG decay is observed below 110°C, which is acceptable for nonlinear optical device applications. [ABSTRACT FROM AUTHOR]

ABSTRACT Novel X-type polyurethane 4 containing 4-(4-nitrophenylazo)-6-nitroresorcinoxy groups as nonlinear optical (NLO) chromophores, which are parts of the polymer main chains, was prepared and characterized. Polyurethane 4 is soluble in common organic solvents such as acetone and N, N-dimethylformamide. It shows thermal stabilities up to 270 °C from thermogravimetric analysis with glass transition temperature obtained from differential scanning calorimetry of about 134 °C. The second harmonic generation (SHG) coefficient ( d33) of poled polymer film at 1064 nm fundamental wavelength is 5.37 × 10−9 esu. Polymer 4 exhibits a thermal stability up to Tg, and no significant SHG decay is observed below 135 °C, which is acceptable for NLO device applications. © 2013 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2014, 52, 760-766 [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of high-dose inhaled corticosteroids (ICS) on chronic cough patients with elevated fractional exhaled nitric oxide (FeNO) levels. In a prospective study, adults with chronic cough and FeNO ≥ 25 ppb, without any other apparent etiology, received fluticasone furoate (200 mcg) for three weeks. Outcomes were evaluated using FeNO levels, cough severity, and Leicester Cough Questionnaire (LCQ) before and after treatment. Of the fifty participants (average age: 58.4 years; 58% female), the treatment responder rate (≥ 1.3-point increase in LCQ) was 68%, with a significant improvement in cough and LCQ scores and FeNO levels post-treatment. However, improvements in cough did not significantly correlate with changes in FeNO levels. These findings support the guideline recommendations for a short-term ICS trial in adults with chronic cough and elevated FeNO levels, but the lack of correlations between FeNO levels and cough raises questions about their direct mechanistic link. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of high-dose inhaled corticosteroids (ICS) on chronic cough patients with elevated fractional exhaled nitric oxide (FeNO) levels. In a prospective study, adults with chronic cough and FeNO ≥ 25 ppb, without any other apparent etiology, received fluticasone furoate (200 mcg) for three weeks. Outcomes were evaluated using FeNO levels, cough severity, and Leicester Cough Questionnaire (LCQ) before and after treatment. Of the fifty participants (average age: 58.4 years; 58% female), the treatment responder rate (≥ 1.3-point increase in LCQ) was 68%, with a significant improvement in cough and LCQ scores and FeNO levels post-treatment. However, improvements in cough did not significantly correlate with changes in FeNO levels. These findings support the guideline recommendations for a short-term ICS trial in adults with chronic cough and elevated FeNO levels, but the lack of correlations between FeNO levels and cough raises questions about their direct mechanistic link. [ABSTRACT FROM AUTHOR]

Purpose: Codeine is a narcotic antitussive often considered for managing patients with refractory or unexplained chronic cough. This study aimed to evaluate the proportion and characteristics of patients who responded to codeine treatment in real-world practice. Methods: Data from the Korean Chronic Cough Registry, a multicenter prospective cohort study, were analyzed. Physicians assessed the response to codeine based on the timing and degree of improvement after treatment initiation. Follow-up assessments included the Leicester Cough Questionnaire and cough severity visual analog scale at six months. In a subset of subjects, objective cough frequency was evaluated following the initiation of codeine treatment. Results: Of 305 patients, 124 (40.7%) responded to treatments based on anatomic diagnostic protocols, while 181 (59.3%) remained unexplained or refractory to etiological treatments. Fifty-one subjects (16.7%) were classified as codeine treatment responders (those showing a rapid and clear response), 57 (18.7%) as partial responders, and 62 (20.3%) as non-responders. Codeine responders showed rapid improvement in objective cough frequency and severity scores within a week of the treatment. At 6 months, responders showed significantly improved scores in cough scores, compared to non-responders. Several baseline parameters were associated with a more favorable treatment response, including older age, non-productive cough, and the absence of heartburn. Conclusions: Approximately 60% of chronic cough patients in specialist clinics may require antitussive drugs. While codeine benefits some, only a limited proportion (about 20%) of patients may experience rapid and significant improvement. This underscores the urgent need for new antitussive drugs to address these unmet clinical needs. [ABSTRACT FROM AUTHOR]

Different patterns of bacterial communities have been reported in the airways and gastrointestinal tract of asthmatics when compared to healthy controls. However, the blood microbiome of asthmatics is yet to be investigated. Therefore, we aimed to determine whether a distinct serum microbiome is observed in asthmatics by metagenomic analysis of serum extracellular vesicles (EVs). We obtained serum from 190 adults with asthma and 260 healthy controls, from which EVs were isolated and analyzed. The bacterial composition of asthmatics was significantly different from that of healthy controls. Chao 1 index was significantly higher in the asthma group, while Shannon and Simpson indices were higher in the control group. At the phylum level, Bacteroidetes was more abundant in asthmatics, while Actinobacter, Verrucomicrobia, and Cyanobacteria were more abundant in healthy controls. At the genus level, 24 bacterial genera showed differences in relative abundance between asthmatics and controls, with linear discriminant analysis scores greater than 3. Further, in a diagnostic model based on these differences, a high predictive value with a sensitivity of 0.92 and a specificity of 0.93 was observed. In conclusion, we demonstrated distinct blood microbiome in asthma indicating the role of microbiome as a potential diagnostic marker of asthma. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the feasibility and utility of longitudinal cough frequency monitoring with the Hyfe Cough Tracker, a mobile application equipped with cough-counting artificial intelligence algorithms, in real-world patients with chronic cough. Methods: Patients with chronic cough (> 8-week duration) were monitored continuously for cough frequency with the Hyfe app for at least one week. Cough was also evaluated using the Leicester Cough Questionnaire (LCQ) and daily cough severity scoring (0–10). The study analyzed adherence rate, the correlation between objective cough frequency and subjective scores, day-to-day variability, and patient experience. Results: Of 65 subjects consecutively recruited, 43 completed the study. The median cough monitoring duration was 13.9 days, with a median adherence of 91%. Study completion was associated with baseline cough severity, and the adherence rate was higher in younger subjects. Cross-sectional correlation analyses showed modest correlations between objective and subjective cough measures at the group level. However, in time series correlation analyses, correlations between objective and subjective measures widely varied across individuals. Cough frequency had greater day-to-day variability than daily cough severity scores in most subjects. A patient experience survey found that 70% of participants found the cough monitoring helpful, 86% considered it acceptable, and 84% felt it was easy to use. Conclusion: Monitoring cough frequency longitudinally for at least one week may be feasible. The substantial day-to-day variability in objective cough frequency highlights the need for continuous monitoring. Grasping the implications of daily cough variability is crucial in both clinical practice and clinical trials. [ABSTRACT FROM AUTHOR]

This prospective observational study examined whether Staphylococcus aureus (SA) nasal colonization and staphylococcal enterotoxin (SE)-specific IgE sensitization synergistically affect clinical outcomes of adults with late-onset asthma (onset age ≥ 40 years). Nasal swabs were taken to evaluate SA colonization. Serum SE-IgE level was measured. Subjects were classified into 4 groups according to SA colonization and SE-IgE sensitization positivity. Among 181 patients with late-onset asthma recruited, the proportions of SA/SE (‒/‒), SA/SE (+ /‒), SA/SE (‒/ +), and SA/SE (+ / +) were 33.7%, 15.5%, 28.2%, and 22.6%, respectively. Severe asthma was more frequent in the SA/SE (+ / +) group than in the SA/SE (‒/‒) group (41.5% vs. 13.1%). The relationship of SA/SE (+ / +) with severe asthma was significant in multivariate logistic regression (vs. SA/SE (‒/‒); adjusted odds ratio: 4.36; 95% confidence intervals: 1.50‒12.73; p = 0.007), whereas SA/SE (+ /‒) or SA/SE (‒/ +) was not. In conclusion, SA nasal colonization and SE-IgE sensitization may synergistically affect disease severity in late-onset asthmatics. [ABSTRACT FROM AUTHOR]

Few studies have investigated the relationship between asthma and sarcopenia. We aimed to examine the relationship between asthma and sarcopenia in a community-dwelling geriatric population, especially regarding lung function and asthma control. A cross-sectional dataset from the Korean National Health and Nutrition Examination Survey 2008–2011 was utilized. Data regarding asthma history, age at asthma onset, recent asthma exacerbations, and hospitalization for asthma exacerbations were obtained using structured questionnaires. Appendicular skeletal muscle was calculated as the sum of the skeletal muscle mass, and physical activity was assessed using the International Physical Activity Questionnaire. Asthma presented an estimated incidence of 6.17 ± 0.37% in the elderly. Groups were divided and analyzed according to asthma, muscle mass, and physical activity. Sarcopenia was associated with aging, male sex, smoking history, low body mass index (BMI), and reduced lung function with or without asthma. Sarcopenic asthma had a younger onset and reduced physical activity than non-sarcopenic asthma. Obstructive patterns were more frequent in asthmatics exhibiting low or moderate physical activity levels than in those with high activity, but asthma control was not associated with sarcopenia and physical activity. Multivariate logistic regression analyses showed that compared with control, sarcopenic asthma was associated with FEV1 < 60%, and airway obstruction, and with aging, male, and lower BMI, compared with non-sarcopenic asthma. Our findings suggest that decreased muscle mass and physical activity levels contribute to reduced lung function in elderly asthmatics. Furthermore, sarcopenic asthma was associated with aging, low BMI, and reduced lung function in the elderly. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Maxillary sinus hypoplasia (MSH) is a radiologically detectable abnormality of the maxillary sinus that can be associated with sinusitis. Symptomatic MSH patients with a patent ostiomeatal complex (MSHPO) constitute a particular therapeutic challenge. Methods: Ostiomeatal unit CT scans of 1293 patients with various sinonasal symptoms such as purulent discharge, postnasal drip, facial pain or headache were reviewed to determine the incidence, clinical symptoms and outcomes of MSHPO following medical treatment. Results: Seventy-five cases (5.8%) were found to have MSHPO. Excluding patients with nasal septal deviation and positive allergy test, 37 of those 75 patients (2.86% of the original cohort) had MSHPO as the only definable sinonasal abnormality. Radiographs showed all patients had antral mucosal thickening. Postnasal drip (43.2%) was the most common symptom, followed by nasal obstruction (40.5%), purulent rhinorrhea (32.4%), hyposmia or anosmia (32.4%), cough (21.6%) and headache (18.9%). Medical treatment consisted of clarithromycin and ebastine for all patients. Medical treatment resulted in complete symptom resolution in only 24.3% of patients. Conclusions: Primary MSHPO was present in approximately 3% of patients with sinonasal symptoms. The response rate to medical treatment was poor. MSHPO should be considered a differential diagnosis in patients presenting with non-specific sinonasal complaints. [Copyright &y& Elsevier]

Delayed local reactions after the first administration of the ChAdOx1 nCoV-19 vaccine Patients with more severe delayed local reactions tended to experience more intense solicited systemic symptoms. Patients 1 and 2 reported mild delayed local reactions and experienced mild or no solicited symptoms. [Extracted from the article]