Upper respiratory symptoms worsen over time and relate to clinical phenotype in XXXX .

@entity1 @entity1030
RATIONALE: How nasal symptoms in @entity1 with @entity1030 ( @entity1030 ) change over time and resolve during naturally occurring exacerbations has not been described previously. OBJECTIVES: To evaluate the evolution and impact of upper airway symptoms in a well-defined @entity1030 cohort when stable and at exacerbation. METHODS: @entity1 in the London @entity1030 cohort were asked about the presence of nasal symptoms (nasal discharge, sneezing, postnasal drip, blocked nose, and anosmia) over an 8-year period (2005-2013) every 3 months at routine clinic visits while in a stable state and daily during exacerbations with the use of diary cards. Data were prospectively collected, and, in a subgroup of @entity1 , @entity1030 Assessment Test scores and @entity1 rhinovirus identification by polymerase chain reaction were available. @entity1 were also defined as having infrequent or frequent exacerbations (<2 or >= 2 exacerbations/yr, respectively). MEASUREMENTS AND MAIN RESULTS: At an aggregate of 4,368 visits, 209 @entity1 with @entity1030 were asked about their nasal symptoms. At 2,033 visits when the @entity1 were stable, the odds ratio (OR) for nasal discharge increased by 1.32% per year (95% confidence interval [CI], 1.19-1.45; P   <   0.001); the OR for sneezing increased by 1.16% (95% CI, 1.05-1.29; P   =   0.005); the OR for postnasal drip increased by 1.18% (95% CI, 1.03-1.36; P   =   0.016); and the OR for anosmia increased by 1.19% (95% CI, 1.03-1.37; P   =   0.015). At visits when the @entity1 were having exacerbations, nasal discharge was present for 7 days and blocked nose, sneezing, and postnasal drip increased for just 3 days. Anosmia did not change. Nasal discharge was more likely in @entity1 with frequent exacerbations (OR, 1.96; 95% CI, 1.17-3.28; P   =   0.011), and @entity1030 Assessment Test scores were higher by 1.06 units (95% CI, 0.32-1.80; P   =   0.005) when @entity1 were stable and higher by 1.30 units (95% CI, 0.05-2.57; P   =   0.042) during exacerbations. CONCLUSIONS: Upper airway symptoms increase over time in @entity1 with @entity1030 and are related to the frequent exacerbation phenotype. These longitudinal changes may be due to increasing airway inflammation or to progression of @entity1030 .
