A 57-year-old woman presented with a 1-month history of dry cough and weight loss. She had a history of polymyalgia rheumatica (PMR) that had been diagnosed at 55 years old. Dullness in both upper limbs with elevated inflammatory markers and improvement with low-dose prednisolone might have led to this diagnosis, although her chief complaint at that time was a chronic cough. After excluding pulmonary diseases, contrast-enhanced computed tomography showed wall thickening of the descending aorta (Picture 1); positron emission tomography revealed an intense fluorodeoxyglucose uptake in the same areas (Picture 2). Following a diagnosis of large-vessel vasculitis (LVV), all symptoms improved with high-dose prednisolone. One of tt hypothesized mechanisms of cough in LVV is arterial inflammation contiguous to a vague nerve branch (1). As proper selection of radiographs is crucial in diagnosing LVV (2), LVV should be considered as a differential diagnosis of chronic cough, especially in cases with PMR-like symptoms in nontypical age groups.

Molnupiravir is among the antiviral agents used to treat COVID-19; however, reported data on the efficacy of this drug are based on results from unvaccinated patients. As such, the efficacy of molnupiravir among vaccinated patients during the B1.1.529 (Omicron) variant outbreak remains unknown. To address this issue, this study retrospectively analyzed data from 294 vaccinated patients with COVID-19 who had at least one risk factor, between May and October 2022. Patients were divided into the molnupiravir group and the control group to investigate the correlations of molnupiravir and other factors with rates of hospitalization and death (hospitalization/death) within 28 days of admission. Potential risk factors were also examined. The study findings indicated that molnupiravir was not associated with the rate of hospitalization/death, while age ≥ 80 years, residence in a long-term care facility, and presence of chronic obstructive pulmonary disease were significantly associated with the rate of hospitalization/death. Although the current results suggest that the effect of vaccination in preventing severe illness against the Omicron variant is well maintained, additional studies on risk factors and outcomes are required to validate this study’s findings.

Sagital view on T2-weighted imaging of MRI revealed a three-layered structure in the spinal canal, consisting of the spinal cord (white arrows), spinal fluid (red arrows), and hematoma (black arrows).