June 30, 2022
Omicron variants: Is vaccine effectiveness negative?
New MedRxiv paper argues that the vaccine effectiveness for the third dose was in negative since December 20, 2021,
with a significantly increased proportion of SARS-CoV2 cases hospitalizations and deaths among the vaccinated
June 25, 2022:
Myocarditis and Pericarditis following Covid-19 mRNA vaccines in French Population
In line with results from a cohort study in Nordic countries, analyses of data from France show a significant risk and population burden of pericarditis following the second dose of the BNT162b2 and mRNA-1273 vaccines.
June 24, 2022:
Breakthrough COVID-19 fatalities after the 4th dose
There were 39 COVID-19 related deaths among the fourth dose recipients in Israel yielding a cumulative mortality of 0.2%.
June 23, 2022:
Cardiovascular disorders after third dose
Most cases of cardiovascular adverse events in vaccine recipients occur following the second dose.
But severe reaction could happen even if the first and second dose did not cause any side effects.
June 15, 2022:
Hepatitis triggered by a complex interplay with SARS-CoV-2 vaccination
Several cases of autoimmune hepatitis following COVID-19 vaccination have been
previously described.
This post discusses two more:
in a 52-year-old woman undergoing immunotherapy and
a 17-year-old woman exposed to SARS-CoV-2 after vaccination with a detectable immune response.
Unusual epidemic of hepatitis in children has been widely reported in recent weeks.
No one has a definite answer to its causes yet.
June 13, 2022:
Hypertensive Anaphylaxis after Moderna vaccine
Acute onset of increased blood pressure after vaccination may be a premonitory symptom of anaphylaxis.
June 12, 2022:
Adverse Effects of Facemasks
Many dermatological and neurological adverse effects of facemasks have been described in medical literature.
June 8, 2022:
Irreversible Cardiomyopathy Induced by COVID-19 Vaccination
Irreversible cardiomyopathy was a result of the inflammatory process associated
with SARS-CoV-2 infection and the subsequent cytokine storm from the vaccination.
June 7, 2022: COVID-19 Vaccine-Associated Transient Amnesia
We observed cases of transient global amnesia (TGA) after the 1st or 3rd dose of a COVID-19 vaccine in the elderly population of our study.
Recent review of reports from the World Health Organization VigiBase® ideitified 289 TGA cases
associated with a COVID-19 vaccine. The Pfizer-BioNTech COVID-19 Vaccine, also known as COMIRNATY® and Tozinameran was mostly represented (147, 50.8%), followed by the Oxford/AstraZeneca or ChAdOx1-SAZD1222 (69, 23,8%), Moderna - SPIKEVAX, elasomeran - (60, 20.8%), and JNJ-78436735 (12, 4.2%).
Cerebrovascular, inflammatory, or migrainous mechanisms may underlie this association. Yet, numerous confounding factors cannot be tackled with this approach, and causality cannot be ascertained.
Here is an exemplar medical case:
Two weeks after receiving the first dose of ChAdOx1 nCov-19 vaccine, a disease-free 38-year-old woman experienced acute onset of abnormal symptoms, such as
amnesia, incoherent speech, and difficulty typing using
communication software.
Her immediate adverse reactions following vaccination were only fever and general malaise for 2 days. On arrival at the emergency department, the patient
was conscious clear but demonstrated psychomotor
slowing and confabulation. Neurological examination
revealed high levels of cortical dysfunction including
poor judgement; disorientation to time, place, and person;
impaired short-term memory; failed abstract thinking;
impaired calculation; and impaired language function (including partial incoherence, agraphia, and anomic
aphasia). The language domains of fluency, reading, and
repetition remained notably intact. No cranial nerve,
motor, sensory, or coordination dysfunction were observed.
Brain computed tomography revealed negative findings
of hemorrhage and structural lesion. While waiting in
the emergency room, the patient experienced a first-time
seizure with a general pattern of a tonic–clonic seizure.
The patient was prescribed lorazepam and levetiracetam,
and the seizure subsided. The patient presented postictal
confusion and agitation. She was admitted for examination
and treatment. Brain MRI revealed a subacute infarction at the
right internal capsule through diffusion-weighted
imaging (Fig. 1A), and magnetic resonance angiography
revealed an irregularity in vascular contour, indicating
potential vasculopathy, such as vasculitis (Fig. 1B). EEG revealed diffuse background slowing with intermittent low to moderate voltage sharp transients at the right
frontotemporal region.
Qualitative serum tests for paraneoplastic neurologic
syndrome, including anti-Tr(DNER), anti-GAD65, antiZic4, anti-titin, anti-SOX-1, anti-Recovertin, anti-Hu,
anti-Yo, anti-Ri, anti-PNMA2(Ma2/Ta), anti-CV2, and
anti-amphiphsyin, were all negative. Qualitative serum
and CSF tests for limbic encephalitis, including antiNMDAR, anti-AMPAR1, anti-AMPAR2, anti-GABABR,
anti-LGI1, and anti-CASPR2, were all negative.
Although autoantibodies were all absent detected,
seronegative autoimmune encephalopathy triggered by
the ChAdOx1 nCov-19 vaccination was highly suspected.
In addition to levetiracetam, the doctors initiated steroid pulse
therapy at the start of treatment. The regimen was
methylprednisolone 1000 mg IV daily for 5 days, which
was subsequently changed to prednisolone 30 mg PO daily
starting from day 6 of admission. The patient’s symptoms
dramatically improved from day 3 of admission. The
patient was discharged without neurological deficit or
sequelae. One week after discharge, the patient received
repeat EEG, which revealed resolved slow waves without
epileptiform discharges (Fig. 3). Three months later,
repeated brain MRI revealed regressive change of previous
irregularity of vascular contour. (Fig. 1C)
REFERENCES
Merino D, Gérard AO, Van Obberghen EK, Ben Othman N, Ettore E, Giordana B, Viard D, Rocher F, Destere A, Benoit M, Drici MD. COVID-19 Vaccine-Associated Transient Global Amnesia: A Disproportionality Analysis of the WHO Safety Database. Frontiers in Pharmacology. 2022:1858.
Huang YJ, Huang CS. Postvaccinal Encephalopathy Presenting with Amnesia and Seizure After ChAdOx1 nCov-19 Vaccination: A Case Report. Acta Neurologica Taiwanica. 2022 Sep 18;31(3):111-5.
May 16, 2022: Resolving subtypes of COVID-19 in the elderly.
SARS-Cov-2 is one of the most complex viruses known to medical science. Patients with COVID-19 present a broad spectrum of clinical manifestations, ranging from asymptomatic infection to lethal outcome. Both the young and the old may have very different clusters of symptoms and responses to medications, including the COVID-19 vaccines. Each type is associated with how severe of an illness a patient might experience, ranging from asymptomatic to lethal.
Precision medicine approaches such as whole-exome sequencing can provide insight into the phenotypes, endotypes and underlying mechanisms of the disease. The high cost of cutting-edge approaches, however, keeps these tools out of reach for many research teams.
In this age of big data and large clinical studies, we should not forget about the value of individual cases
. A good case report tells a detailed story. It describes a unique phenotype and offers unique clues to its resolution into an endotype.
A new systematic review of case reports aims to answer questions about COVID-19 subtypes in octogenarians, nonagenarians, and centenarians and offer possible solutions to organize the knowledge and identify the gaps.
REFERENCES
Irene S. Gabashvili. The outcomes of COVID-19 vaccination and SARS-CoV-2 infection in octogenarians, nonagenarians, and centenarians. PROSPERO 2022 CRD42022332621 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022332621
Irene S. Gabashvili (2022), “COVID-19 vaccine and SARS-CoV-2 in the oldest old: rapid literature review”, Mendeley Data, v1
http://dx.doi.org/10.17632/6sk33d9z7s.1 https://data.mendeley.com/datasets/6sk33d9z7s/1
May 18, 2022:
Long COVID symptoms don't resolve due to subsequent vaccinations
A new study from Mount Sinai followed 453 COVID-19 patients with post-acute sequelae of COVID (PASC)
72% of got vaccinated in the following 6 months but this did not resolve anosmia,
respiratory symptoms, depression, anxiety, PTSD, or quality of life.
May 16, 2022:
Fatal Breakthrough COVID-19 in a Heart Transplant Recipient
A 71-year-old male is gdiagnosed with a breakthrough COVID-19 16 days after his second mRNA vaccine dose.
May 13, 2022:
Pericardial effusion as a complication of vaccination against COVID-19
Cases following vaccination in adults and fetuses after maternal COVID-19 vaccination
May 12, 2022:
Urological Adverse Effects of COVID-19 Vaccination
More than 10% of individuals experience deterioration in
storage lower urinary tract symptoms
after COVID-19 vaccination
May 10, 2022:
Fatal autoimmune acquired factor XIII/13 deficiency after COVID‐19 vaccination
A 78-year-old woman with no personal or family history of abnormal bleeding
dies of CNS bleeding induced by her COVID-19 mRNA vaccination.
May 6, 2022:
Long Breakthrough COVID
Cases of fully vaccinated and boosted individuals developing long COVID after breakthrough infection
May 5, 2022:
Fatal Guillain-Barré syndrome after COVID-19 vaccination
A fit and healthy 77-year-old woman went from capable of loading firewood to being paralyzed
after her 1st dose.
April 30, 2022:
Precision medicine for IBD
A precision medicine approach discovers hidden genetic connections in Inflammatory Bowel Disease
April 29, 2022:
Increased cardiovascular emergencies during vaccine rollout
Using a unique dataset from Israel National Emergency Medical Services (EMS) from 2019 to 2021,
an increase of over 25% was detected in both cardiac arrest (CA)
and acute coronary syndrome (ACS) EMS calls during January–May 2021, compared with the years 2019–2020
April 28, 2022:
15-year-old boy commits suicide after cyberbullying for false rumor of being non-vaccinated
A 15-year-old boy enrolled at a prestigious private school had a promising future —
that is, until he became a victim of relentless cyberbullying by his classmates.
April 25, 2022:
Diabetes after COVID-19 vaccination
Diabetes risk rises after COVID and, in some cases, after COVID-19 vaccination.
April 20, 2022:
On Cabbage and SELENBP1
Mutations in the gene encoding Selenium Binding Protein
were found in multiple individuals with extra-oral halitosis.
April 5, 2022:
Fatal outcomes despite 4 COVID-19 vaccine doses
COVID-19 vaccines reduce hospitalization and death, but they don't completely eliminate it,
not even after four doses.
April 1, 2022:
April Fools' 2022
April Fools' Technology jokes can be prophetic or ominous,
wishful thinking or a reflection of real concerns.
March 31, 2022:
COVID-19 Vaccine Effectiveness during Pregnancy
We describe case series for pregnant women and discuss recent findings that
pregnant individuals were 90% more likely to have been infected with coronavirus
than the same number of people who were not pregnant, despite vaccination.
March 27, 2022:
Autoimmune skin conditions in the elderly after vaccination
We discuss 29 cases of bullous pemphigoid with a median age 82.
March 21, 2022:
Passive Sensors for Health Monitoring
Health data can be collected passively enabling continuous data collection and home-based trials.
March 19, 2022:
Long COVID and Adverse Effects of Vaccination in incontinentia pigmenti
Patients with certain genetics are prone to more severe COVID-19, long COVID and adverse reactions to vaccination.
March 11, 2022:
Multisystem Inflammatory Syndrome in Children after SARS-CoV-2 Vaccination
Multisystem inflammatory syndrome can follow SARS-CoV-2 infection, but it can be also
induced by vaccination without current COVID-19 infection.
March 6, 2022:
Hearing Loss after COVID-9 Vaccination
In a study of vaccinations in Israel, an association was found between the BNT162b2 mRNA COVID-19 vaccine
and Sudden Sensorineural Hearing Loss.
Similar case reports from other countries have been published in peer-reviewed journals.
March 3, 2022:
Getting Out of Echo Chambers
We need critical thinking and cultural intelligence analysis skills
to recognize the legitimacy and ongoing necessity of opposing views.
February 28, 2022:
Fatal outcomes in elderly patients after COVID-19 vaccination
Many elderly individuals whose death was linked to the vaccine had preexisting cardiovascular diseases.
Genetic predispositions could be also involved.
February 20, 2022:
Acute liver failure after COVID-19 vaccination
A healthy 34-year-old health care worker with no history of COVID-19 dies from hepatic infarction a few days after his first dose
of ChAdOx1nCov-19 vaccine.
February 16, 2022:
Catecholamine-Mediated Stress Cardiomyopathy after COVID-19 Infection & Vaccination
An overly exuberant immune response to the vaccine can cause myocardial injury
mediated by similar immune mechanisms as described with SARS-COV-2 and multisystem inflammatory syndrome (MIS-C) cytokine storms.
February 15, 2022:
Fatal breakthrough infections in solid organ transplant recipients
4 case reports of fatal breakthrough infections among liver and kidney transplant recipients aged 13-69.
February 13, 2022:
Fatal COVID-19 breakthroughs in kidney disease patients
Brazilian and Scottish studies show that patients with kidney disease do not benefit from existing COVID-19 vaccines.
February 2, 2022:
Fatal COVID-19 breakthrough in an 88-year-old male
Yet another report about a healthy person (except benigh prostate) who dies despite 2 doses of a COVID-19 vaccine
February 2, 2022:
Deaths of elderly individuals wrongly given an extra dose of the vaccine.
They were given too many doses too soon - due to insufficient documentation or vaccine passport bureaucrats.
February 1, 2022:
Who benefits the least from COVID-19 vaccines?
Vaccines help some people more than others.
February 1, 2022:
Vaccinated 71-year-old male dies from breakthrough COVID-19 on the 2nd day of symptom onset
71-year-old double-vaccinated overweight male started to feel unwell on the 7th day and died on the 9th day -
while sitting in his easy chair shortly before an ambulance arrived.
January 30, 2022:
Severe breakthrough COVID-19 in vaccinated patients with multiple sclerosis.
Multiple sclerosis patients have a higher risk of breakthrough infection
January 21, 2022:
Another case report on fatal breakthrough with brain involvement.
Neurological manifestations are common in COVID-19.
A sudden-onset reversible cerebral vasoconstriction syndrome (RCVS),
possibly caused by a transient dysregulation of cerebral vascular tone,
is described in this fatal COVID-19 vaccine breakthrough case.
January 18, 2022:
Fatal Anorexia caused by COVID-19 vaccination.
A 90-year old woman in stable health receives the first dose of the COVID-19 vaccine,
experiences inreased heart rate, develops anorexia and dies 28 weeks later.
January 16, 2022:
A fatal case of COVID-19 breakthrough infection in a 61-year old man
A 61-year-old man with a history of arterial hypertension (PA 145/95 mmHg)
and obesity with a body mass index (BMI) of 37.11
was vaccinated with a double dose of mRNA vaccine, but
4 months after the 2nd dose was diagnosed with COVID-19
and died 15 days after diagnosis despite treatment.
January 13, 2022:
Young COVID-19 vaccine breakthrough fatalities
Vaccine effectiveness may fail for individuals with particular genetics and we need more studies and more medical case reports to develop personalized preventative and curative approaches.
January 12, 2022:
Post-infectious body odor
A paper posted today on MedRxiv tells that
dogs can easily detect long COVID - and not only acute COVID-19 - in at least half of the cases.
Vaccine effectiveness may fail for individuals with particular genetics and we need more studies and
more medical case reports to develop personalized preventive and curative approaches.
January 8, 2022:
Risk Factors for Severe COVID-19 Outcomes Among Vaccinated Individuals
New Morbidity and Mortality Weekly Report (MMWR) emphasizes the usual risk factors for fatal breakthroughs:
age 65 or older or at least one of these conditions:
diabetes mellitus, immunosuppression, chronic kidney disease, chronic liver disease,
chronic neurologic disease, chronic cardiac disease, or chronic pulmonary disease.
