Peter Lederman in Second Bout With COVID-19

To those doctors that have posted here. I have sent some clips to my Rheumatologist. This is a doctor who really CARES, and is a rare find. He has been helping me in researching and testing methods to treat my autoimmune disorder I have had for 30 years. God Bless him.

My posting this is not to continue this aspect of the thread, but to inform you of what someone who knows my medical history and someone who is brilliant medically has to say. I wish EVERYONE God bless - and stay safe. Covid is NOT going away.

Hi Peter-

 I guess I am taking these posts out of context because I am just seeing portions and missed the thread.

 But I do offer a few thoughts...

 First of all, it remains unclear exactly what happened to you. As I understand it, you were exposed to the coronavirus and were infected prior to the second vaccine. Then, unknowingly, did receive the second shot right around the time that symptoms would emerge, leading to a terrible reaction. Was the blood clot and PE a result of COVID19 re-infection or the vaccine? How can one tell?

 Both vaccinations and natural immunity ( following a previous infection, as in your case) help to reduce the risk of repeat infection, but cannot eliminate it .

 One explanation might be that getting the vaccine coincident with the true infection resulted in a massive immune activation that made you sick and contributed to the clots. Another might be that you had an exaggerated vaccine reaction that was responsible, rather than the infection itself (most people who have been reinfected with COVID have experienced a much milder course of illness than the first time). A third might simply be that the vaccine was not effective in your case , nor was natural immunity and you became reinfected and got quite sick and developed the blood clots, due to the infection. Blood clots, as you know have been associated with the J and J vaccine, not the one you received, but HAVE been seen frequently in  bad COVID infections.

 Those blood clots in many cases have been associated with the development of autoantibodies, induced by the virus, which impairs the clotting system.( We should check for those in your case, if not already done)

 And, you and I know, Peter, that your immune system is not exactly "normal". Long before all of this, we have been struggling with understanding what the nature of your autoimmune condition is and how to manage it.

 Perhaps your particular immune system is more susceptible to COVID infection, for some reason. Or maybe it renders you less responsive to vaccination thus leaving you vulnerable, so that either natural or vaccinated immunity is weak in your case. These are questions that we really cannot answer.

 As far as that other doctor's post about ADE ( antibody dependent enhancement) goes--there is so far, no evidence thatI am aware of that this exists in the case of COVD vaccination . It has only been seen in Dengue and remains mostly a theoretical phenomenon. Some virologists/immunologists/infectious disease experts expressed concern that this could happen with COVID vaccines, but so far, despite hundreds of millions of receiving various vaccine products throughout the world this has not been reported.

 And the notion that those with previous COVID infection should not receive the vaccine is, in my opinion , wrong. We know that natural immunity is of short duration and vaccination confers, in general, a better and longer protection.

I believe that it is true that individuals with prior infection histories tend to have  a stronger reaction to the first vaccination ( with COVID "virgins" tend to react-if at all-to the second shot) which is one reason, many experts recommend waiting 3 months after recovering from COVID before getting the vaccine.

( I recently saw a couple who both had severe COVID infections--he was hospitalized for nearly 3 months and almost died and she for a month and also had a pulmonary embolism) They went and got the vaccine about a month after recovering from that fiasco and both get real sick. He told me he felt as though he had COVID again--but it lasted a week and then they recovered fully)

 Some People are just generally against the vaccines and find others who share their opinion and then selectively support their position with "facts" and opinions that agree with their position.

 I feel terrible about what happened to you, but I think it is rare and I still believe that the vaccination programs are in the best interests of the society as a whole

 Respectfully,

DL

@retipper

thanks for sharing that

please don’t push yourself to get back to work too soon... as we age we heal slower... need time to let body try to get right

dunno if you have a couch (maybe have a colleague get you pillow, air mattress, blanket and put somewhere in your workplace??) to lie down at work, take 30 min breaks/naps while there

please take care of yourself let yourself get better -- the work can wait

Now, that is level-headed response by Dr. DL. It does not make some things about confirmation clear, though. There is also something called MIS-A. Hopefully, this case has been reported to the vaccine manufacturer, or whoever is keeping eyes on long-term effects. If the people from the hospital published it as a case report, it might help someone down the line.

viber6,

You have an interesting concept of dying. Out of curiosity, was Dr. Guay taking testosterone supplements?

@retipper glad you are climbing out of the hole. For the love of a good dog and music we will do much. I also hope you can find a way to take time to heal.

autoimmune is a nefarious Bastard. It runs in my wife’s family - Lupus and nonspecific... so my empathy as you fight that

My best to you

jim

Dear Peter, In my opinion, your own rheumatologist did a good job dissecting the issues in your case. Of course, I like what he wrote, by and large, because he agrees with me, (1) even if you’ve had COVID, it is still a good idea to get vaccinated, and (2) ADE is unlikely to play an important role in the genesis of severe COVID, with or without vaccine. When you told us about your recent medical history, I was struck by the fact that, were it not for your telling us you had a positive PCR test for virus in association with your acute illness, I would have doubted that you actually had a second infection, which is to say that it is not necessary to postulate that you had a second infection in order to explain your recent pulmonary emboli. For one thing, what you described are major thromboembolic phenomenon that blocked some of your major vessels. Although that probably can happen in COVID, COVID more typically causes "microthrombi" of the capillary bed that feeds pulmonary alveoli, the air sacs responsible for gas exchange in the lungs. Similarly, small clots can also form in other organs where the ACE2 receptor protein required by the virus for cell entry is expressed (heart, brain, etc), by a similar mechanism. Those are not "embolic"; they don’t come from somewhere else in the body. They are thought to be caused by direct infection of endothelial cells that line the pulmonary capillary wall. Those cells efficiently express ACE2. When they get infected, they release a clotting factor that alone can start the cascade that leads to microthrombi. Having very elevated D-dimers is not proof of COVID per se. Elevation of D-dimers in blood (and fibrin consumption) can occur in several other pathologic states. For another thing, you don’t describe much in the way of other symptoms that characterize COVID, except that you felt lousy for a few days before going to hospital. However, those who took care of you know much more about your case than I ever will, and if they say you had a second illness from COVID, I am in no position to doubt it.
I would take issue with only one point your doctor made: In COVID, absent vaccination, autoantibodies are not implicated in clotting abnormalities. See above for the accepted pathogenesis of "micro" clots in lungs and other organs. Autoantibodies are definitely implicated in the very rare cases of severe and often fatal thrombo-embolic disease in those who received either of the two vaccines that use adenovirus as a vector (AstraZeneca and J&J). The mechanism is very recently described (last week) and seems to be due to the fact that adenoviruses bind to platelets. In rare cases, this results in the generation of antibodies that recognize platelets, and that results in platelet destruction. The resulting very low platelet concentration in blood heralds the clotting problems that ensue. (It’s paradoxial that low platelets leads to clotting, but that is another story.) The incidence is very very low, probably lower than one case per million vaccine doses, but the consequences have been grave for those who contract this problem. When an adverse event is that rare, (and there is no prior basis to suspect it, because there have never been any other adeno-vectored vaccines in widespread use), there is no way to design a clinical trial to detect the problem prior to release of the vaccine. Fortunately, the recent reports also describe effective treatment regimens, if they are implemented promptly.