I'm very excited to announce that our survey data have now been published on a preprint:
Characterising long COVID-like COVID-19 vaccine reactions


I've already summarised key findings in the thread below 👇🏻
#postvac #vaccineinjuries #medtwitter zenodo.org/records/105820…

Infographic of symptoms that can occur post-vac (fatigue, cognitive dysfunction, weakness, tinnitus, pain, tachycardia, etc), diagnoses to consider with relevant tests: Cardio/respiratory: BP, ECG, MRI, echo, D-dimer, FBC, PFT, VQ/DECT. MCAS. Connective tissue disorders: imaging, beighton score. SFN, nerve conduction, QSART, QST, skin biopsy. Nutrition screen. Autoimmune: ANA, ANCA, PR3, MPO, CRP, ESR, APS, reactivated pathogens. ME (see NICE). Endocrine: thyroid, renin, aldosterone. Dysautonomia: NASA lean test, 24 h urine Na.  Support patients by: Listening; showing empathy; curious; beli...
Summary of key findings:
- Patients often had a high symptom burden
- Most tests came back normal, especially for mRNA recipients
- #MCAS and #POTS targeted therapies generally seemed most effective with few side effects
- Experience of healthcare was poor
We also ran some cluster analyses to see if we could identify patients with similar symptoms and link these to other things like test results. Unfortunately we did not find any notable clusters; possibly because the sample is too small, and/or because the disease is heterogeneous
HUGE thanks to all who participated - we appreciate this took significant effort.

Thanks to @dylanarmbruste3 for help with some coding and all others involved @ukcvfamily

The qualitative analysis paper has been drafted and we hope to get that out as soon as possible.
Thank you also to @react19 for sharing the survey, please do theirs too!


They are hoping for a larger sample so hopefully will find better trends. We have also been sicker longer so may have better diagnoses/tests than when we did our surveyreact19.org/study
Please note that we do not make any conclusions pertaining to the general safety of vaccines, but are solely focused on those who experienced chronic reactions
Finally, apologies this took so long to complete. My health kept declining which delayed things!
cc: @VirusesImmunity @resiapretorius @dbkell @DrAnnaNZ @doctorasadkhan @irish_cv_clan @scottish_vig @CoVerseAU @BrianneDressen @Charletukcvfam @Sunny_Rae1 @drclairetaylor @cazd45
Thanks to @NHSGrampian for providing funding thru their Endowment Fund for survey software
#TeamClots
@React19org sorry I stuffed up tagging you 🙈

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More from @angryhacademic

Jan 22
When i was employed by @NHSGrampian i wrote a generic letter to your doctor about key things to look for in #longcovid/#postvac:


The aim was to give drs some direction based on emerging evidence as the NHS has offered nothing helpful in terms of guidance dontbelievehype.co.uk/covid-%26-vacc…
I was told to remove any reference that i worked in the NHS which i had initially written in the letter.

The NHS didnt want any association with *checks notes* evidence. It was deemed "too risky".
Its almost like they had an expert employed and deliberately chose not to listen and act accordingly... And now theyre being sued for negligence. I feel like this might have been avoidable, especially so in Grampian's case...
Read 4 tweets
Jan 12
Randomized Controlled Trial of Intravenous Immunoglobulin for Autoimmune #POTS


Clever study design: n = 30 POTS patients (27 completed) received either IVIG or albumin infusion. They did this to control for volume expansion

Results: No difference!researchsquare.com/article/rs-350…
If we look a bit closer at the results, it does look like a subgroup of IVIG patients get distinctively better (> 20 % improvement), and other get a bit or significantly worse. graph showing symptom score change between IVIG (n = 15) and albumin (n = 12). IVIG shows a range of patients getting 40 % worse to 50 % better. 7 of these patients improved by 20 % or more, 5 hovered between 0-10 % worse, 1 was 40 % worse, and the rest were 0-20 % better.  for albumin, 3 patients got 0-10 % worse, 2 got more than 20 % better, and the rest were 5-20 % better.
From this, I surmise that we could maybe predict most will experience light improvement with albumin, but the outcome is less predictable with IVIG, though favouring improvement to some extent.
Read 4 tweets
Jan 12
Fatigue and tiredness are different. Simple way to show this:

First generation antihistamines block histamine action in the brain. Histamines are a wakefulness molecule. Hence a side effect is drowsiness and tiredness.

But these drugs can also significantly relieve fatigue.
If fatigue was a form of tiredness, this would be unlikely to happen, especially considering the other mechanisms of action with first gen antihistamines which are not conducive to wakefulness
This suggests at least for some people with fatigue, their fatigue is caused by excess histamine. This may also explain the (poorly named) "wired & tired" feeling many patients experience. Histamine is keeping them awake ("wired") whilst *also* triggering fatigue ("tired")
Read 7 tweets
Nov 29, 2023
Just had an appointment at the nutrition clinic with my best dr & it leads to an important lesson for #MedTwitter

Ive been on fludrocortisone for about a year or more now i think. Ive been supplementing with potassium...

#POTS #longcovid #postvac
Today my potassium came back just above the threshold of needing to be admitted for IV. Surprisingly having a good week. I had no idea it was this low.

The BNF discusses regular electrolyte monitoring with fludro but the Heart Rhythm Soc POTS guidelines dont (iirc) mention this
Ive heard many POTS cases where electrolytes arent even checked when patients start fludro, let alone long term

How many are ok for 6, 12, 18 months before getting deficient? How many are chronically running a bit low which wont be helping their general wellbeing?
Read 4 tweets
Nov 13, 2023
If someone has cancer & dont respond to treatment, they still have cancer

If someone has MS & dont respond to treatment, they still have MS

If someone has hypertension & dont respond to treatment, they still have hypertension

Yet a common misconception i hear is:👇🏻
#LongCovid
"i dont respond to #MCAS treatments, so i cant have MCAS"

The key difference is that the 3 illnesses i describe above have clear biomarkers. Most with MCAS wont get appropriate tests, & if they do, there are limitations in the tests such that negative results cant rule-out MCAS
This makes MCAS more tricky.

But it is important to keep in mind that non-response to treatment does not necessarily rule-out MCAS. Being mindful of MCAS means you can continue keeping a watch out for triggers and remove them where possible
Read 9 tweets
Nov 8, 2023
Had cognitive tests, follow up with full results next weds. He was quite aware that id probably be above average on lots of things and its relative to my baseline but even without analysing the results he picked up on two things:

#postvac #longcovid
1. My short term memory and short term processing is impaired. I could remember things just as well once id learnt them versus then coming back to them but learning took an unexpectedly long time
2. My function slows disproportionately as the cognitive challenge increases. Simple tasks are ok and he expects some slowing as the complexity increases but was a bit shocked how much it slowed
Read 6 tweets

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