We kindly ask post-Covid, long Covid, and chronic infection related to patients to make their first appointment as an online appointment because it makes no sense seeing them initially in the office as there is a need of collecting information correctly before seeing the patient.
Patients with Covid-related health problems often ask whether their problem makes it advisable to refrain from another COVID vaccination or from vaccinations in general. The answer to this question is that all vaccinations can potentially cause complications and those patients should be studied before taking the decision.
Some patients have severe neurologic and cardiovascular problems persisting for many months, and often also neurologic deficits and neuropsychiatric problems due to the involvement of the cerebral vascular system, neurological deficits and neuropsychiatric problems. Checking pre-existing health conditions is paramount, extremely important here to include chronic all bowel disease, food allergies exposure to molds on the the home environmental history or if there are others in the home which may introduce parasitic or bacterial infections.
A explanatory hypothesis is the imbalance in the renin-angiotensin system which is disturbed by the spike protein and the binding of the spike protein to the ACE2 receptor; although this is maybe only one aspect of the patophysiology.
There are disturbed hormone systems such as the renin angiotensin system. The spike protein binds the virus to the renin angiotensin system and changes the metabolism, but this has not only the consequence that the vascular perfusion changes but a cerebrally altered vascular perfusion and also at the same time neurocognitive and probably psychiatric changes. In conclusion, the therapeutic approach can only be multidisciplinary, cardiologists, immunologists, neurologists, rheumatologists, infectiologists etc.
Patients with Covid or non-Covid long-standing health problems often ask us about getting a booster of a Covid vaccination or not or even ask us about potential problems with other vaccines. Theoretically a side effect can occur in these patients with each vaccination because each vaccination means a stimulus for the immune system. To check the situation of the immune system before getting the vaccine is a viable step to take. Ppatients with EBV infection or long EBV, for example, should not be vaccinated until the EBV disease is cured.
According to studies, young women with autoimmune diseases, food allergies and inflammatory bowel disease are the main risk group. Patients with Long EBV, food allergies, environmental health problems, and the like should be specially screened. In suspected patients, inflammatory activity should always be checked before any vaccination.
Luckily vaccination against SARS-COVID 2 was put on the market very fast. Knowledge about the disease and possible problems with the vaccine are arising slowly with a large stream of new information appearing weekly. Informations are partly confusing so it is advisable to just rely on information based on practical experience and check the references. Do not forget we are talking about 3, not just 1 disease in SARS-COVID 2.
As of now, according to many studies, it appears that blood thinning to prevent coagulation at least diminishes if not rules out vaccination associated problems when using certain vaccines. Many refer always finding high D-dimer values (a marker for thrombosis) in the blood analysis of patients with vaccination associated symptoms. This leads to the recommendation to take blood thinning medication when getting the vaccination. For this different medications are used, it should be done according to medical advice. Studies also show that antithrombotic therapy is paramount in the outpatient treatment of Covid when a marked decrease of blood oxygen saturation has taken place, the patients will often see a quick rise of the oxygen saturation after treatment with antithrombotic drugs. It might be advisable getting informed before getting the COVID vaccine or its booster.
Getting the booster in Lisbon is theoretically possible but in practice it is rather difficult. Two patients of ours were able to get the booster in Lisbon but others were not able getting it despite trying at different sites. Maybe the best initial step is to go to a SNS administration office, like for example the one near the Mercado 31 Janeiro.
Lastly as it was always stressed but apparently was stopped short ago: when you give an intramuscular injection, always make an aspiration before injecting, in COVID vaccines it makes a big difference. It makes a big difference if your body is exposed to the vaccine in the muscle or inside a blood vessel, the reaction and consequences might be totally different as studies point out.
Vaccination in Portugal is only here.
Links:
https://www.nature.com/articles/s41420-019-0188-0
Thrombosis in Covid vaccines a google search
Mit MRNA Impfstoffen erreicht man nur eine Antikörper Immunität, die T Zellen werden nicht stimuliert. Mit einem Totimpfstoff wird man eine T Zellen Immunität erreichen welche mehrere Jahre anhalten kann.
https://youtu.be/b_eR6t4aFf4
