With input from Dr Monica Vasudev

1460:  Several European countries stop use of AstraZeneca vaccine

Denmark, Iceland and Norway have stopped the administration of AstraZeneca COVID-19 vaccine while Italy has banned the use of a batch of the AstraZeneca doses as a precautionary measure following reports of people developing blood clots.

Health authorities in Denmark, Norway and Iceland discontinued the use of AstraZenecas vaccine after there were reports of blood clots among some people who had received the jab. The Danish Health Authority has stopped the use of the vaccine for 14 days. The move came after reports of serious cases of blood clots among vaccinated people. The Danish Medicines Agency has started a probe into the vaccine.

On Monday, Austria discontinued the use of the AstraZeneca vaccine while investigation was on for a death from coagulation disorders and an illness from pulmonary embolism. Spain and France continue to use the vaccine. French Health Minister Olivier Veran has stated that the upside of vaccinations currently outweighs the risks.

22 cases of such events have been reported across 3 million people who have been given the AstraZeneca vaccine dose as of March 9. [https://www.dw.com/] 

1461: Positive after the vaccine

1. People are not going to test positive on the basis of the vaccination itself.
2. If someone tests positive shortly after vaccination, its either because they are infected or they have recently contracted the infection.
3. Once people recover from COVID-19, they can continue to shed the RNA for weeks. This suggests that they were infected recently or at some point in the near past. It doesnt mean that they are necessarily going to transmit the virus or they are contagious.
4. People who were seropositive for COVID, who had prior infections, have immense rise in their neutralizing antibodies after a single dose of the vaccine. Vaccination can serve as a booster. [Medscape]

1462: Postural orthostatic tachycardia syndrome in COVID long-haulers

A small case series from Sweden reinforces that COVID-19 long-haulers may experience symptoms suggestive of postural orthostatic tachycardia syndrome (POTS).

Three young patients suspected of having COVID-19 in spring last year were diagnosed with POTS more than 3 months later, based on orthostatic tachycardia and chronic symptoms of orthostatic intolerance after ruling out competing etiologies, reported clinicians in a paper published online in JACC: Case Reports.

Symptoms pointing to POTS included persistent fatigue, headache, palpitations, dizziness, brain fog, or exercise intolerance while recovering from COVID-19. Clinicians performed a combination of the Valsalva maneuver and active standing and head-up tilt tests to diagnose POTS in these patients.

Treatment included increased fluid intake, compression stockings, ivabradine, and beta-blockers. [Medpage Today]

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA