Inside Medicine. What Are You Seeing? [COVID-19 medical news]

My daughters boyfriend had a positive rapid home test. Left immediately to get a PCR because his work place wanted a non at home test to give paid leave….so tested within 25 minutes of the rapid. Came back negative. His doctor was like “ that really shouldn’t happen.” He did test several more times. Negative.

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There appears to be a new neurological syndrome that is specific to Omicron. Occurs approximately 2 weeks after infection with Omicron. Not MIS-C, and not respiratory. Patients present with encephalitis symptoms: headaches, seizures, ataxia, confusion, vomiting, weakness, etc. Happenening in vaccinated and unvaccinated, don’t know about booster status.

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How common among those infected?

The neuro issues are really concerning. One of my kids has neuro issues (seizure, disability from TBI) and had dizziness for weeks after vaccine. Mono caused temporary inability to see (and consequently inability to walk) due to effect on brain from virus. COVID is really scary for people with these issues.

Too early to say. Just starting to see occasional admissions, pediatricians noticing a few patients here and there, enough that there is an official reporting form now. CDC and Pediatric Infectious Disease Society starting to collect data.

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Is this only being seen in the pediatric population?

The oldest I heard was 20.

Another huge thanks to @TexasTiger2 for her informative posts.

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His doctor should know better. False positives and false negatives are to be expected in all testing; even if the false positives are rare, they still occur.

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I have a friend who has “normal encephalitis” which is causing her dizziness. She had to have spinal tap and may need a brain shunt. I’m wondering whether maybe she had undiagnosed Covid. She lives in FL and has been dining indoors from time to time at restaurants. Otherwise she doesn’t know why she has this problem.

Seems encephalitis is a rare complication of covid in adults going back to the early days according to this review

Yes, thanks for that. Many viruses can cause encephalitis, coronavirus included. This is a different spike, so far only reported in kids with omicron. A physician recently admitted 3 teenagers, all healthy, over the course of 3 days. Several other pediatricians reporting, similar to the early rumblings of MIS when it started showing in kids. Increased enough that pediatricians are being notified that this could be an issue with omicron, to be on the lookout for it 2 weeks or so after Covid, and to please report to track.

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Yikes! That sounds scary! Glad it’s rare but really not a diagnosis anyone wants.

Page about Omicron, antibodies, vaccines, and T-cells:

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To piggyback on that article, the PCR test detects three SARS-CoV-2 genes, S gene, N gene, and ORF1ab gene. The current dominate Omicron variant (BA.1) has so many mutations in the S gene that it results in S gene target failure (PCR doesn’t pick it up).

The test is now reported in our lab as:

  • Omicron
    • Omicron interpretation: The SARS-CoV-2 N gene and ORF1ab gene but not the S gene were detected. This pattern is suggestive of the SARS-CoV-2 omicron variant.
  • Not Omicron
    • Not Omicron interpretation: The SARS-CoV-2 N gene, ORF1ab gene and S gene were detected. This pattern is consistent with a variant other than omicron.
  • Indeterminate
    • Indeterminate interpretation: Variant analysis cannot be determined.
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So I shouldn’t trust my negative PCR after having mild symptoms when my family members were positive? Or because one of them had a positive PCR I would have too if I had the same variant?

-super confused and super immune or not immune?

Update Mother PCR negative.

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Meaning this now (assuming you mean that the day 5 test result came back)?

Day Toddler Mother Father Grandmother Grandfather
0 Symptoms Contact Contact
1 Contact Contact
2 Tested (- rapid)
3 Tested (+ rapid)
4 Tested (- PCR(7))
5 Tested (- PCR(8))
6 Tested (- PCR(9)) Tested (- PCR(9)) Tested (- PCR(9))

Assumed: Toddler, Mother, Father in contact with each other daily. Grandmother and Grandfather contact with Toddler, Mother, Father as listed. PCR(N) means result gotten on day N.

Yes day 5 test, mother only did one test.

The paper was discussing mutations in various genes and how antibodies are failing to detect/attack these mutations. Omicron has marked antigenic drift (the more drift, the less effective antibodies, either naturally-occurring or vaccine-induced will be). I have a diagram somewhere showing the antigenic drift, I’ll see if I can find it.
My follow up post was saying the same thing but with PCR. PCR still detects all the variants, including omicron, but with omicron there are so many mutations in the S-gene (you can see it in a diagram in the paper) that PCR can’t recognize it anymore. But it will still be positive because it detects the 2 other genes.

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