Rogue antibodies involved in almost one-fifth of Covid deaths | Hacker News Reader

Rogue antibodies involved in almost one-fifth of Covid deaths

nature.com

176 pointsgmays85 comments

Purely anecdotal but my loss of taste,smell came nearly two days after the primary COVID-19 symptoms had passed; making me wonder about the role immune response played into those apparent after-effects. Tangentially related, an acquaintance of mine (62+, history of lung disease) had lung failure leading to lung transplant following their vaccination. Causation is clearly not guaranteed here but I am still left to speculate about the role of the immune system in these outcomes.

I'm the only person I know that had an adverse reaction to my 2nd dose (Moderna). About 2 weeks after the shot I had 2 weeks of 1-2 degree daily fevers and fatigue with no other symptoms. My docs made me take 2 separate covid tests across that time - both were negative. During the end of the fevers I developed tinnitus in one ear.

I'm under the strong impression right now that the tinnitus will never go away. Thankfully mine is not a tone but a constant humming, like a dishwasher or refrigerator.

But yeah, something weird can occasionally occur with a very small % of the population either from the disease or the protection.

That being said one of my colleagues at work - fully vaxxed - was infected by an un-vaxxed family member at a family reunion. He passed it onto another fully vaxxed work colleague. Both were sick for about two weeks and one lost his taste of smell. That was months ago. He says it has returned but only by about 50%.

Re being ill after being vaxxed - the vaccine doesn't stop you getting it, it reduces the risk of you dying from it. Likely, if they were really badly ill when vaxxed then they would have needed medical help, could have died.

To be clear, it also reduces your risk of infection.

It reduces your risk of infection taking hold, rather than being cleared fast by exposure to the pre-primed immune response ready and waiting.

macroscopically that can look like prevention of infection.

Would one know to get tested if they didn't have symptoms?

Increasingly nominally. Right now, the protection is about 50%. I expect it will continue to fall as the virus evolves.

50% is a lot from a public health perspective -- there's a huge difference in the exponent -- but not something you can rely on to keep yourself or your relatives safe.

So what you’re saying is: it reduces your risk of infection? :)

I agree that it’s waning, and likely boosters will help, but it is far better (and safer) than doing nothing; just doesn’t preclude the need to mask up around unvaxed folks, etc.

It doesn't preclude the need to mask up around vaxed folks either. Delta is spreading in part because vaxed folks stopped taking precautions, trusting in vaccines. That's not good for anyone. Vaxed folks won't get severe cases, but the jury is still out on long COVID. It also applies strong evolutionary pressure to vaccine-jumping mutations.

Note: Before anyone jumps on the above statement, I'm not trying to imply anything else. Vaxed folks who don't take reasonable additional precautions ARE a major source of spread COVID19. That's not meant as a comparative statement (unvaxed folks are ALSO a major source of spread).

Sure, fair point.

Nevertheless, vaccines do significantly still reduce your risk of infection. Agreed on the rest.

> About 2 weeks after the shot I had 2 weeks of 1-2 degree daily fevers and fatigue with no other symptoms. My docs made me take 2 separate covid tests across that time - both were negative.

And this is one of the maddening things about finding causality in disease. It might have been a reaction to the vaccine. Or you might have picked up an entirely unrelated illness on the same day as getting vaccinated... Because, for example, you had to stand in line with a handful of people and sit in the same chair as, perhaps, a couple hundred more, all of whom could have had God-knows-what.

You probably didn't have COVID because two tests came back negative, but without knowing what else it could be, doctors don't know what test to try to find what you did have. Usually, if enough people report similar symptoms, the CDC would do outbreak follow-up with the testing site to see if something got brought in and spread widely.

I got tinnitus in both ears after first dose of Pfizer (got a very strong reaction in general, was feeling sick and weak for about 3 days after first shot). Been hesitant about getting the second because I don't want it to get worse.

Interesting to read that I'm not the only one with this reaction. It's been 5 months now so I also assume that its permanent.

One person I know got high fever, 102-103F, after first Pfizer shot. No side effects whatsoever after the second shot. So, it’s all over the place.

I caught covid in 2020. One of the strange effects was tinnitus in left ear. The strange thing is I started noticing the 'ringing' almost right at same time I dimly perceived I was getting sick, when things were still just at 'mild headache' level.

I wonder if this is the work of spike protein causing some physical damage?

One of the interesting mechanisms is that the spike proteins poke out of already infected cells and activate a calcium-ion channel which ultimately triggers infected cells to fuse together so you get these massive cells with 20 nuclei all producing more virus and fusing other cells.

It seems like this mostly targets reparatory cells, but it's probably not great for hearing/smell if something similar happens to those cells.

https://www.nature.com/articles/d41586-021-02039-y

I also experienced tinnitus about two days after the second Pfizer dose. I had always had very mild tinnitus, noticeable only with specific attention in quiet rooms, and this was a clear increase that was noticeable in normal situations. I also had sensations of ear pressure and "fullness".

Went to see an ENT who basically said "Yeah, maybe the vaccine, weird, but we know nothing here." and offered no solution. I had a hearing test which showed a slight decrease in sensitivity at low frequencies, but still in the clinical range for "normal hearing", so there wasn't really much to be done.

In severe cases or those involving clear hearing loss, most people seem to think that oral steroids or steroid injections directly into the middle ear would be effective at reversing whatever inflammatory process is occurring and avoid long-term damage. Steroids have their own side effects, and to be effective, need to given as soon as possible. I had waited a bit to make the ENT appointment and didn't feel like my case was severe enough to ask for this.

Now two months later the ear sensations have gone away and the tinnitus is back to the mild level I experienced previously. But it was an unpleasant experience that I do not wish to repeat. I will probably avoid the booster if possible.

However, many people have also reported permanent hearing loss and tinnitus after contracting COVID. For all I know, getting the vaccine may have saved me from much more serious and long-lasting symptoms that would have come with an actual COVID infection. No way to know unfortunately.

Goddamn biology. Back to coding now.

In my case it was an undiagnosed long dormant bacterial tick borne infection that periodically became active and became worse the last couple of years. Subsequent treatment resulted in a heavy spike of symptoms i had long forgotten I once had years ago or accepted as the "normal" state. Of almost all of those symptoms I was unaware they might be somehow connected, one of them being Tinnitus in the right ear. There are probably lots of low level infections that cause no to only mild symptoms for years. My first BioNtech/Pfizer shot also triggered it again and some other funny symptoms that lasted for more than three weeks. Second shot will be next week.

Next time try Flonase up the nose, much less invasive than a shot into the middle ear.

> However, many people have also reported permanent hearing loss and tinnitus after contracting COVID

Thanks for pointing this out. It's definitely sad that people are having side effects to the vaccine, but most of the discussion about it seems to be implicitly asserting that the choice was either to get the vaccine, or go on without it while staying healthy indefinitely. Obviously that's not the case, the choice is to get the vaccine or eventually catch Covid unvaccinated and roll the dice with what might happen in that case, which by all indications is much more likely to lead to serious side effects than the vaccine.

There’s a third choice, which is not getting the vaccine because you already have natural resistance to COVID, such as through a previous infection with COVID. In this case, a vaccine could introduce unnecessary risk.

That’s the second choice. You’re just later on after catching COVID

It’s not the second choice though, since the initial state is different, and thus so are the risks and rewards of getting the vaccine.

What I'm still curious about is re: the risks of the naturally immune taking the vaccine. If they're immune, wouldn't they have fast deployment of antibodies to the vaccine-induced creation of the s-protein? Then surely it wouldn't be any greater risk than catching covid again, right? Meaning both situations (getting vaxx or getting covid again) would likely result in mild or no reaction (presuming an otherwise healthy risk profile). What am I missing?

One very small (but real) risk of the RNA vaccines is that it is quite difficult to dose the s-protein production. The amount of cellular uptake of the lipids envelopes, efficiency of ribosomes and many other factors play a role. The vaccine RNA is optimized to promote transcription. Someone who's cells are naturally happen to be great at transcription may create a lot more s-protein than someone else.

Too much s-protein can provoke a higher than optimal immune response which can also be dangerous.

Ok. I guess my question was: would it be safer for an otherwise healthy person that had covid and recovered to face covid again or to get the vaccine? And I guess the answer is: "it depends" - chiefly on which produces a larger viral load. And that might depend on how much virus you get sneezed into the open wound you're getting stitched up by the roadside Guatemalan doctor skimping on mask costs whose been feeling a wee bit snotty that afternoon. Or whether your cells produce more than is necessary and you have a bad immune response.

My mom had a bad case of COVID (13 days in the ICU). It affected her hearing. She said the hearing in her left ear would just cut out almost completely, and then later come back but not as strong as before. She went for a hearing test and they verified she had some hearing loss. She also experienced a number of other side effects but she's thankfully mostly back to normal now. You may have dodged a bullet by getting the vaccine, but like you said there's really no way to know.

I was stiff in my right leg the day after being vaccinated with AstraZeneca. I could hardly walk, although the effects wore off during the day.

You're not alone. Acute tinnitus (making it hard to sleep) is the most important symptom in a range of problems (many looking like allergy ones) my wife got at her second dose of Moderna. It's still here 2 months after the injection.

There are a few articles on the links between those vaccines and tinnitus but right now it doesn't look like a deeply studied problem, nor even one physicians are interested into.

> I'm the only person I know that had an adverse reaction to my 2nd dose (Moderna)

I don't _personally_ know anyone who died from COVID. Yet people are clearly dying from it. They are also sometimes getting adverse reactions to vaccines, up to and including death. Personal anecdotes are not data, however, and it's annoying and alarming that COVID deaths are inflated (got run over by a bus, but had COVID that only shows up at 40 PCR cycles? you died "with covid"), whereas vaccine adverse effects are carefully swept under the rug. It is also extremely counterproductive if the goal is to persuade people to get vaccinated, and it demolishes what little trust in the authorities people still had.

I wish responsible adults, and not political operatives (or former / future Big Pharma corporate board members), ran our health authorities such as the FDA and the CDC.

PS: I'm vaccinated, obviously, since I'm not an idiot.

Congratulations on pissing off every possible group with different parts of this comment. I upvoted you anyway.

In the age of lies telling the truth is a revolutionary act. We're most certainly being had, and a crisis is being put to a good use by the interested parties: politicians, businesses, banks/hedge funds, and plain ol' facebook/twitter mouth breathers who vie for popularity and likes. Adults have left the room decades ago, as far as I can tell, if there were any adults in the public sector in the first place.

Agreed: moral acts are received as evil. We are attempting to 'save our democracy' and 'protect everyone' and that always only ends in one place: totalitarianism. The paradox of sustaining safety/risk is where we need to sit. But the coordination (blind and ideological; I don't think any of it is evil) of media wanting clicks, politicians being paid means we all serve The Economy. Thank you for your comments!

> COVID deaths are inflated (got run over by a bus, but had COVID that only shows up at 40 PCR cycles? you died "with covid")

This is false and an annoyingly persistent myth. A death is only included in COVID statistics if it was one of the four contributing causes of death. If someone died from trauma such as a vehicle accident, but is found to have had COVID, that's not recognised as a contributing factor but merely incidental.

The WHO guidelines are very clear on this. [0]

[0] https://www.who.int/classifications/icd/Guidelines_Cause_of_...

Many people I know felt rotten for the twenty-four hours after the 2nd Moderna dose, and I was one of them.

That's interesting, my buddy got tinnitus from the J&J shot.

I also developed Tinnitus after the J&J shot. Both ears. The ringing was on and off for the first few weeks after the vaccine shot but at about 4-5 weeks was a full fledged in both ears. Was so loud at first I couldn't focus on anything because of the anxiety. I'm either used to it now or it's quieted down enough that I can at least get through my day. An ENT didn't help me out besides prescribing something that's typically used for insomniacs so that I can sleep at night.

In the flu pandemic of 1918, the group it was most dangerous for was the inversion of covid (and normal flu): healthy young people. Our best guess for why this is is that was because it caused a cytokine storm, which is basically an autoimmune response where the body ends up killing itself because the immune system goes way overboard.

Unfortunately while the general idea of cytokine storms had been floating around for quite a while, it wasn't named until 1993, and wasn't really studied as its own thing until 2002/2003. No chance they would have been able to do anything about it in 1918.

I read recently this might be linked to people who were exposed to the 1889 flu pandemic.

https://www.smithsonianmag.com/history/why-did-1918-flu-kill...

Maybe, maybe not. There is growing evidence that the 1889 pandemic wasn't caused by influenza at all but rather by another coronavirus.

https://ec.europa.eu/research-and-innovation/en/horizon-maga...

My understanding of the cause behind the longer-term loss of smell and taste is that it is related to damage to the cells that support your nerve cells. The nerve cells can function for some amount of time without that support, but will eventually start to die off, which causes the sensory loss. This suggests that the symptom could still be caused by damage from the infection, just in a way that has the potential to be a lagging indicator.

I've had such bad sinusitis that I've lost my sense of smell thus taste for months at a time. It came back slowly but it was awful. The treatment I use now is nasal cortosteroids to prevent an oncoming attack. But I do not dare suggest anything of course, considering.

Your comment has attracted a host of comments containing personal anecdotes from various people having different adverse experiences with different COVID-19 vaccines. What purpose do these comments (and yours) serve, except to divert attention away from science and towards personal anecdotes and rumor?

People like to share their experiences. Sharing them with people who experienced similar things gives that warm fuzzy feeling of community. One that we're not getting enough due to the pandemics.

A result is scientific not when experiments confirm it, but only when repeated attempts at disproving it all fail. Without the skeptics, the crackpots, the deniers, there is no science.

When vaccines are concerned, the skeptics have been censored and ostracized (generally speaking, not on HN). Therefore, whatever results are claimed to be science are not such, or at least not yet. Relying on anecdotes is the only recourse that we have to restore some semblance of scientific process.

The science is there to affect/improve/save people's lives. Those comments are talking about people's lives.

We should just be assigned numbers and allowed one pre proposed sentence by HN topic. Here "Science is great, keep up the good work".

I live in China, where we do that. You re welcome to join, something tells me you'll like it here.

Covid-19 symptoms coming in two waves is something I've heard from a few people, and anecdotally fits my experience - generic symptoms (body aches, fatigue, fever) cleared up, then about a day later my blood oxygen levels dropped sharply with no obvious symptoms (happy hypoxia). I wonder what causes this apparent pattern.

I had a positive PCR test during the first set of symptoms FWIW.

I hope anyone who has an adverse event related to a vaccine reports it to Health and Human Services (if you're in the US) or your respective gov't agency.

https://vaers.hhs.gov/reportevent.html

Patients can report adverse events. Even suspected adverse events can/should be reported. This is how rare side effects can be identified and evaluated. A single report of tinnitus is unlikely to be flagged, but 10,000 reports? Absolutely.

As someone whose heart was damaged by Rheumatic Fever, this looks fairly similar between what we’re seeing with Covid and Covid Vaccinations (heart inflammation)- immune response going after the body’s own proteins:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1905712/

That remind me of why antibiotics are used to treat Strep-Throat/Scarlet Fever. The antibiotics do not make a significant impact in the time it takes for one to recover from the bacteria. If I recall correctly, I think antibiotics speed up recovery by a day or two (someone correct me if I am wrong).

However, antibiotics are used to help prevent one from getting Rheumatic Fever from the bacteria.

Just in case anyone is concerned by the risk vaccination poses. The European Medical Agency recently reported that

* Pfizer-BioNTech - 145 cases of myocarditis and 138 cases of pericarditis out of 177m doses given

* Moderna - 19 case of myocarditis and 19 cases of pericarditis out of 20 million doses given

Five people died. The review said they were all either elderly or had other health conditions.

According to the CDC (as of August 18th) there are at least 742 cases of myocarditis and myopericarditis associated with vaccination, potentially upwards of ~1,300 [1].

For males age 16-17 the reporting rate of myopericarditis after 2 doses of Pfizer is 71.5 per 1 million doses administered (0.0071%) [1].

For males aged 18-24 the reporting rate after 2 doses of Pfizer or Moderna is ~37 per 1 million doses (0.0037%).

[1] https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-...

Is slide #7 showing 20 times higher myopericarditis than baseline for 18-24 year old males?

Are these numbers higher or lower than what we’d expect to see in terms of myocarditis and myopericarditis cases resulting from infection with COVID-19?

I’m genuinely curious as I haven’t been able to find a good comparison on my own but I have read that damage to heart tissue is a potential long-term complication resulting from natural infection.

Great question, I'm only aware of one paper that somewhat answers that question in a limited sub-population (college athletes). To truly answer that question we would need perform cardiac magnetic resonance imaging on a large population-representative sample. If anyone is aware of such a study please do share.

> Representing 13 universities, cardiovascular testing was performed in 1597 athletes (964 men [60.4%]). Thirty-seven (including 27 men) were diagnosed with COVID-19 myocarditis (overall 2.3%; range per program, 0%-7.6%); 9 had clinical myocarditis and 28 had subclinical myocarditis. If cardiac testing was based on cardiac symptoms alone, only 5 athletes would have been detected (detected prevalence, 0.31%). Cardiac magnetic resonance imaging for all athletes yielded a 7.4-fold increase in detection of myocarditis (clinical and subclinical). Follow-up CMR imaging performed in 27 (73.0%) demonstrated resolution of T2 elevation in all (100%) and late gadolinium enhancement in 11 (40.7%).

[1] Prevalence of Clinical and Subclinical Myocarditis in Competitive Athletes With Recent SARS-CoV-2 Infection https://jamanetwork.com/journals/jamacardiology/fullarticle/...

I wonder how far away we are from the future where a blood sample is able to predict your propensity for a huge range of possible ailments (from Alzheimer’s to the flu). Feels very sci-fi, but also within reach.

Elizabeth Holmes has something she'd like you to invest in.

The Authority Voice Changer(tm). Tiny hidden device that will deepen your voice to give it more authority.

That particular thing seems to be about someone feeling they have to change some superficial trait, to get past prejudices.

Probably depends on your definition of "huge range". It's already possible for several different ailments. Of course, there's only the incentive to do it if, upon knowing such a thing, you can do something about it.

This is already possible for certain genetic disorders.

For late-life diseases though, it's likely they are linked to exposure to something during the individuals lifetime (i.e. parkinson's disease from pesticide exposure) and genetic makeup can only predict probabilities for susceptibility.

Alzheimer's specifically is thought to be linked to chronic aluminum exposure (e.g. water treatment, antiperspirant deodorant, etc.).

Do you have any sources on the antiperspirant bit? I feel like this has entered the influencer zeitgeist, but antiperspirants have been around forever and I have yet to see any studies linking the two.

Antiperspirant has been linked to all sorts of things, so far with little to no evidence. A few years ago it was breast cancer. It seems to be a favourite target among the alt-inclined crowd.

I don't believe that your anecdote about aluminum exposure has been scientifically validated.

"At present, there is no strong evidence to support the fears that coming in to contact with metals through using equipment or through food or water increases your risk of developing Alzheimer's disease."

https://www.alzheimers.org.uk/about-dementia/risk-factors-an...

That's why I said "thought to" instead of "proven to". There is enough evidence to show that aluminum in drinking water accelerates Alzheimer's [1], while the antiperspirant is hypothesized, but not proven or disproven yet.

[1] https://academic.oup.com/aje/article/152/1/59/139168

I thought PD and Alzheimers were both related/correlated to a misfolded protein that no one understands why it fucks up?

I don't think there will be some massive change in the number one day. We can already detect some things in the blood. I suspect we'll just keep slowly adding things we can detect and eventually it will get cheap enough to make it worth doing for everyone.

your blood doesn't contain everything to fight every sickness just waiting around all day.

some molecules/enzymes/structures are only made in response to a disease- so i'd say analyzing DNA/RNA capability would be more useful than analysis what's currently floating around in the blood.

How do autoantibodies form and is there actually purpose for them - maybe moderating interferons? Are all interferon type 1 good or their number needs to be regulated? Perhaps it's ratio of interferon to autoantibody, not the actual number that is important?

Typically antibody-producing B-cells are screened for binding to self-antigens during their development inside bone marrow, where if they were the type to produce autoantibodies then they would be destroyed before even entering the body.

Antigen matching is rarely 100% exact though, and it's possible that an antibody match could have partial binding to existing normal body proteins, especially if the virus is using those proteins itself. Hypothetically that would lead to an autoimmune response in addition to an immune response to the virus.

True, but there is more to it then that, as even the B cells that leave the bone marrow are not hyper specific and capable of targeting multiple different antigens (they are still "naïve B cells"). The second level of differentiation that can result in highly specific antibodies does not occur until B cell activation.

I suspect this means the helper T cells also play a role in preventing generation of auto-antibodies (at least for T cell-dependent (TD) antigens).

And once the B-Cell is activated and forms a germal center to specialize, I'm not sure what if any negative selection system is used to prevent accidentally targeting autoantigens in addition the foreign antigen. (If an autoantigen is similar to the foreign antigen, then this seems like it is rather possible.)

The whole process is crazy complicated. Like most of biology, it seems like a miracle that it even works at all, much less that is seems to generally work rather well in general, despite the problems that can occur.

>I'm not sure what if any negative selection system is used to prevent accidentally targeting autoantigens in addition the foreign antigen

From an evolution perspective, it may improve survival chances to form antibodies with partial autoimmune match and beat the infection, rather than form less antibodies period. Also because the infection is an immediate death threat, while autoimmune disorders (like Celiac's) can be a major inconvenience that doesn't stop reproduction.

I was reading just yesterday that people with Sjogren's, an autoimmune condition, were more likely to end up in hospital with Covid. I'm sure there's lots of potential confounding factors that mean I shouldn't jump to conclusions, but as someone with Sjogren's it still worries me.

A month or so ago I read some papers about classical monocytes being turned into non-classical monocytes that do not undergo apoptosis by the s1 spike protein and that these antibodies are cytotoxic and live in your blood for up to 15 months, and build up with exposure to covid and the vaccine, and this was responsible for a lot of cardiovascular complications with both. Is this article related to that? Seems to use a lot of different language but it sounds similar, does anyone more knowledgeable on this topic have some insight to share?

A monocyte is not an antibody, so your article is at least a bit confused.

Now, is there a comparable study on long haul covid patients? I know detecting novel macromolecules (like antibodies) is not a perfected science, but having such a method would be a great boon for autoimmune disease studies.

I wonder if this can be used to engineer a test for COVID-19 susceptibility? It'd be helpful for people to know if they have enhanced likelihood to die from the disease if they contract it.

Which would be useful how? Seems like it would just encourage people to skip the vaccine.

Holy crap reading the replies here I'm really at a loss to imagine what an "UNSAFE and effective" vaccine would look like.

"Yeah Bob, got the flu shot yesterday and I can't hear, can't sleep, and can barely walk." WTF?

Yeah yeah yeah, downvote away.

Take this with a grain of sugar. We know so little about the human body.

This is a very large and carefully executed study. From the conclusions:

> A sample of more than 30,000 people is “too big to ignore”, according to Ring.

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