Any connections between bibasilar atelectasis, autoimmune diseases, Covid infections and/or Covid vaccinations?

[Horsewhisper]

Hello everyone, just wondered if anyone has any info on the above? I had a CT scan in November of the abdomen to check out my bladder and kidneys and it picked up bibasilar atelectasis and nodules <3 cm in both lungs. I got the letter just before Christmas, so will follow up with GP in the New Year.

I have UCTD, GCA and PMR and I’ve had 2 bouts of Covid - the first in Oct 2021 which was fairly mild and the second in Sept 2022 which was more severe. I was very breathless and unwell for about 4 weeks. I had an antiviral infusion to help reduce symptoms and it worked very well. I also had a chest infection in Nov this year, after the CT scan and it was treated with antibiotics.

Regarding Covid jabs, I’ve had 4 to date - 2 very bad reactions (one allergic reaction with AZ and one neurological one with Pfizer, which is still being investigated.) I’m still deciding whether to go for the 5th or not. I’m struggling a bit at the moment with breathlessness and I’ve hit a PMR flare probably from overdoing it recently, so yesterday I increased Pred from 11 mg to 15 mg to help calm PMR symptoms. Oximeter reading daily average 95%.

Any suggestions gratefully received, thank you.

[SnazzyD]

No idea about the atelectasis but I heard on the radio or a podcast a piece about Covid effects on the heart and lungs. I have no idea if it has any bearing but it rang a bell because of your basal location. The consultant said that they regard Covid as a thrombosis forming disease (his term was far better) rather than primarily respiratory as such. What they were finding is that the base of the lungs are affected by micro clots that are formed as the virus enters via the blood stream and because of the way the blood enters the lung tissue it is undergoing maximum gravitational effect at that point so there is a concentration of Covid there hence a higher concentration of clots and affected lung tissue.

Regards the Covid vaccination, I wont be having any more unless there is a really good case like it being super effective for ‘modern’ variants because of the neurological effects I had with each one that got progressively worse with each vaccine.

[Horsewhisper in reply to SnazzyD]

Thanks Snazzy, most interesting to hear about Covid affecting the bottom part of the lungs, it may well have caused this partial collapse. Sorry to hear that you have been affected by the vaccine, such an unnecessary set of additional symptoms you can well do without. All the best wishes to you.

[PMRpro Ambassador]

healthline.com/health/bibas...

my.clevelandclinic.org/heal...

the second mentions Covid as a cause and the search results included a lot of mention of the Covid connection but not much for autoimmune diseases.

pubmed.ncbi.nlm.nih.gov/345...

mentions a rare association of the vaccine with interstitial lung disease but I can't find an association between that and bibasilar atelectasis. Who knows?

One of those (I think) mentions pred as the treatment ...

[Horsewhisper in reply to PMRpro]

Thanks Pro, these links are really helpful. It’s reassuring to read that it’s not considered serious and that one can recover from it. I suspect Covid is the culprit here…I hope you are well.

[Blearyeyed]

There is one study I'm aware of which demonstrated that bibasilar atelectasis could occur in up to 24% of patients with SARS-CoV-2 pneumonia, was more likely in patients whom also suffered from Autoimmune or autoinflammatory diseases of the lungs prior to COVID and those whom had reduced oxygenation during the early stages of treatment.There is continuing research into severe reactions to the COVID vaccines which also appear to show that patients with autoimmune conditions , or the genes responsible for making it more likely to develop an autoimmune condition , can have an autoimmune like reaction to the vaccination and more severe temporary side effects . Full papers and results are yet to be published.

The most recent dual vaccinations have caused some rare complications to do with liver function from my reading but I've not come across any research about kidney dysfunction as yet as it isn't an area I've had to look up so far.

If you are struggling and your oxygen levels are low I would suggest that you pace yourself very carefully , don't try and push yourself to fulfill festive obligations, and try the COVID breathing exercises through the day that can be found on YouTube to help the breathlessness until you can be seen for further treatment.

Make sure you continue to use COVID safety precautions to reduce the chance of you catching the virus a third time including use of masks in public spaces , limiting the amount of people you are in an internal space with and keeping it well ventilated. Hand washing , and, social distancing with people that spend a great deal of time with lots of people or in high risk jobs.

I still get my family to test themselves before coming to visit me and I don't have visits with people whom have been contact with someone whom is COVID positive in the 7 days beforehand, it isn't worth the risk in my situation.

As you have had issues with vaccines you need to carefully consider whether the benefits outweigh the risks for you with your unique health needs and past reactions. This is probably a decision that you need to make after getting a full diagnosis of your current lung issues and treatment needs. Discuss other options apart from Pfizer and AZ with your Specialist point out that you would not like to attempt use of these again because of previous side effects. It may be that they suggest you require a vaccination because of your current level of lung damage, as, if you got a third bout of COVID it could be even more severe than before. On the other hand , you may find that the reactions you have had would make it better to arrange an emergency care plan without a vaccination because it doesn't suit you , and with your GP ensure that you can call and immediately start on antiviral medications when you test positive , even if symptoms are mild.

Has anybody discussed the use of a nebuliser with you to improve your breathing ?

[Horsewhisper in reply to Blearyeyed]

Hi Blearyeyed, thank you so much for all this useful info, it’s really helpful. I am taking things easy at the moment and minimising contact with people outside of my immediate family. I mask up if I have to go into a shop and keep up with the sanitising etc. I definitely don’t want a third bout of Covid! I’ll have a chat with the GP about an alternative vaccine to the two I have had along with further investigations to the lung issue. Thanks again!