COVID-19 PCR Results and Managing Symptoms at Home

Positive Rapid Test for COVID-19 (Continuation 2)

Hello Dr.
Hong, I am a patient who tested positive for COVID-19 through a rapid test and PCR a few days ago.
Since my diagnosis on June 14, I have experienced some changes in my health.
Yesterday, June 19, I retested for PCR, and the report data is as follows: SARS-CoV-2 Gene RdRp: 26.30 (the first test was 23.25) and SARS-CoV-2 ORF 1ab: 22.96 (the first test was 21.26).
New symptoms include a significant amount of rash on my thighs that is spreading both upward and downward; I have lost my sense of smell and taste; the phlegm in my throat has changed from clear to yellow; I have nasal congestion and a heavy nasal voice; I have also experienced sudden headaches and pain around my eyes over the past two days (but the pain usually lasts only a few minutes); when lying flat, I feel a pulling sensation in my thigh muscles or tendons; my morning temperature ranges between 35-36°C, and my blood oxygen levels are around 97-98%.
Medications taken include: "triprolidine HCl 2.5mg, Pseudoephedrine HCl 60mg," along with "Acetylcysteine 200mg," and I have also taken "Qingguan No.
1" in between.
Due to the rash, I added one "cetirizine dihydrochloride 10mg" before bed.
(I initially took "Kenacort triamcinolone 4mg" for the first two days but later discontinued it.) I would like to ask the doctor: 1.
What do the two report values represent, and do they indicate a positive trend? 2.
My blood oxygen levels are currently within the normal range, but I would like to understand if a drop in numbers could lead to symptoms or if the rate of decline could be sudden? 3.
Can I continue to isolate at home and treat myself in this manner, or do I need to seek more aggressive treatment at a hospital in Indonesia? Thank you, Dr.
Hong.

J, 30~39 year old female. Ask Date: 2021/06/20

Dr. Hong Yuanbin reply Internal Medicine

Hello,
1.
The value you mentioned should refer to the CT value of the PCR test.
A higher CT value indicates a lower viral load, and values above 30 suggest that there is almost no transmissibility.
Therefore, based on your values, it seems you are gradually recovering.

2.
If the blood oxygen level is below 94%, it indeed indicates the possibility of silent hypoxia, which means that pneumonia may be starting to cause oxygen deficiency.
However, one may not necessarily notice this, so it is important to seek medical attention promptly.

3.
Given that the CT values are increasing and your blood oxygen levels remain above 94%, it is not necessarily required to seek medical care at this time; you can continue to monitor your blood oxygen levels.

Thank you for your question.

Reply Date: 2021/06/20

More Info

Hello! Thank you for your detailed inquiry regarding your recent COVID-19 experience and the associated PCR results. Let's break down your questions and concerns systematically.

1. Understanding PCR Results: The two data points you provided from your PCR test, namely SARS-CoV-2 Gene RdRp and SARS-CoV-2 ORF 1ab, represent different genetic targets of the virus. The RdRp (RNA-dependent RNA polymerase) gene is often used as a primary target for detecting the virus, while ORF 1ab is another region of the viral genome that can also indicate the presence of the virus. The values you mentioned (26.30 and 22.96) are the cycle threshold (CT) values, which indicate how many cycles of amplification were needed to detect the viral RNA. Lower CT values generally suggest a higher viral load. In your case, both values have increased compared to your previous test, which may indicate a decrease in viral load, suggesting that your body is clearing the virus. However, it is essential to interpret these results in conjunction with your symptoms and clinical context.

2. Monitoring Blood Oxygen Levels: Your blood oxygen saturation levels of 97-98% are within the normal range, which is reassuring. However, it is crucial to monitor these levels closely, especially if you notice any changes in your symptoms. A drop in oxygen saturation can occur rapidly in some cases, particularly if there is an underlying respiratory issue. If your oxygen levels fall below 94%, or if you experience increased shortness of breath, chest pain, or confusion, you should seek medical attention immediately.

3. Home Isolation and Treatment: Given your current symptoms and the fact that you are managing them with medications, it is reasonable to continue your home isolation and treatment as long as your symptoms remain manageable and you do not experience severe complications. The medications you are taking, including antihistamines and mucolytics, can help alleviate some of your symptoms. However, if your condition worsens or if you develop new symptoms, such as persistent high fever, difficulty breathing, or chest pain, it would be prudent to seek medical care at a hospital in Indonesia for further evaluation and treatment.

In addition to the above points, it is essential to maintain good hydration, rest, and monitor your symptoms closely. If you notice any new symptoms or if your current symptoms worsen, do not hesitate to reach out for medical advice.
Lastly, regarding your concern about the rash, it is not uncommon for viral infections, including COVID-19, to cause skin manifestations. If the rash becomes extensive, painful, or is accompanied by other concerning symptoms, it would be wise to consult a healthcare provider for further assessment.

In summary, continue monitoring your symptoms and PCR results, maintain your current treatment regimen, and seek medical attention if your condition changes. Stay safe and take care!

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