Post-COVID PCR Results and Ongoing Symptoms: Expert Insights

Positive result on rapid test for COVID-19 (continued three)

Hello Dr.
Hong, I am a patient who tested positive via PCR on June 15.
After self-isolating in Indonesia and taking Indonesian cold medicine for the first week, along with Qingguan No.
1 for about two weeks, and currently continuing with traditional Chinese medicine, my third PCR test result came out on June 29: SARS-CoV-2 Gene RdRp: 36.26 (23.25 on June 15, 26.30 on June 19) and SARS-CoV-2 ORF 1ab: 35.50 (21.26 on June 15, 22.96 on June 19).
There has been significant positive progress, but since the CT value in Indonesia needs to be greater than 40 to be considered negative, the report still indicates positive.
Currently, my symptoms include occasional dry cough, frequent headaches, fatigue, reduced sense of smell, and body rashes that are slowly subsiding.
I have a few questions for Dr.
Hong: 1.
Given that it has been over 14 days from June 15 to June 29 and the CT values are improving, does this still mean I am positive and potentially infectious? 2.
Will my body develop antibodies after being infected with the coronavirus, and how long will they last? 3.
Is it possible to get vaccinated now, or how long should I wait before getting vaccinated? 4.
Is it normal to still have symptoms, especially noticeable headaches, and I am concerned about developing a dependency on painkillers? Thank you, Dr.
Hong.

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

Dr. Hong Yuanbin reply Internal Medicine

Hello,
1.
Any case with a detectable CT value is considered positive, but the threshold for determining infectiousness and the criteria for ending isolation vary by country, with some countries setting the threshold at 26, 30, or even 40.
These are regulations specific to each country.

2.
Once infected, antibodies can persist for many years.
However, your concern may be whether reinfection can occur.
Current research suggests that approximately 1 in 4 individuals may experience reinfection.
Additionally, if the virus mutates, the protective efficacy of antibodies may be reduced.

3.
Theoretically, as long as symptoms improve, individuals can receive a vaccine to boost antibody response, but this is subject to local government regulations.

4.
Yes, this is normal.
Many individuals experience symptoms that can last for several weeks.
Thank you for your question.

Reply Date: 2021/06/30

More Info

Hello! Thank you for your detailed inquiry regarding your ongoing symptoms and PCR results following your COVID-19 diagnosis. Let's address your questions one by one, while also providing some context based on current medical understanding.

1. CT Values and Infectiousness: Your PCR results show a gradual increase in CT values, which indicates a decrease in viral load. However, it's important to note that a CT value above 40 is typically considered negative, and since your results are still below that threshold, they are classified as positive. This does not necessarily mean you are still infectious. The infectiousness of a person is generally highest during the initial days of symptom onset and tends to decrease as the viral load diminishes. While you may still have detectable viral RNA, it does not always correlate with the ability to transmit the virus. The CDC suggests that individuals can be considered non-infectious 10 days after symptom onset, provided that symptoms are improving and you have been fever-free for at least 24 hours without the use of fever-reducing medications.

2. Antibody Development: Following a COVID-19 infection, your body does develop antibodies against the virus. Studies indicate that these antibodies can be detected within a few weeks after infection and may provide some level of immunity. However, the duration of this immunity can vary significantly among individuals. Current research suggests that antibody levels may decline over time, but T-cell immunity may persist longer. It is still unclear how long this immunity lasts, and reinfections can occur, particularly with new variants.

3. Vaccination Post-Infection: It is generally recommended to wait at least 3 months after recovering from COVID-19 before receiving a vaccine. This is to allow your body to fully recover and to ensure that the vaccine can elicit a robust immune response. Given that you were diagnosed on June 15, you may consider getting vaccinated after September 15, assuming you have fully recovered and are symptom-free. Vaccination after infection can enhance your immune response and provide broader protection against variants.

4. Ongoing Symptoms: Experiencing lingering symptoms after a COVID-19 infection, often referred to as "Long COVID," is not uncommon. Symptoms such as fatigue, headaches, and reduced sense of smell can persist for weeks or even months after the initial infection. The exact cause of these lingering symptoms is still being studied, but they may be related to the body's immune response or residual effects of the virus. It is advisable to monitor your symptoms and consult with a healthcare provider if they worsen or if you have concerns about taking pain medications regularly. They can help assess your situation and suggest appropriate management strategies.

In conclusion, while your PCR results indicate a positive status, the increasing CT values suggest a declining viral load, and you may not be infectious. Your body is likely producing antibodies, but the duration of immunity varies. It is advisable to wait a few months before vaccination and to monitor your ongoing symptoms closely. If you have any further concerns or if your symptoms persist, please consult your healthcare provider for personalized advice. Thank you for your questions, and I hope this information helps clarify your situation!

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