COVID-19 PCR Results and Symptoms: A Patient's Inquiry

Positive result on rapid test for COVID-19 (Continuation Four)

Hello Dr.
Hong,
This week I underwent the fourth PCR screening, and the CT value has decreased again.
The report is as follows: SARS-CoV-2 Gene E: 33.06 (previously, the tested item was SARS-CoV-2 Gene RdRp with results of 23.25 on June 15, 26.30 on June 19, and 36.26 on June 29.
This time the report item is SARS-CoV-2 Gene E) SARS-CoV-2 ORF 1ab: 32.74 (21.26 on June 15, 22.96 on June 19, and 35.50 on June 29).

Physical symptoms: My sense of taste had previously improved, but recently I have started to lose it again.
My sense of smell still requires very strong odors, and I can only detect them when they are almost right next to my nose.
I still experience sudden headaches from time to time.
My menstrual period is 9 days late, and I have a lot of discharge (both light yellow and clear).
Sometimes I can feel the discharge about to come out and think about wiping it away with tissue, but sometimes I can't make it in time, and it drips on the floor (regarding my menstrual cycle: it was stable before I contracted the virus).
In the past couple of days, I have started to feel sudden pain in my left chest (around the area where the left breast meets the midline of the body).
My mind often feels dull, and I suddenly forget what I was going to say.
In the morning, my heart rate is around 68-80, and my blood oxygen level is between 97-98.

I would like to ask Dr.
Hong the following questions:
1.
What is the difference between the SARS-CoV-2 Gene E and SARS-CoV-2 Gene RdRp tests?
2.
Does the decrease in CT value indicate that the virus has regained activity in my body? Does this mean that my infectiousness has increased, or could it be a second infection?
3.
Do my physical symptoms indicate a worsening of my condition?
4.
Can COVID-19 affect menstrual cycles or gynecological health?
5.
Given that the only vaccine available in Indonesia is the Sinovac vaccine, does my current condition meet the criteria for vaccination?
Thank you, Dr.
Hong.

J, 30~39 year old female. Ask Date: 2021/07/10

Dr. Hong Yuanbin reply Internal Medicine

Hello,
1.
This refers to the detection of antigens at different locations of the virus.
The CT values of different reagents cannot necessarily be compared with each other.

2.
Since these are different reagents, this does not necessarily indicate a relapse.
Additionally, during the COVID-19 period, slight fluctuations in CT values are normal and do not necessarily indicate disease worsening.

3.
Based on your symptoms, as you described, you should gradually recover, so it is likely not a worsening or a secondary infection.

4.
It can indeed occur, but the extent of the impact varies from person to person.

5.
Currently, internationally recommended vaccines suggest vaccination six months after infection.
The Sinovac vaccine does not seem to have specific recommendations, but it is still advised to get vaccinated six months after recovery.

Thank you for your question.

Reply Date: 2021/07/10

More Info

Understanding COVID-19 PCR Results and Symptoms: A Patient's Inquiry
Hello, thank you for your detailed inquiry regarding your recent COVID-19 PCR test results and the associated symptoms you are experiencing. I will address your questions one by one, providing insights based on current medical knowledge.

1. Difference between SARS-CoV-2 Gene E and SARS-CoV-2 Gene RdRp Tests: The SARS-CoV-2 Gene E and RdRp tests are both molecular tests used to detect the presence of the virus. The Gene E test targets a different region of the viral genome compared to the RdRp test. The RdRp gene is often used in initial testing due to its sensitivity, while the Gene E test can be used for confirmation. The cycle threshold (CT) values from different tests are not directly comparable because they may vary based on the specific assay used. Therefore, a lower CT value in one test does not necessarily indicate a higher viral load when compared to another test.

2. Interpretation of Decreasing CT Values: A decrease in CT values can suggest an increase in viral load; however, it is essential to consider that fluctuations in CT values can occur for various reasons, including the timing of the test in relation to the infection phase. It does not automatically indicate that the virus has regained activity or that you are experiencing a reinfection. It is common for CT values to vary during recovery, and a lower CT value does not necessarily correlate with increased transmissibility. Continuous monitoring and clinical correlation with symptoms are crucial.

3. Symptoms and Disease Progression: The symptoms you describe, such as loss of taste and smell, headaches, and chest discomfort, can be associated with post-viral syndromes or lingering effects of COVID-19, often referred to as "long COVID." These symptoms do not necessarily indicate that your condition is worsening or that you are experiencing a secondary infection. It is essential to monitor these symptoms and consult with your healthcare provider for appropriate management.

4. Impact of COVID-19 on Menstrual Cycle and Gynecological Health: COVID-19 has been reported to affect menstrual cycles in some individuals. Hormonal fluctuations, stress, and illness can all impact menstrual regularity. The changes you are experiencing, such as delayed menstruation and unusual discharge, may be related to the stress of illness or the physiological effects of the virus. It is advisable to discuss these symptoms with a gynecologist for further evaluation.

5. Vaccination Eligibility Post-Infection: Regarding vaccination with the Sinovac vaccine in Indonesia, current guidelines suggest that individuals who have recovered from COVID-19 should wait at least six months after infection before receiving a vaccine. This recommendation is based on the understanding that natural immunity may provide some level of protection, but vaccination is still encouraged to enhance immunity. It is essential to consult local health authorities for specific guidelines regarding vaccination in your area.

In summary, your situation involves multiple factors, including the interpretation of PCR results, symptom management, and considerations regarding vaccination. It is crucial to maintain open communication with your healthcare provider to address your concerns and ensure appropriate follow-up. Monitoring your symptoms and seeking medical advice when necessary will help you navigate your recovery process effectively. Thank you for your questions, and I wish you a smooth recovery.

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