Weird case of covid (no antibodies, two possible infections)

[JollyRoger]

Hello,

I've caught COVID a month ago (PCR positive; CT 31,5, mild symptoms).
Fortunately, i found a doc who prescribed paxlovid because of my CFS and small fiber neuropathy so I started it the fourth day.
My PCR test was negative four and fifteen days after my infection.

I did an antibody test times as well (the first test two weeks after infection and the second after 3,5 weeks).
They were always negative.

Neither IgM nor IgG were positive.

Exactly one month after the infection I was positive again (PCR positive, CT of 29).
I'm more exhausted than usual and and I have sore muscles but beside that no signs of infection.


So is it a rebound or reinfection?

From what I've read rebound happens two to eight days after a course of paxlovid. In my case it would be three weeks. And there are no antibodies whatsoever.
The antibodies of my vaccine were around 500BAU and didn't rise further after the infection. (I'm vaccinated thrice btw...)

Should I take Paxlovid again?

Was the first test maybe false positive?

Maybe the immune response for the first infection was too weak because of Paxlovid so i was reinfected again (no antibodies). CT of 31.5 is quiet high and would be an explanation...


Thank you for you wisdom in advance...

 

[Alvin2]

Lack of antibodies despite vaccination and infection may be because your immune system is not creating them.
This is uncommon but its sometimes found in seniors and since ME is an immune condition its possible your body is currently unable to make antibodies to vaccines and infections.

This could be a very serious immune dysfunction. I assume you are not (untreated) HIV positive?

 

[JollyRoger]

Lack of antibodies despite vaccination and infection may be because your immune system is not creating them.
This is uncommon but its sometimes found in seniors and since ME is an immune condition its possible your body is currently unable to make antibodies to vaccines and infections.

This could be a very serious immune dysfunction. I assume you are not (untreated) HIV positive?

I'm so sorry for the the misunderstanding:
I mean, I have antibodies (around 500BAUs 10 months after the last shot) but it didn't rise during and after the infection.
I edited my post to avoid the confusion.

 

[Alvin2]

I'm so sorry for the the misunderstanding:
I mean, I have antibodies (around 500BAUs 10 months after the last shot) but it didn't rise during and after the infection.
I edited my post to avoid the confusion.

Ah, i understand.
It is confusing since you have positive tests, if you had negative tests you might have caught RSV which is going around (cold/flu season started very early this year).

 

[JollyRoger]

Ah, i understand.
It is confusing since you have positive tests, if you had negative tests you might have caught RSV which is going around (cold/flu season started very early this year).

This could be right for the first infection since the CT value was quiet high ( in Germany every value over 30 is considered to be not contagious) and the lack of antibodies after the infection.
But since Paxlovid rebounds are a big thing I'm still thinking about other options.

And I'm not sure if two rounds of paxlovid are good.
It's still an experimental drug.

 

[hapl808]

I think it's really hard to understand the Paxlovid rebound, or the rebound even without Paxlovid. Most people would stop testing once their test turned negative, so I wonder if we miss a lot of rebounds. I think it's interesting that almost every major government official who has taken Paxlovid has reported a minor rebound, but possibly it's because they have to get tested constantly even with no symptoms.

I wish we had easier ways to sequence infections, so we could see exactly what strain is involved. That could help determine rebound vs reinfection, etc. I'm quite disappointed in our lack of technological advancement after an initial jump. I thought almost three years in and we'd have a very different testing landscape, but it's largely the same as 2020 (although RATs were harder to source, but they still used the same technology).

 

[godlovesatrier]

As it happens @hapl808 in the UK the most immunocompromised can get WGS tested at Oxford and that showed persistence of the infection over the course of several months and years post infection. It was a study published 2 days ago. Really interesting.

So it can be done but I think most places lack the equipment.

They also showed that these patients tended to have one place in the covid genetic makeup mutate every 2 to 4 weeks. In the same way that HIV mutates in the host therefore becoming potentially more immune evasive over time and resistant to the bodys attempts at killing it. Which explains why ME patients with certain viruses don't get better on certain drugs and get worse as the years go by.