Recent test results related to current Covid-19

[Davidcara]

If anyone is interested, posting recent experience

Had 3 Pfizer and two Moderna Vaccines, made zero antibodies. Was on ibrutinib during all vaccines

Had full dose Evusheld March 1st, seven weeks later had 740 antibodies

Infected with covid July 21, got Bebtelovimab July 22nd. Took 80 days to rapid test negative.

Got Moderna bivalent vaccine Oct 10, had low grade fever and felt achy for two days post. Was off BTKi therapy from July 22, and remain off therapy

November 1, had PCR, still positive. The PCR was required for tomorrow’s Evusheld injection. Not sure what will happen now with a still positive PCR and consistently negative rapid test

November 1, had Lab Corp Spike antibody test, result 192.0, Nucleotide antibodies zero

Not 100% sure what this all means. Thinking if I had any natural immunity from covid it is gone. Doubt I ever made natural antibodies but, will never know for sure.

I think for the first time I made some vaccine antibodies.

[gardening-girl]

David, I hope that you are able to get Evusheld tomorrow. Let us know.

It does look like you made some antibodies in response to vaccination, being that you tested negative for anti-nucleocapsid antibodies. I guess that means that being off BTKi therapy allowed your immune system to recover a bit. That's very encouraging. Apparently you haven't had any rebound from stopping Zanubrutinib. Is that right?

As I said keep us posted.😊

[Davidcara in reply to gardening-girl]

I was on ibrutinib for 2 years, transitioned to zanubrutinib for four months. So was on BTKi for approximately 28 months. Muted 13q, labs all good since July when I stopped Zanubrutinib. So yes, made vaccine antibodies, being off BTKi probably greatly helped. But only 194 antibodies but better than nothing.

Will see if ID clears me for Evusheld hopefully today

[Davidcara in reply to gardening-girl]

got the Evusheld

[Classicaljazz]

cdc.gov/coronavirus/2019-nc...

"After a positive test result, you may continue to test positive for some time after. You may continue to test positive on antigen tests [rapid tests] for a few weeks after your initial positive. You may continue to test positive on NAATs [PCR testing] for up to 90 days. Reinfections can occur within 90 days, which can make it hard to know if a positive test indicates a new infection."

And see:

labcorp.com/tests/160236/sa...

"The presence of antibodies specific to the SARS-CoV-2 viral nucleocapsid protein is consistent with natural infection as currently available COVID-19 vaccines induce antibodies against the viral spike protein receptor binding domain (RBD) only...It has also been reported that certain patients with confirmed infection do not develop SARS-CoV-2 antibodies. Furthermore, waning of antibody titers has been reported in some individuals within a range of months after infection, a feature which has also been reported for other coronaviruses."

Plus ongoing research is needed for the new BA.1 and other new variants regarding length of time for viral shedding/infectiousness -- see:

ncbi.nlm.nih.gov/pmc/articl...

"Early studies investigating Omicron variant viral shedding have found that this variant was cleared faster than the Delta variant [11] while others have found no difference in time to negative PCR post-symptom onset between Delta and Omicron variant infections [12]. Preliminary report evaluating Omicron infectiousness looked at specific time period, such as five DPSO [13]. Given the current pandemic context, it is essential to update isolation guidelines, which are still largely based on studies performed on previous SARS-CoV-2 variants that are no longer circulating."

[Davidcara in reply to Classicaljazz]

thanks classicaljazz, would be nice to have a negative PCR but, no control over that.

[Classicaljazz in reply to Davidcara]

A new article gives several examples of persistent vs. re-infection COVID cases with immunocompromised patients accessible for free by clicking on the PDF icon at: academic.oup.com/cid/advanc...

"We are now applying real-time WGS to characterise SARS-CoV-2 infection to guide patient-tailored treatment decisions. The workflow takes 24 hours from sample receipt to results, allowing expedited treatment decisions. In this brief communication we present 6 cases where real-time WGS showed utility in guiding treatment...

WGS TO DISTINGUISH CHRONIC INFECTION FROM RE-INFECTION.

Pre-emptive therapy is advised for immunocompromised patients with acute infection at high risk of developing severe disease[1]. Chronic infection with SARS-CoV-2 can also occur in immunocompromised patients[5] and the limited evidence around its management suggests patients may benefit from combination therapy and/or longer courses[6]. WGS can distinguish chronic infection from reinfection, by offering [whole genome sequencing] determining both the lineage assignment and non-lineage defining single nucleotide polymorphisms (SNP)[7]. Highly related genomes from longitudinal samples from one individual likely represent chronic infection rather than re-infection[7]. "

[Davidcara in reply to Classicaljazz]

Thanks Classicaljazz, I read the article I had a long reply but when I went to post it, it vanished. Anyways, I think we and the medical community are going to have several more years to try to figure this out, unfortunately.

[bennevisplace]

It could be that suspending treatment gave you a better chance to develop antibodies to the Oct 10 vaccine. Five months on, you should have some residual monoclonal antibodies too.

[Davidcara in reply to bennevisplace]

not sure how many monoclonals I would have after a covid infection, with positive rapid test for weeks. But anything is possible. I think being off BTKi was the biggest factor

[bennevisplace]

According to thelancet.com/journals/ebio... Evusheld was 14 times weaker at neutralizing Omicron BA.5 compared with the ancestral strain. I'm not sure if this means that many of the residual monoclonals would simply have ignored the antigen, thus surviving your late July infection to register on the Labcorp test.

[Davidcara in reply to bennevisplace]

I also had fever and feeling like bad for 36 hours after vaccine, which I did not have on five previous vaccines. Regardless, I feel 194.0 was from vaccine. Could some or all of those been from March Evusheld, sure but I do not so