Here is My Question:
If I think I had Covid 19, and my antibody test came out negative, is it possible that the Covid virus might just hang around in my body since my B cells have been depleted by Ocrevus?
COVID 19 Antibody testing
A recent Cochrane review (this is a specific type of analysis of multiple studies) reported that the rate of COVID19 positive antibody results 1,2 and 3 weeks after a known COVID19 infection onset was 30 %, 70 % and 90 % positive, respectively. More recent studies suggest that antibody responses wane over time, but a large study from NYU showed that antibody responses are still detectable in 90 % of people for more than 3 months. Generally, it appears that antibody response may drop more rapidly in people with mild infections. In these cases it is likely that a negative antibody test results occurs because the level of antibodies drops below the lowest level of detection NOT because there are no antibodies present anymore.
We have virtually no published data on antibody responses to SARS-CoV-2 in people with different levels of immunosuppression, either naturally (i.e. though aging) or as a result of medical therapies (such as Ocrevus).
So how does this relate to the COVID 19 virus lifecycle in your body? With mild infections the virus is not detectable in respiratory secretions after 10 days and with more severe infections it is usually not detectable after 20 days. This is the basis for current isolation recommendations.
There are reports of a small number of people who appear to recover from COVID 19 and then experience another infection. There are several possible explanations for these reports that researchers are trying to figure out. These cases could represent the same initial infection but with viral and antibody levels falling below the lower limits of detection before re-emerging. Alternatively, these cases could represent viral dormancy and latent infections. This is a common mechanism of viral persistence in the host, whereby the virus remains dormant (not reproducing) in certain cells (often in the nervous system) and later becomes reactivated. Think of the chickenpox virus (varicella) laying dormant and later getting reactivated to cause shingles as an example.
Hope this helps
Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego
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