Thread by @TheMenacheryLab

Gotten questions about reactivation/reinfection with #SARSCoV2 & wanted to see some data

But since data isn't a requirement these days for #COVID19 speculation, I'll offer:

I doubt this is some kind of herpes virus like latency/reactivation

RNA positive PCR is not live virus

So what is happening? Here are possibilities

1) These people hadn't cleared the virus in the 1st place

2) The viral RNA remains in debris/damage after virus is cleared & pushes + test as it is repaired

3) #SARSCov2 evolved a complex latency/reactivation mechanism

For 1) hadn't cleared the virus

Test sensitivity is dependent on quality of the sample & threshold of RNA observed.

If sample quality wasn't great the results could lead to false negative.

If low amount vRNA, it may also impact. Would want to know CT values to interpret

2) vRNA in debris/damage

We know #COVID19 causes huge lung/respiratory damage. How that is cleared is complex and may impact testing results.

Possible as debris is released and removed, PCR could go positive again. Here, PCR thresholds important for interpretations

3) #SARSCov2 has evolved a complex latency/reactivation mechanism

I guess it is possible. Herpes viruses are about 5X larger and code tons of proteins to mediate this. Could #COVDI19 evolve to do something no other CoV has ever done?

I'm not there without data.

I also want to understand why these people were tested again.
Did they have rebounding disease?
How many days out were they from initial onset?
Were they readmitted?
Did any of them progress to severe disease?
Did they have neutralizing serum AB?

Most important

Did they isolate live virus from these people?

Like has been said, viral RNA is not virus. If they are finding live virus weeks after the people have been released, I'll change my tune.

But viral RNA a few days after release make me want more data to evaluate.