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Is it possible to have COVID-19 without testing positive for SARS-CoV-2? Yes!*
COVID-19 is the disease state post-infection with SARS-CoV-2. The disease state can last for many weeks after infection with SARS-CoV-2. (1/5)
The COVID-19 disease state can last long after a patient's body has cleared SARS-CoV-2, or has limited virus spread to low/undetectable levels.
How? COVID-19 is caused by the virus's assault, namely in the lungs. This assault takes weeks for a patient's body to repair... (2/5)
... And in many instances, the body's attempts to repair the damage can actually make the lungs worse off. This can lead to a feedback loop of inflammation, causing major restrictions in airflow that may never resolve, leading to death. (3/5)
SARS-CoV-2 is an acute infecting virus, and much of this occurs long after peak viral loads. Depending on how long after infection a COVID-19 patient seeks care, they may not have any detectable SARS-CoV-2 in them at time of admission. (4/5)
COVID-19 hospitalizations can last weeks, and the virus itself may never be detectable during this. The infection had already been cleared, but the damage was still ongoing.

*This applies to the SARS-CoV-2 PCR diagnostic and not the serology (antibody) test. (5/5)
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