An Antibodies Mystery

In late April, I came down with COVID-19 and recovered. I feel very fortunate that I had a milder case and recovered without problems, but am still grappling with a resulting mystery.

3 aspects of a COVID-19 antibody test

In September, my doctor ordered an antibody blood test to see if I had protection against the virus several months later. Research has found thus far that most recovered patients have protective antibodies for COVID-19 five months or longer.1 The test had three aspects: antibodies that appear when a person is currently infected, antibodies for the virus when a person has a severe case (such as pneumonia), and longer-term antibodies for people who have recovered.

On all three I came up negative. Snake eyes! But we also had my husband Richard tested as he was sick right before me. And he came up positive for the longer-lasting antibodies! So we confirmed that I had the virus (it would be virtually impossible for me not to considering my and my husband’s COVID positive tests, plus his positive antibody test), but also that I didn’t have active antibodies.

RA patients COVID-19 antibody track record

My doctor said that most of his rheumatology patients who had the virus had later tested positive for the longer-term antibodies, so this was definitely puzzling. He said a few scenarios could possibly be in play.

3 possible scenarios

First, perhaps something about my biologic medication for my rheumatoid arthritis is suppressing my antibodies. This is not uncommon for people taking immune suppressing medication to have aspects of their immune system go quiet.

Second, perhaps my RA is messing with my antibodies. I have a very confused immune system that attacks and sleeps at inopportune moments of my life. It could be my RA is interfering with my antibody development.

Third, it could be that I previously had antibodies that already faded and were no longer detectable (possibly with the help of my biologic and RA issues). In this case, it may be possible to have a more sensitive test to pick up the antibodies. Or, it could be that my T or B immune cells have the memory of the virus and will create antibodies if I should have another exposure. While a test has been developed and is being tested for this type of immunity, unfortunately, it is not yet available.

Protecting immune system & COVID-19

While I wish I could get down to the bottom of this antibody mystery, there’s nothing more I can do right now to determine if my immune system will respond and snuff out another exposure to COVID-19. My doctor said, "You just have to continue being careful." I need to act like I never had the virus in order to continue staying safe from it.

So, I continue staying at home, wearing a mask when I do have to go out, and keeping a safe distance to keep myself (and others) safe from virus spread. I am fortunate that Richard tested positive for the antibodies so in some ways I feel I have a bit of a protective shield. While he continues to be careful, he can visit places like the pharmacy and feel a bit reassured that he can’t easily pick up the virus and pass it to me.

Surpressing rheumatoid arthritis

Perhaps one day we will be able to figure out my strange immune system. In the meantime, I have to do my best to suppress the RA and avoid infections like COVID-19 to keep as healthy as possible.

Thankfully, so far reinfections have been rare and reported only a couple of times. I’m hoping that between the pandemic precautions and my weird immune system, I can stay safe through these challenging times. In the future, I would love to learn more about my mysterious immune system and those disappearing antibodies.

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