Abstract
Research studies comparing antibody response from coronavirus disease 2019 (COVID-19) cases that retested positive (RP) using reverse transcription polymerase chain reaction (RT-PCR) and those who did not retest positive (NRP) were used to investigate a possible relationship between antibody response and retesting status. Seven data bases were searched. Research criteria included cohort and case-control studies, carried out worldwide and published before September 9, 2020, that compared the serum antibody levels of hospitalized COVID-19 cases that RP after discharge to those that did NRP. There is some evidence that immunoglobulin G (IgG) and immunoglobulin M (IgM) antibody levels in RP cases were lower compared with NRP cases. The hypothesis of incomplete clearance aligns with these findings. The possibility of false negative reverse transcription polymerase chain reaction (RT-PCR test results during viral clearance is also plausible, as concentration of the viral ribonucleic acid (RNA) in nasopharyngeal and fecal swabs fluctuate below the limits of RT-PCR detection during virus clearance. The probability of reinfection was less likely to be the cause of retesting positive because of the low risk of exposure where cases observed a 14 day-quarantine after discharge. More studies are needed to better explain the immune response of recovered COVID-19 cases retesting positive after discharge.
Highlights
Coronavirus disease 2019 (COVID-19) is a novel disease that results from infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]
There is some evidence that immunoglobulin G (IgG) and immunoglobulin M (IgM) antibody levels in retested positive (RP) cases were lower compared with not retest positive (NRP) cases
The possibility of false negative reverse transcription polymerase chain reaction (RT-PCR) test results during viral clearance is plausible, as concentration of the viral ribonucleic acid (RNA) in nasopharyngeal and fecal swabs fluctuate below the limits of RT-PCR detection during virus clearance
Summary
Coronavirus disease 2019 (COVID-19) is a novel disease that results from infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. The cause of the disease was later confirmed to be a novel coronavirus [2]. The SARS-CoV-2 outbreak was declared a pandemic by WHO on March 11, 2020 [3]. As of October 14, 2020, 75% of the 38,508,475 internationally confirmed cases of COVID-19 have recovered [4]. There is evidence that some recovered COVID-19 cases discharged from hospital with negative COVID-19 tests later retested positive (RP) [5]. Research studies comparing antibody response from coronavirus disease 2019 (COVID-19) cases that retested positive (RP) using reverse transcription polymerase chain reaction (RT-PCR) and those who did not retest positive (NRP) were used to investigate a possible relationship between antibody response and retesting status
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