Science Of Testing
The One Way To Know.
Covid-19 Antigen Testing
Novel swab 256
Covid-19 PCR testing
Covid-19 Qualitative and Quantitative Antibody Testing
Covid-19 Antigen Testing
The coronavirus has spike proteins that are homologous with all known strains in the world. The antigen test is useful at the point of care or even at home to determine if one is infected with the coronavirus. This antigen test is easy and usually less than 5 to 10 minutes to perform lending itself helpful as a screening modality. If a person is symptomatic and has a corona antigen test that is positive, then with very high probability the patient is infected with coronavirus. If the patient has not been tested with the coronavirus antigen test but had been symptomatic previously and recovering, then has an antigen test that is positive one can assume that the patient has had the coronavirus infection and is recovering. Serology test should be given concomitantly. In asymptomatic individuals that have been given the coronavirus antigen test which turns out to be positive then one can assume that the patient has been infected with coronavirus.
Medically we cannot tell when the infection occurred, but the patient is most likely infectious and will need repeat testing in a week to be sure the antigen has cleared. Serology test likewise should be given concomitantly. Individuals who have a negative coronavirus antigen test and are asymptomatic most likely have not recently been infected with the coronavirus. There are false negative tests meaning the antigen is present but the sample did not retrieve the antigen because of poor sample or the antigen is in such low concentrations the test could not detect the antigen. Serologic test should also be given concomitantly to these individuals. Therefore, a follow up PCR test that can measure a lower concentration of the virus should be done to rule out a false negative test. This type of testing needs to be done continuously until there is an adequate accuracy of the false negative rate of this particular coronavirus antigen test.
Other variables that need to be considered is the collection of the specimen through different types of swabs in the mouth or anterior nares. Ongoing testing will be done with different types of configurations of the swab as well as different materials to be able to collect a better specimen.
Covid-19 PCR testing
This type of testing also requires a good specimen collection and preventing degeneration of the virus and RNA overtime. The test requires the whole virus to be opened and the RNA intact inside so a copy can be made by a polymerase enzyme into DNA. The PCR test also has a limit of concentration that a virus can be measured. Therefore the PCR testing also has a false negative rate and is different in each of the types of products on the market and analyzer used. The PCR testing also has to be done in a Clia laboratory of moderate to complex types of analysis.
Novel swab 256
Most of the collection protocols for saliva, posterior pharyngeal and anterior nares utilize cotton swabs. New generations of swabs are being made with different configurations and with different polymers to help improve the collection rate for the coronavirus and corona antigen.
Covid-19 Qualitative and Quantitative Antibody Testing
Both qualitative and quantitative testing can be done. Serology testing should be done at the point of care when any testing is done such as the coronavirus antigen or any new type of testing coming to the forefront at the point of care or at home. The reason that the serology test is done in combination is that the individual will have an understanding they are sero-converting with IgM and IgG to neutralize the virus and in hopes the antibodies will be protective for future exposure to the coronavirus. The determination of titers of IgG by doing quantitative testing is helpful to possibly determine the timing of infection in the past as well as following the change in antibody tighter of IgG over the course of time. While following the titers of IgG over the course of time will help determine the length of possible immunity to the coronavirus in the individual.
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