{"id":18640,"date":"2020-04-05T14:11:53","date_gmt":"2020-04-05T19:11:53","guid":{"rendered":"http:\/\/thepapergown.zocdoc.com\/?p=18640"},"modified":"2023-03-06T11:15:47","modified_gmt":"2023-03-06T16:15:47","slug":"why-antibody-testing-matters-so-much-in-the-fight-against-coronavirus","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/advice\/why-antibody-testing-matters-so-much-in-the-fight-against-coronavirus\/","title":{"rendered":"Why We Need Antibody Testing to Fight the Coronavirus"},"content":{"rendered":"

Coronavirus information changes quickly, so please note the publication date on this story. You can find current<\/em> recommendations and national outbreak data on the CDC<\/a> website. Or, if you want local coronavirus updates and stats, check out the department of health website for your state<\/a> or your city<\/a>. Enjoy reading and stay safe.\u00a0<\/em><\/span><\/p>\n

\n

So far, most patients being tested for COVID-19 get a nasal swab to see whether they\u2019re positive or negative. But another testing tool is now making its way into doctor\u2019s offices: serological tests, which examine the blood to detect antibodies created in response to COVID-19. Serological tests, sometimes called antibody tests, can help identify people who were infected with the coronavirus but either never developed symptoms or only developed mild symptoms without realizing what they were. This type of testing is important because it can help us get a clearer picture of how widespread the virus is \u2014 especially since asymptomatic cases of COVID-19 appear to be a lot more common<\/a> than epidemiologists originally thought.\u00a0<\/span><\/p>\n

Manufacturers have been scrambling to make test kits that analyze blood taken from a vein, as well as a rapid finger-prick test kit. <\/span>Coronavirus antibody tests are <\/span>already being used in Asia<\/span><\/a>. In the US, <\/span>the <\/span>FDA recently authorized the first coronavirus antibody test<\/span><\/a>, which requires blood drawn from a vein. The status of the various tests that are currently in the works is rapidly evolving.\u00a0<\/span><\/p>\n

\u201c<\/span>It\u2019s kind of like the wild wild West right now,\u201d says Dr. Cheng Ruan, an internist at the Texas Center for Lifestyle Medicine. \u201cThis is all very new to the US. Everyone\u2019s in a race to do it.\u201d<\/span><\/p>\n

Serological tests might also offer a lifeline to critically ill COVID-19 patients. In Texas, Houston Methodist Hospital became the first<\/span> academic medical center in the country to transfuse donated blood plasma from a recovered COVID-19 patient to a critically ill one, hoping the antibodies will help them recover. In China, five critically ill coronavirus patients <\/span>improved after receiving plasma transfusions<\/span><\/a>.\u00a0\u00a0<\/span><\/p>\n

Ruan\u2019s office is among the first in the country to start testing patients\u2019 blood for coronavirus antibodies. We asked him to explain<\/span> the different types of tests that are currently being offered, what\u2019s in development, how tests work, what they tell doctors and how long they take.<\/span><\/p>\n

\n

The primary test right now is a swab test. How does it work?<\/h3>\n

(Dr. Ruan) <\/em>You\u2019re looking for<\/span> genetic material from the virus, or RNA. It entails putting a nasal swab in your nose all the way up to the sinuses. It\u2019s not only uncomfortable, but you need a health care practitioner to do it right. It\u2019s labor intensive. Plus, if you\u2019re not forming enough mucus, you may not even be able to detect the RNA that’s in there, so you might have false negatives. That\u2019s a downside. Results can take several days<\/span> to come back. There\u2019s one company coming out with an at-home swab, but it\u2019s not available right now for the general public.<\/span><\/p>\n

What does the blood test look at?<\/h3>\n

It\u2019s different because it doesn\u2019t test for the presence of the virus, but instead how your body responds to it from previous exposure. Serological tests look at<\/span> immunoglobulins; they\u2019re the bullets of our defense system. Within three to seven days of contracting this virus, your immune system will start to try to fight it off. It does that by producing antibodies against specific parts of the virus. One is IgM; it\u2019s the largest antibody and the first to appear in response to toxins and viruses. As IgM continues to go up, our bodies then start producing another antibody, IgG. [It\u2019s] like a heat-seeker missile against the virus. That too shows you were exposed to the virus and you\u2019ve developed defenses against it.\u00a0<\/span><\/p>\n

Why should we test patients\u2019 blood?<\/h3>\n

The benefit of testing immunoglobulins is that you can now stage where you are with the disease. If you have IgM against the virus \u2014 the first antibodies to develop \u2014 but not IgG, then we can assume you\u2019ve had a recent exposure. It hasn\u2019t been long enough for you to produce IgG. So then we can think about who you were in contact with recently and we can identify those people and start reaching out to them right away.<\/span> I\u2019ve already tested a few dozen patients and sent the samples to the lab for analysis. It\u2019ll take about three to four days to hear back. The standard for this testing should be labs that have the most broad analysis of immunoglobulin toward different parts of the virus.<\/span><\/p>\n

What can results tell us?<\/h3>\n

We\u2019re probably going to find out more people have been exposed to the virus than we originally predicted, and that it\u2019s been in the US a few months longer than we thought. One issue is that right now there are no official guidelines about what to do with results. I\u2019m working with infectious disease, critical care and ER doctors around the world to try to come up with guidelines.\u00a0<\/span><\/p>\n

Another benefit might be that blood plasma could help critical COVID-19 patients. How does that work?<\/h3>\n

If a person tests with a high level of IgG, that means they\u2019re actively producing heat-seeker missiles against the virus, and they can potentially save someone else\u2019s life through a transfusion process. There could be a lot of people out there harboring life-saving immunoglobulins.\u00a0<\/span><\/p>\n

What about drawbacks to the blood test?<\/h3>\n

The downside of testing immunoglobulins is that people who assume they might be immune to the virus may not self-isolate. You might be immune toward one part of the virus, but it could mutate and you could pick up a mutated chain. So it still means stay at home. It doesn\u2019t mean don\u2019t wear masks and gloves. All it means is that you\u2019ve been exposed in the past and you developed an immune reaction.<\/span><\/p>\n

There\u2019s also a finger-prick test in the works. How is that different?<\/h3>\n

That also tests for<\/span> immunoglobulins, and results are much much faster, around 10 to 15 minutes. The whole idea is to abandon the blood draw, because it still requires people to come into a doctor\u2019s office. A finger stick test could be ordered by a doctor and done at home, then follow-up could be done by telemedicine.\u00a0<\/span><\/p>\n

These tests will be readily available. We\u2019re close to this. Everybody should get a finger-prick test. (<\/span>One finger-prick test ordered by the UK<\/span><\/i><\/a> works much like a home pregnancy test. Blood drops are added to a sample well, and lines appear that show a negative result, IgG detection or IgM detection.<\/span><\/i>)<\/span><\/p>\n

Patients haven\u2019t been paying for nasal swabs. Is insurance also covering blood tests?<\/b><\/h3>\n

Insurance companies haven\u2019t created a procedural code to cover them. That might change in the next few weeks though. That’s a big possibility.\u00a0<\/span><\/p>\n

You\u2019re also working to set up a national monitoring program for high-risk patients. Tell us more about that.<\/h3>\n

Here in Houston, we recently set up stations in our parking lot to enroll Medicare patients in remote monitoring. We also enrolled people across the country. In total, a few hundred have signed up. We took their baseline oxygen reading, and then we have them self-monitor at home with a pulse oximeter, which measures heart rate and the level of oxygen going into your lungs. <\/span>(Some patients with severe cases of COVID-19 develop serious respiratory infections and need supplemental oxygen.)<\/span><\/i> Then we follow them. If we see anything abnormal, we reach out to them.\u00a0<\/span><\/p>\n

We\u2019re the first ones to do this, and I\u2019m trying to launch a national platform for doctors to monitor high-risk patients. I see this type of emergency prevention medicine continuing. COVID-19 is not a one-time thing. We know this isn\u2019t the last time [something like] this is going to happen.<\/span><\/p>\n

\n

This interview has been condensed and lightly edited.<\/i><\/p>\n

\n

Ready to book a doctor’s appointment? Visit Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"

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