Tests for coronavirus

Coronavirus antibody testing

Coronavirus is a highly contagious pathogenic viral infection caused by SARS-CoV-2. Some sufferers are asymptomatic but still pass the virus on to the people around. In other cases, the disease may assume a very hard course and even lead to death. Therefore, it is so important to have your health tested in this regard. Below, you may find the solutions offered by Damian Medical Centres and information on different types of currently available tests and their application.

There are three types of laboratory tests available for SARS-CoV-2:

Damian Medical Centre offers:

The genetic PT-PCR test – swab collection at home by a nurse
in Warsaw

Price: PLN 780*

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The genetic PT-PCR test – swab collection in mobile
collection points

Price: PLN 450*

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The genetic PT-PCR test – a set for self-collection of the swab with delivery all across the country

Price: PLN 450*

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Screening genetic tests FRANKD
in mobile collection points

Price: PLN 250*

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The serological examination detecting IgM antibodies available in the centres of Centrum Medyczne Damiana

Price: PLN 120*

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The serological examination detecting IgG antibodies available in the centres of Centrum Medyczne Damiana

Price: PLN 120*

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Learn more:
Serological test for the presence of antibodies
Damian Medical Centre's recommendations on types of serological tests
Antibody testing for SARS-CoV-2 virus at Damian Medical Centre
Interpretation of results and medical recommendations
RT PCR test
Preparing the patient for the PT-PCR test
The offer of PT-PCR tests in Damian Medical Centre
Molecular screening test FRANKD
Antigen test
Scientific facts about SARS-CoV-2

Serological test for the presence of antibodies

The purpose of this test is to check whether our body has produced antibodies against SARS-CoV-2.

The IgM class of antibodies (the so-called acute phase antibodies) are the first to appear in the course of infection. They can be detected on day 7 or later, i.e. after 12 days of infection at the earliest. They persist for different periods of time for many weeks, although their level gradually decreases.

The IgG class of antibodies are the second type of antibodies. They appear after another 7 days of the disease, persist longer than IgM antibodies, and it is now believed that they can protect most people from the next SARS-CoV-2 infection. This opinion is based on an analogy with other viruses in this group. Unfortunately, it is not established yet, for how long this protection is possible.

Serological diagnostics may be of particular importance in people with asymptomatic infection or with only mild symptoms. Determining the optimal time to perform serological tests is based on the phenomenon of the "serological window" (in the case of COVID-19 this is 7-14 days).

The latest Polish diagnostic, therapeutic and organisational recommendations for treating individuals infected or exposed to SARS-CoV-2 infection issued on 23 April 2020 say that the primary indications for serological tests are conducting epidemiological investigations and retrospective diagnosis of SARS-CoV-2 infections to estimate the number/percentage of people who have had contact with the virus, as well as population studies.

According to these recommendations, the basis for determining the absence of infection is confirmation of anti-SARS-CoV-2 IgG antibodies production based on a reliable serological test combined with a negative result of the RT PCR test.

It is important to remember that:

  • testing negative for these two IgG and IgM classes of antibodies does not mean that the patient is not currently infected, this is done with the RT PCR test,
  • testing positive for IgM and IgG in the blood requires the exclusion of the current possibility of infection by an additional RT PCR test, because despite the presence of antibodies at a later stage of the disease, the virus can still be detected in secretions,
  • a positive IgG and negative IgM result may with high probability indicate a past and completed infection, but for absolute certainty it is recommended to additionally perform the PCR RT test and a negative result will exclude continued infection.

Results of serological tests should be consulted with a doctor.


Recommendations of the Damian Medical Centre regarding different types of serological tests

  1. Rapid Test Cassette - from either capillary or whole blood

They are produced by many companies unknown in Poland and they have not been validated in Poland. Until the diagnostic reliability improves, the use of the qualitative Rapid Test Cassette (immunochromatographic) tests for anti-SARS-CoV-2 antibodies is not recommen­ded. Therefore, the DMC Medical Department does not recommend these tests, cannot indicate any company whose tests would be qualitatively better than others and does not take responsibility for the interpretation of their results.

  1. Blood tests using the immunoenzymatic ELISA or chemiluminescence method from blood or plasm

Tests of confirmed laboratory quality are venous blood tests by immunoenzymatic (ELISA) or chemiluminescence method performed in certified laboratories. DMC Medical Department confirms that the presence of IgG anti-SARS-CoV-2 antibodies diagnosed with these tests in combination with a negative RT PCR molecular test result can be the basis for determining antibody production, prior infection, healing, and current absence of infection.


Test for antibodies against SARS-CoV-2 virus at Damian Medical Centre

At Damian Medical Centre the tests for antibodies against SARS-CoV-2 virus are performed by the chemiluminescence (CLIA) method:

  • Quantitative test for IgM antibodies against SARS-Cov-2 by the CLIA method
  • Quantitative test for IgG antibodies against SARS-Cov-2 by the CLIA method

The sample material is venous blood. The specimens are taken at all Damian Medical Centre collection points during opening hours, with the hours preferred for anti-SARS-COV-2 antibody tests being 12:30-14:30.

Tests can be performed at the patient's request, a referral from a doctor is not required. There is no need to fast before blood draw. The cost of the tests is PLN 140 (for each immunological class).*

Turnaround time: 2 business days.

Interpretation of serological tests

  • IgM (-), IgG (-): no antibodies produced against SARS-CoV-2 - no current infection, or an asymptomatic infection phase not excluded,
  • IgM (+), IgG (-): no anti-SARS-CoV-2 antibodies in IgG class; present IgM antibodies that may indicate current infection - likely ongoing coronavirus infection. Necessary sick leave and social isolation as well as performing the RT PCR test - in the case of a positive result, information should be sent to the Poviat Sanitary and Epidemiological Station competent for the patient's place of residence for quarantine,
  • IgM (-), IgG (+): quite high probability of past and completed infection. There are no indications for social isolation and sick leave. In order to ensure the absence of infection, it is necessary to perform an RT PCR test - in the case of a positive RT PCR result, information should be sent to the Poviat Sanitary and Epidemiological Station competent for the patient's place of residence for quarantine.

In the case of positive or doubtful results, it is recommended to visit or contact a GP via a teleconsultation to discuss the results of the tests and further proceedings.


RT PCR test

The purpose of RT PCR is to detect the presence of a virus in a secretion taken from the throat or nasopharynx. A positive result for the presence of a virus indicates infection in the subject tested.

Molecular tests involving a throat or nasopharyngeal swab detecting the genetic material of the virus approximately 2 days before symptoms appear, during illness and during recovery.

If a virus is detected, it is necessary to follow the guidelines of the Poviat Sanitary and Epidemiological Station (Powiatowa Stacja Sanitarno-Epidemiologiczna, PSSE) competent for the place of residence of the individual in order to report such a result and comply with further recommendations, including quarantine or a recommendation to stay at an infectious hospital.

Please note that the result reflects only the state at the time of material sampling. One result can be negative, and after several hours the next one can be positive. This is due to the amount of virus in the blood and the ability to detect virus presence by this method. The result must always be consulted with the doctor and PSSE in the context of the clinical condition of the examined individual (symptoms, contacts with other people).

According to WHO recommendations, this is the only test recommended by the Medical Department of DMC to determine the current presence of SARS-CoV-2 coronavirus and widely used in Poland by sanitary and epidemiological services.

Preparing the patient for the PT-PCR test:

  • The swab should be taken in the morning, on an empty stomach, or about 4 hours after the last meal.
  • Do not smoke, brush your teeth, use mouthwash, throat lozenges or chewing gum for 4 hours before collecting the sample.
  • The swab should be taken at least 2 hours after taking nasal antimicrobials (drops, ointments, sprays).
  • Do not rinse or blow your nose before the sample collection.
  • Removable dentures should be removed before sample collection.

The offer of PT-PCR tests in Damian Medical Centre

  1. A swab for SARS-CoV-2 in the Collection Point at ul. Nowolipie 18 in Warsaw.

The tests are performed on the spot, in compliance with all epidemiological procedures and safety rules. The Collection Point is located in a special part of the building with a separate entrance so that the people entering this place stay away from contact with other patients. To use the services offered by the Point, schedule your visit for a concrete hour (admission every 10 minutes), by calling our Hotline at 22 566 22 22. The test should be paid for on-line HERE (for sanitary reasons, it is not possible to pay on the spot).

The cost of the test is PLN 450*.

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  1. The set for self-collection of the swab for SARS-CoV-2

We deliver the swab self-collection set straight to the patient’s door all over the country. After you take the swab, the courier collects the parcel and delivers it to the laboratory. Thanks to this solution, the potentially positive patients do not have to leave their homes, stay in the queues at the post office or wait in the doctor’s office, which helps to limit interaction with other patients (also potentially positive) and prevents the imminent spread of the virus. 

The cost of the package is PLN 450*.

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For more information, please visit page COVID-19 test.

  1. SARS-CoV-2 PCR smear test at the patient's home

The SARS-CoV-2 PCR smear tests are carried out at patients’ homes in Warsaw. Our nurse, wearing protective overalls, arrives by special transport at the designated location. She collects the sample for examination and brings it to the lab. Results take up to 48 hours.

The cost of the nurse’s visit along with the test is PLN 780*.

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Interpretation of molecular test results (PT-PCR)

In the event the virus is detected, it is necessary to follow the guidelines of the District Sanitary and Epidemiological Station (PSSE) competent for the place of residence of the person infected, in order to report the result and follow further instructions, including quarantine or necessary stay in hospital isolation ward.

Follow-up tests for infected people

A follow-up test is performed at least 10-14 days after the first positive test for SARS-CoV-2 infection. Two negative results obtained from swabs taken at least 24-48 hours apart confirm the elimination of the virus from the respiratory tract. Due to the fact that excretion of the virus with faeces takes longer, it is necessary to continue the increased health regime for another 7 days.


Molecular screening test FRANKD

It is a genetic screening test that offers a new, quick and effective method for detecting the SARS-CoV-2 virus, developed by Polish scientists from the GeneMe laboratory. The tests are CE- and IVD-certified, and comply with WHO guidelines.

A positive result of the FRANKD screening test is confirmed by the genetic RT-PCR test (without the Patient incurring any additional costs of the test), and the analysis is carried out using the material collected during the screening test. As a result, there is no need for the Patient to have another appointment.

Features of a molecular screening test:

  • It detects the genetic material of the virus.
  • It has a specificity of 100% and sensitivity of 97%.
  • Identifies one gene using six primers.
  • It has CE and IVD certfificates in compliance with the European standards.
  • It uses a patented polymerase enzyme (patent No. P.426093).

The FRANKD molecular screening test uses the patented polymerase enzyme and detects the RNA of the SARS-CoV-2 virus through isothermal amplification of nucleic acids, without the need to use changing temperature cycles. It is a genetic test conducted at a constant temperature, contrary to the standard PCR tests. This means a considerable reduction of the test duration and the waiting time for the result.

The primary material for the test is the pharyngeal swab. The cost of the test is PLN 250*.

For more information, please visit page Screening genetic tests for COVID-19.


Antigen test

The antigen test detects viral antigens, i.e. structures recognised by the human body as foreign, which stimulate the immune system to function. Antigens are only detectable at the initial stage of the disease, when the virus is actively multiplying, and these tests could be used at this stage. Currently - due to the lack of proper validation - they are not recommended as a method of detecting SARS-CoV-2 infection.


Scientific facts about SARS-CoV-2

Is SARS-CoV-2 similar to common cold and flu viruses?

COVID-19 is caused by the SARS-CoV-2 virus, whose genome is a single strand of RNA. One of the interesting aspects of coronaviruses is that they have the largest genomes of all known RNA viruses (≈ 30 kb). These large genomes led researchers to suspect the presence of a “proofreading mechanism” to reduce the mutation rate and stabilise the genome. This relatively low mutation rate will be of interest for future studies predicting the speed with which coronaviruses can evade our immunisation efforts (such as vaccinations).

The flu is caused by an entirely different family of RNA viruses called influenza viruses. The flu viruses have smaller genomes encoded in eight distinct strands of RNA. They infect human cells in a different manner than coronaviruses.

The common cold is caused by a variety of viruses, including some coronaviruses and rhinoviruses. Cold-causing coronaviruses (e.g. OC43 and 229E strains) are quite similar to SARS-CoV-2 in terms of their genome lengths and gene contents, but different from SARS-CoV-2 in terms of sequence and infection severity.

How stable and infectious is the virion (complete, infectious form of the virus outside the host cell, with RNA or DNA core and capsid) on surfaces?

SARS-CoV-2 RNA has been detected on various surfaces several weeks after they were last touched (Moriarty et al., 2020). The data regarding probability of human infection from exposure to contaminated surfaces is not yet available, because the experiments to test this aspect are very difficult.  However, caution and protective measures should be taken. Further study on the risk of infection from touching surfaces is urgently needed.

How do N95 masks block SARS-CoV-2?

The N95 masks probably protect against several viral transmission modes. Measurements of the particle filtration efficiency of N95 face masks show that they are capable of filtering approx. 99.8% of particles with a diameter of around 0.1 μm (Regnasamy et al., 2017). SARS-CoV-2 is an enveloped virus (≈0.1 μm in diameter) so N95 masks are capable of filtering most free virions.

The N95 face masks block various particles, not viruses only. Viruses are often transmitted through respiratory droplets produced by coughing and sneezing.

Respiratory droplets are usually divided into two sizes: large droplets that fall rapidly to the ground and are thus transmitted only over short distances, and small droplets which can evaporate and remain suspended in air for significant periods of time. There is currently no direct evidence of SARS-CoV-2 transmission through small evaporated droplets. Rather it is believed that larger droplets are major vector for SARS-CoV-2 transmission, usually by settling onto surfaces that are touched and transported by hands onto mucosal membranes such as the eyes, nose, and mouth (CDC 2020). Therefore, N95 masks probably protect against several viral transmission modes.

How long does it take a single infected person to yield one million infected people?

The basic reproduction number (R0) suggests that each infection generates directly 2-4 more infections in the absence of countermeasures such as physical  distancing. Once a person is infected, it takes a period of time called the latent period before they are able to transmit the virus. The current best-estimate of the median latent time is ≈3 days followed by ≈4 days of close to maximal infectiousness (Li et al., 2020, He et al., 2020). The exact durations vary among people, and some are infectious for much longer. Using R0≈4, the number of cases will quadruple every ≈7 days (or double every ≈3 days).

Therefore, going from one case to 1,000 requires about one month. So we expect one million cases in two months, and one billion cases in three months. Even though this calculation is highly simplified, ignoring the effects of super-spreaders, herd-immunity and incomplete testing, it emphasises the fact that viruses can spread at a bewildering pace when no countermeasures are taken. This illustrates why it is crucial to limit the spread of the virus by physical distancing.

Why was the initial quarantine period set to two weeks?

The period of time from infection to emergence of symptoms is called the incubation period. The median SARS-CoV-2 incubation period is estimated to be roughly 5 days (Lauer i in. 2020). Yet, there is much person-to-person variation. Approximately 99% of those showing symptoms will show them before day 14, which explains the two week confinement period.

Importantly, this analysis neglects infected people who never show symptoms. Since asymptomatic individuals are usually not tested, the number of such tastes is still not clear or for how long asymptomatic people remain infectious.

What is the effect of physical distancing?

Let’s suppose that you are infected, and you meet as many as 50 persons over the course of a day of working, commuting, socialising, and running errands. Let’s also suppose that you have a 2% chance of transmitting the virus in each of these encounters, so that you are likely to infect one new person each day. If you are infectious for 4 days, then you will infect four others (on average).

If you follow the rules of physical distancing, you will meet 5 people during the day – not 50.

 

* The price shown is for information purposes only and does not constitute an offer within the meaning of Article 66 paragraph 1 of the Civil Code.