Tests for coronavirus

Tests for coronavirus

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 four types of laboratory tests available for SARS-CoV-2:

Choose the best solution for yourself:

Screening genetic tests FRANKD (RT – LAMP) in mobile collection points

Price: 250 zł*

BUY ONLINE

 

Find out more

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

Price: 420 zł*

BUY ONLINE

 

Find out more

Rapid antigen test for the diagnosis of SARS-CoV-2 infections at collection points

Price: 150 zł*

BUY ONLINE

 

Find out more

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

Price: 750 zł*

  BUY ONLINE

 

Find out more

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

Price: 120 zł*

BUY ONLINE

 

Find out more

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

Price: 120 zł*

BUY ONLINE

 

Find out more

 

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
How and where can you perform RT-PCR tests?
Molecular screening test FRANKD
Antigen test
Interpretation of the antigen test results
Comparison of SARS-CoV-2 coronavirus tests
How to buy a coronavirus test in Warsaw and other towns?
How long does the coronavirus test take?
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 RT-PCR 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.

2. 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 120 (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.

When to perform an RT-PCR test for coronavirus?

The RT-PCR test for coronavirus infection is performed in order to confirm the SARS-CoV-2 infection in individuals with:

  • typical symptoms of COVID-19, such as fever, shortness of breath and cough, loss of taste and smell,
  • previous positive results of screening test (RT-LAMP method, e.g. FRANKD) or test for antibodies against SARS-CoV-2.

Genetic testing is also performed to confirm that the virus is no longer in the body and that the patient has been cured.

Preparing the patient for the PT-PCR test:

  • The swab should be taken in the morning, on an empty stomach, or about 2 hours after the last meal.
  • Do not smoke, brush your teeth, use mouthwash, throat lozenges or chewing gum for 2 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.

How and where can you perform RT-PCR tests?

Damian Medical Centre offers the following options for performing the RT-PCR test:

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 420*.

CALL AND ORDER THE TEST

 

2. Swab for the SARS-CoV-2 coronavirus at mobile Collection Points in Poland

The tests are performed at mobile collection points located in Gdańsk, Poznań, Wrocław, Kraków, Warsaw, Lublin, Łódź, Mysłowice, and Szczecin. You need to purchase the test online at sklep.damian.pl or make an appointment via DAMIAN ONLINE and pay by card on location.

The cost of the test is PLN 420*.

CALL AND ORDER THE TEST

 

3. 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 750*.

CALL AND ORDER THE TEST

 

Interpretation of molecular test results (PT-PCR)

The positive result of the RT-PCR test indicates SARS-CoV-2 infection in the tested individual. If a virus is detected, the guidelines of the Poviat Sanitary and Epidemiological Station (PSSE) appropriate for the person's place of residence should be followed in order to report such a result and adhere to further recommendations, including quarantine or a stay in an infectious disease hospital.

The negative result means that no SARS-CoV-2 genetic markers were found in the sample. However, you should be aware that a negative result does not rule out an infection. Consequently, if a patient shows typical COVID-19 symptoms or had documented close contact with a confirmed COVID-19 case, it is advisable to re-test another sample.

The inconclusive result means the result is not clear as the outcome is at the limit of analytical sensitivity. In this case, the test should be repeated within 24-48 hours.

Follow-up tests for infected people

RNA virus can persist in the respiratory tract for up to 6 weeks, but infectivity ceases in most patients after about 8 days from symptoms onset (in patients with immunodeficiency it may last up to about 3 weeks). Therefore, in a patient with a confirmed diagnosis of SARS-CoV-2 infection, it is currently not recommended to perform molecular control tests to determine the elimination of the virus.


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 97,4% and sensitivity of 97,1%.
  • 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 qualitatively detects the specific SARS-CoV-2 antigens in a nasopharyngeal swab. It is intended for individuals with symptoms that may indicate SARS-CoV-2 infection.

Same as RT-PCR and FRANKD (RT-LAMP) tests, the antigen test is now recognised by the Chief Sanitary Inspector.

Antigen tests detecting SARS-CoV-2 antigens in the samples from the respiratory tract are characterised by lower sensitivity than PCR tests, but high specificity. They give positive results within the time period with the greatest viral load in the respiratory tract, i.e. usually from 1-3 days before to 5-7 days after symptoms onset.

According to the recommendations of the World Health Organization, the antigen test for diagnostic use should have a sensitivity of ≥ 80% and a specificity of ≥ 97% compared to molecular tests. Due to the serious consequences of false-negative results, the experts team in Poland recommends the use of antigen tests with diagnostic sensitivity ≥ 90% and diagnostic specificity ≥ 97%.

The tests used at the Damian Medical Centre are characterised by:

  • sensitivity of 96.52% (Roche), 93.3% (Abbot)
  • specificity of 99.68% (Roche), 99.4% (Abbot)

When to perform an antigen test?

According to the World Health Organization and the Centers for Disease Control and Prevention guidelines, antigen tests can be used, for instance, to diagnose infections in symptomatic patients within the first 5-7 days after the onset of symptoms.

They are not screening tests.

In asymptomatic patients at risk or with suspected SARS-CoV-2 infection, molecular tests (RT-PCR, RT-LAMP) should be performed.

Preparation for the antigen test:

  • Do not smoke for 4 hours before the examination.
  • Do not apply nasal antimicrobial agents (drops, ointments, sprays) within 2 hours before taking the swab.
  • Do not rinse or blow your nose.

How is the study going?

  1. The healthcare professionals take a medical history because the interpretation of the antigen test result depends on the patient's health.
  2. The patient tilts the head back. The nurse inserts a sterile swab into the nose, takes the material by gently rubbing and rotating the swab for about 10 seconds in each nostril.
  3. The patient is asked to wait for the result. During this time, the medical staff performs a test on the collected sample.
  4. The result is provided to the patient after 15-30 minutes.

Interpretation of the antigen test results

The test may give positive, negative or invalid results, but their interpretation depends on the patient's health status.

If the test was performed in an individual with COVID-19 clinical symptoms:

  • positive result – the patient should put in isolation; there is no need to repeat the test (due to the special epidemic situation in Poland, the national definition of a confirmed COVID-19 case of 31 October 2020 includes the possibility of laboratory confirmation of the case by detecting the SARS-CoV-2 antigen in the clinical material),
  • negative result – it does not rule out SARS-CoV-2 infection; for confirmation, an RT-PCR test should be performed, and until a negative molecular test result is obtained, the patient should stay in isolation.

If the test was performed in an individual without COVID-19 symptoms, the results may be false.

If the test shows an invalid result, it should be repeated immediately.

Antigen test price

The prices of antigen tests in Poland vary, for instance due to their characteristics. When selecting a test, please make sure to pay attention to whether their sensitivity and specificity are in line with recommendations of Polish experts.

At the Damian Medical Centre, we use Roche and Abbot tests, which are characterised by high sensitivity and specificity. The price of the test is PLN 150*.


Comparison of SARS-CoV-2 coronavirus tests

RT-PCR test (molecular)

Application:

  • diagnosis of SARS-CoV-2 infection,
  • control tests - evaluation of virus elimination from the respiratory tract.

Material to be collected: material from the upper (swab, discharge) or lower (sputum, discharge) respiratory tract.

WHO recommendations: yes

Waiting time: up to 48 hours

Test price:

  • SARS-Cov-2 RT-PCR at the collection point - PLN 420*
  • SARS-Cov-2 RT-PCR at the patient's home in Warsaw - PLN 750*

FRANKD (molecular screening test)

Application:

  • rapid screening diagnostics,
  • in the case of a positive result - RT-PCR test confirming the result (included in the test price and from the same sample).

Material to be collected: pharyngeal swab.

WHO recommendations: yes

Waiting time: up to 48 hours

Test price:

  • SARS-Cov-2 FRANKD (rapid test) – PLN 250*

Serological (antibodies)

Application:

  • for retrospective diagnosis in people with asymptomatic or mild infection (it is also necessary to obtain a negative RT-PCR test result),
  • in epidemiological studies.

Material to be collected: blood.

WHO recommendations: for research only

Waiting time: up to 24 hours

Test price:

  • Anti SARS-Cov-2 IgM antibodies using the quantitative CLIA method - PLN 120*
  • Anti SARS-Cov-2 IgM antibodies using the quantitative CLIA method - PLN 120*

Antigen test

Application: at early disease stage (if the tests will be validated)

Material to be collected: upper respiratory swab.

WHO recommendations: : yes, only for patients with symptoms of SARS-CoV-2 infection

Waiting time: from 15 to 30 minutes

Test price:

  • Rapid in vitro diagnostic test for the qualitative detection of SARS-CoV-2 antigen (Ag) – PLN 150*

How to buy a coronavirus test in Warsaw and other towns?

  1. Go to website https://sklep.damian.pl/.
  2. Choose one of the available options:
  • SARS-CoV-2 FRANKD genetic screening test - buy a test
  • Swab for SARS-CoV-2 by RT-PCR at the Collection Point - buy a test
  • Swab for SARS-CoV-2 by RT-PCR at the patient's home (within Warsaw's  boundaries) - buy a test
  • Rapid antigen test - buy a test
  • Anti SARS-Cov-2 IgM antibody detection test - buy a test
  • Anti SARS-Cov-2 IgG antibody detection test - buy a test
  1. Select the town in which you want to perform the test: Warsaw, Gdańsk, Kraków, Lublin, Łódź, Poznań, Wrocław, Mysłowice, Szczecin.
  2. Book a date.
  3. Make a payment.

You have a wide range of payment options: Blik, Millenium Bank, Bank Nowy BFG S.A., Bank Pekao, Banki Spółdzielcze, BNP Paribas, Credit Agricole, Pocztoywy24, Getin Bank, Nest Bank, Noble Bank, Alior Bank, City Handlowy, Idea Bank, Inteligo, iPKO, Plus Bank, BOŚ Bank, ING, Santander, Toyota Bank, Volkswagen Bank, mBank transfer, Visa, Master Pass, Alior Raty, mBank Raty, Google pay, Pay Po, Sky Cash, banking by Alior Bank, P24.

  1. Perform the test at one of the facilities in Warsaw or other towns in Poland.

How long does the coronavirus test take?

Depending on the type of test, the duration time is from a few seconds to one minute.

Genetic (RT-PCR) and screening (FRANKD) tests involve touching the nasopharynx with a swab. It takes a while. Antigen tests require rubbing for 10 seconds in each nostril. Antibody testing takes a little longer. It is a blood test, so the first step is preparation (setting a tourniquet, disinfection), and then a sting and blood sample collection.


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.