Ethan Rhodes
The COVID-19 pandemic has brought about a range of testing methods to detect SARS-CoV-2, the virus that causes COVID-19. Testing is a crucial tool to prevent and contain the spread of the virus. There are two main types of tests: antigen tests and nucleic acid amplification tests (NAATs), which include PCR tests. Antigen tests are rapid tests that usually produce results in 15-30 minutes, while NAATs are considered the gold standard for COVID-19 tests, offering higher accuracy and taking up to 3 days for results. Both tests are conducted by taking swab samples from the back of the nose or throat. While at-home testing kits are available, tests are also offered at hospitals and testing centres for those with or without symptoms.
| Characteristics | Values |
|---|---|
| Testing helps | Prevent and contain the spread of COVID-19 |
| Who should get tested | Anyone with symptoms or exposure to a suspected/confirmed case, regardless of vaccination status |
| Testing type | Nucleic acid amplification tests (NAATs), including PCR tests, and antigen tests |
| NAAT test procedure | A healthcare provider takes a sample from the nose or mouth, which is then sent to a laboratory for testing |
| NAAT test result time | Up to 3 days |
| Antigen test procedure | Self-tests or at-home tests are available, and samples can be collected without going to a specific testing site |
| Antigen test result time | Rapid results in 15-30 minutes |
| Antigen test accuracy | Less likely to detect the virus than NAAT tests, especially when symptoms are absent |
| Antibody test | Available for individuals who think they had COVID-19 but are currently asymptomatic; not recommended as the sole basis for diagnosis |
| PCR test | A swab sample is collected from the back of the nose or throat to detect the SARS-CoV-2 virus |
| Drive-thru PCR test | Conducted in a car outside the hospital, with results sent via email and WhatsApp within 48 hours |
| Preventative measures | Maintain a safe distance, wear a mask, wash hands, avoid touching your face, clean surfaces, exercise, drink water, eat healthily, and rest |
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What You'll Learn
- Antigen tests: Rapid tests with results in 15-30 minutes, but less likely to detect the virus than NAAT tests
- NAAT tests: Nucleic acid amplification tests, including PCR, are the gold standard for COVID-19 tests
- At-home tests: Self-tests that can be taken without going to a testing site, but may require repeat testing after a negative result
- PCR tests: Swab samples from the nose or throat with a higher accuracy for diagnosing COVID-19
- Testing recommendations: Testing is recommended for individuals with symptoms or exposure to COVID-19, regardless of vaccination status
Antigen tests: Rapid tests with results in 15-30 minutes, but less likely to detect the virus than NAAT tests
Antigen tests are rapid tests that usually produce results in 15-30 minutes. They are also known as rapid antigen tests (RATs) or rapid antigen detection tests. These tests are relatively inexpensive and can be used at the point of care. They can be conducted by anyone, anywhere, and the results can be interpreted within 15-30 minutes.
Rapid antigen tests use laboratory-produced antibodies to seek out and attach to proteins on the surface of SARS-CoV-2 particles in the sample. If the specimen contains SARS-CoV-2 antigens, they will bind to the SARS-CoV-2 antibodies coated on the test line region and generate a coloured line on the test strip, indicating a positive result. If the antigens are not present, no coloured line will appear in the test line region, indicating a negative result. As a procedural control, a coloured line will always appear in the control line region, indicating that the test procedure has been performed correctly.
While antigen tests are rapid and relatively easy to use, they are less likely to detect the virus than NAAT tests, especially when symptoms are not present. Therefore, a single negative antigen test cannot rule out infection. To be confident that you do not have COVID-19, the FDA recommends two negative antigen tests for individuals with symptoms or three antigen tests for those without symptoms, performed 48 hours apart. A single NAAT test can be used to confirm an antigen test result.
A Johns Hopkins Medicine-led study found that rapid antigen tests for COVID-19 administered at home yield results comparable to those performed by a medical professional. The study involved nearly 1,000 patients and showed that rapid antigen tests could be used with accuracy in a high-volume setting.
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NAAT tests: Nucleic acid amplification tests, including PCR, are the gold standard for COVID-19 tests
Nucleic acid amplification tests (NAATs) are the gold standard for COVID-19 tests. NAATs can identify SARS-CoV-2, the virus that causes COVID-19, by detecting viral RNA in specimens from the respiratory tract. This makes NAATs more sensitive for the detection of SARS-CoV-2 than rapid antigen tests (RATs). NAATs, including polymerase chain reaction (PCR) assays, were the main method for diagnosing COVID-19 in 2020-2021 and remain the most sensitive and specific tests available.
NAATs work by analysing the RNA or DNA from appropriate body-fluid samples to detect the genetic sequences specific to the invading pathogen. The nucleic acid is amplified in terms of the number of its copies as the test progresses, enabling the detection of the target gene sequence at some level of amplification. The real-time polymerase chain reaction (PCR) is a scientifically established gold standard for these tests, where thermal cycling is used to amplify the nucleic acid. The PCR works on the extracted (released) target nucleic acid that is added to the reaction mix (master mix) containing all the necessary reactants (primers, nucleotides, covalent ions, buffer, and enzyme). The mixture is then placed into a thermal cycler to undergo amplification.
NAATs can be performed in laboratories or at the point of care. For laboratory-based tests, SARS-CoV-2 nucleic acid (RNA) is extracted and transcribed to DNA, followed by amplification and detection. Point-of-care NAAT kits can provide results in approximately one hour and are suitable for use outside the main laboratory, such as in emergency departments or remote clinics. However, they generally require a trained operator and must be performed under the supervision of healthcare professionals.
NAATs can remain positive for weeks following infection due to low-level shedding of non-viable viral fragments. Therefore, a single negative antigen test cannot rule out infection, and a negative RAT result may warrant a NAAT or repeat RAT for confirmation. Positive RAT results should also be verified by NAAT testing, specifically RT-PCR.
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At-home tests: Self-tests that can be taken without going to a testing site, but may require repeat testing after a negative result
At-home COVID-19 tests are antigen tests that can be taken without visiting a testing site. They are available over the counter at local pharmacies or online. These tests are designed to detect SARS-CoV-2, the virus that causes COVID-19, by testing specimens from your nose or mouth.
At-home testing kits typically include detailed instructions, a swab for collecting your nasal specimen, test strips, reagent tubes, and secure packaging for sending the sample to a designated laboratory. The instructions provided in the kit should be followed carefully to ensure accurate results. The tests are designed to be user-friendly, allowing individuals to confidently perform the test without requiring assistance from healthcare professionals.
It is important to note that a single negative antigen test cannot rule out infection. Therefore, the FDA recommends repeating the test after a negative result to reduce the risk of a false negative. For individuals with symptoms, two negative antigen tests performed 48 hours apart are recommended. For those without symptoms, three antigen tests performed 48 hours apart are advised.
After performing the test, individuals should report the results to their healthcare provider for appropriate guidance and public health actions. It is advisable to keep records of test results for personal tracking and to support public health efforts.
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PCR tests: Swab samples from the nose or throat with a higher accuracy for diagnosing COVID-19
Nucleic acid amplification tests (NAATs), including PCR tests, are the "gold standard" for COVID-19 tests. They are more likely to detect the virus than antigen tests. PCR tests are highly accurate and normally do not need to be repeated. They are, however, less readily available than antigen tests, which are often much quicker and can produce results in as little as 15 minutes.
PCR tests are conducted by taking swab samples from the nose or throat. According to researchers, swabbing both the nose and throat can improve detection rates and accuracy. However, throat swabbing alone is not recommended. Nasopharyngeal swabs, which are inserted deep into the nasal cavity, have higher yields than nasal or throat swabs, but they can be uncomfortable for patients and may not always be performed correctly.
To reach the nasopharynx, the swab must be inserted parallel to the floor of the nasal fossa and pushed until it reaches the posterior wall. This technique was demonstrated during the swine flu epidemic in 2009 and updated for the SARS-CoV-2 pandemic. It is important for healthcare personnel to be trained in the correct procedure to avoid inaccurate sampling.
PCR tests must be sent to a lab for processing, and results are typically available within 1-3 days. The longer timeframe is due to the need for laboratory processing. Antigen tests, on the other hand, can be performed at home or at testing sites without requiring a laboratory.
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Testing recommendations: Testing is recommended for individuals with symptoms or exposure to COVID-19, regardless of vaccination status
Testing is recommended for individuals with symptoms or exposure to COVID-19, regardless of their vaccination status. This includes people who are awaiting test results or have not been tested. If you are experiencing symptoms such as fever, chills, or other new or unexplained symptoms consistent with COVID-19, it is advised that you wear a high-quality mask or respirator and promptly leave the workplace.
If you have been exposed to someone with COVID-19, it is recommended that you wear a mask and practice physical distancing when interacting with others for at least 10 days from the date of your last contact with the positive case. It is also important to monitor for symptoms during this time. If you develop symptoms, you should isolate yourself and consider getting tested. For those who have recovered from COVID-19 within the past 31-90 days, viral antigen tests are recommended.
In healthcare settings, a series of three tests is recommended for individuals, including residents, patients, and staff, following exposure to SARS-CoV-2, regardless of vaccination status. Asymptomatic individuals who have had close contact with a positive case should be tested immediately, generally 24 hours after exposure, and then again on days 3 and 5 post-exposure.
There are two main types of viral tests: nucleic acid amplification tests (NAATs), including PCR tests, and antigen tests. NAATs are considered the "gold standard" as they are more likely to detect the virus. Antigen tests, on the other hand, are rapid tests that usually provide results within 15-30 minutes. However, a single negative antigen test does not rule out infection, and the FDA recommends multiple tests for accurate results.
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Frequently asked questions
The coronavirus test can be done in hospitals in several ways. The PCR test is one of the examinations to diagnose Covid-19 with a swab sample from the back of the nose or throat to detect the SARS-CoV2 virus. The test is usually administered by a healthcare professional and transported to a laboratory for testing.
The turnaround time for a coronavirus test in hospitals varies. The PCR test results are typically sent via email or WhatsApp within a maximum of 48 hours. However, the test sample is usually sent to a laboratory, which can take up to 3 days to process the results.
There are two main types of viral tests available in hospitals: Nucleic acid amplification tests (NAATs), including PCR tests, and antigen tests. NAAT tests are considered the "gold standard" for Covid-19 tests as they are more likely to detect the virus than antigen tests. Antigen tests are rapid tests that usually produce results within 15-30 minutes, but they are less sensitive than NAAT tests.
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