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By Dr. Peter J. Plantes

According to retrospective studies from the Chinese episode of the COVID-19 pandemic, we know approximately 40% of individuals who “have had COVID-19” suffered little to no symptoms. They never suspected they had COVID-19, but they were infectious to all those around them. Their SARS CoV-2 RNA genome test would have been positive if they had been tested. But who knew to suspect the 40% asymptomatic folks and use one of the few available COVID-19 genome tests? These folks had no fever. They had no dry cough.

In the coming weeks, we all will be hearing about the “the antibody test” that tells you whether you have had COVID-19. This test will be the ticket to indicate you are unlikely to experience COVID-19 again and that you are immune to others who are shedding the virus, whether they are actively ill or asymptomatic.  It is cheaper, easier, and faster to perform than the SARS CoV-2 RNA genome test and only requires a blood sample instead of the distressing nasal-pharyngeal swab sample.

It is important to understand the difference between the tests used in the diagnosis of acute-phase illness of COVID-19  and a resolved case of COVID-19 (“cured”).

  • The SARS CoV-2 RNA genome test uses a nasal swab sample to check for the virus’s genetic material.
  • The SARS CoV-2 serological antibody test uses a blood sample (that’s the serology part) to look for antibodies the patient made in response to the virus. The immunoglobulin protein IgM antibody is produced early; the IgG antibody is produced later.

These 2 tests define 4 separate periods during an active case of COVID-19.

Test Type Never Infected Early COVID-19 Late COVID-19 “Cured”
Genome (nasal swab) Negative (-) Positive (+) Positive (+/-) Negative (-)
Antibody (blood) Negative (-) Negative (-) Positive (+) with IgM > IgG Positive (+) with IgM < IgG

 

Right now, the free  CV19 Lab Testing Dashboard powered by hc1 only shows test results data for the SARS CoV-2 RNA genome test to help healthcare professionals best respond to the pandemic in the United States. As the antibody tests become more prevalent in the near future, hc1 will strive to develop parallel reporting for SARS CoV-2 serological antibody test results based on the data emerging at the 20,000 lab draw sites feeding into the current dashboard. Visit cv19dashboard.org to request access.

About the Author

Peter J. Plantes, M.D. has three decades of experience creating service and delivery solutions that enhance marketplace success and clinical performance for clinical practice groups, academic faculty group practices, hospitals, health systems, and health care organizations. His success stems from his ability to blend and synergize clinical knowledge, operational expertise, financial performance, and collaborative methodology with his deep commitment to serve patients and improve the health of the community. Dr. Plantes has served in CEO & Physician Executive roles for a number of large healthcare clinical delivery networks including regional community networks, academic practices, national hospital networks, international health systems (Chile, Colombia),  and corporate managed care/HMO networks.

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