Covid 19 PCR and Rapid Antigen Test

The outbreak of the new coronavirus disease, which was first detected in China in December 2019, is continuing to affect people across the globe.

Early and accurate diagnosis of COVID-19 — the disease caused by an infection with the new coronavirus — is critical to curbing its spread and improving health outcomes.

Keep reading to find out what to do if you think you have symptoms of COVID-19, and which tests are currently being used to diagnose this disease in the United States.


When to consider getting tested for a COVID-19 diagnosis

If you’ve been exposed to the virus or show mild symptoms of COVID-19, call your doctor for advice about how and when to get tested. Don’t go to your doctor’s office in person, as you could be contagious.

You can also access the Centers for Disease Control and Prevention’s (CDC) coronavirus self-checker to help you decide when to get tested or seek medical care.

Symptoms to watch out for

The most common symptoms reported by people with COVID-19 include:

  • fever
  • cough
  • fatigue
  • shortness of breath

Some people may have other symptoms, too, such as:

  • a sore throat
  • headache
  • runny or stuffy nose
  • diarrhea
  • muscle aches and pains
  • chills
  • repeated shaking with chills
  • loss of smell or taste
  • The symptoms of COVID-19 typically appear within 2 to 14 days after initial exposure to the virus.

    Some people show few to no signs of illness during the early phase of infection but can still transmit the virus to others.

    In mild cases, home care and self-quarantine measures may be all that is needed to fully recover and keep the virus from spreading to others. But some cases call for more complex medical interventions.

What steps should you take if you want to get tested?

Testing for COVID-19 is currently limited to people who have been exposed to SARS-CoV-2, the official name for the novel coronavirus, or who have certain symptoms, like those outlined above.

Call your doctor’s office if you suspect you’ve contracted SARS-CoV-2. Your doctor or nurse can assess your health status and risks over the phone. They can then direct you as to how and where to go for testing, and help guide you to the right type of care.

On April 21, the Food and Drug Administration (FDA) approved the use of the first COVID-19 home testing kit. Using the cotton swab provided, people will be able to collect a nasal sample and mail it to a designated laboratory for testing.

The emergency use authorization specifies that the test kit is authorized for use by people who healthcare professionals have identified as having suspected COVID-19.

What is involved with the testing?

Polymerase chain reaction (PCR) testing remains the primary COVID-19 diagnostic testing method in the United States. This is the same type of test that was used to detect severe acute respiratory syndrome (SARS) when it first appeared in 2002.

To collect a sample for this test, a healthcare provider will likely perform one of the following:

  • swab your nose or the back of your throat
  • aspirate fluid from your lower respiratory tract
  • take a saliva or stool sample

Researchers then extract nucleic acid from the virus sample and amplify parts of its genome through a reverse transcription PCR (RT-PCR) technique. This essentially gives them a larger sample for viral comparison. Two genes can be found within the SARS-CoV-2 genome.

Test results are:

  • positive if both genes are found
  • inconclusive if only one gene is found
  • negative if neither gene is found

Your doctor may also order a chest CT scan to help diagnose COVID-19 or get a clearer view of how and where the virus has spread.

Are other types of tests going to become available?

The FDA recently authorized the use of a rapid coronavirus diagnostic test as part of its efforts to expand screening capacity.

The FDA approved point-of-care (POC) testing devices made by California-based molecular diagnostics company Cepheid for multiple patient care settings. The test will initially roll out in high-priority settings like emergency departments and other hospital units.

The test is currently reserved for clearing healthcare staff to return to work following exposure to SARS-CoV-2 and those with COVID-19.

How long does it take to get test results?

RT-PCR samples are often tested in batches at sites away from where they were collected. This means it can take a day or longer to get test results.

The newly approved POC testing allows for samples to be collected and tested at the same location, resulting in quicker turnaround times.

Cepheid POC devices produce test results within 45 minutes.

Is the test accurate?

In the majority of cases, RT-PCR test results are accurate. The results may not flesh out infection if tests are run too early in the disease course. The viral load may be too low to detect infection at this point.

A recent COVID-19 study found that accuracy varied, depending on when and how samples were collected.

The same study also found that chest CT scans accurately identified infection in 98 percent of cases whereas RT-PCR tests detected it correctly 71 percent of the time.

The RT-PCR may still be the most accessible test, so talk with your healthcare provider about your options if you have concerns about testing.

When is medical care essential?

Some people with COVID-19 feel increasingly short of breath while others breathe normally but have low oxygen readings — a condition known as silent hypoxia. Both of these situations can quickly escalate to acute respiratory distress syndrome (ARDS), which is a medical emergency.

Along with sudden and severe shortness of breath, people with ARDS may also have an abrupt onset of dizziness, rapid heart rate, and profuse sweating.

Below are some, but not all, of the COVID-19 emergency warning signs — some of which reflect progression to ARDS:

  • shortness of breath or trouble breathing
  • persistent pain, tightness, squeezing or discomfort in your chest or upper abdomen
  • sudden confusion or problems thinking clearly
  • a bluish tint to the skin, especially on lips, nail beds, gums, or around the eyes
  • high fever that doesn’t respond to normal cooling measures
  • cold hands or feet
  • a weak pulse

Get prompt medical care if you have these or other serious symptoms. Call your doctor or local hospital in advance, if you can, so they can give you instructions on what to do.

Getting urgent medical attention is especially important for anyone at higher risk for COVID-19 complications.

Older adults are most at risk of severe illness, as are people with the following chronic health conditions:

  • serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
  • kidney disease
  • chronic obstructive pulmonary disease (COPD)
  • obesity, which occurs in people with a body mass index (BMI) of 30 or higher
  • sickle cell disease
  • a weakened immune system from a solid organ transplant
  • type 2 diabetes

The bottom line

RT-PCR testing remains the primary method for diagnosing COVID-19 in the United States. However, some clinicians may utilize chest CT scans as a simpler, quicker, and more reliable way to assess and diagnose the disease.

If you have mild symptoms or suspect infection, call your healthcare provider. They will screen your risks, put a prevention and care plan in place for you, and give you instructions on how and where to get tested.

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