This email address is being protected from spambots. You need JavaScript enabled to view it.
Image: CDC/ Alissa Eckert, MS; Dan Higgins, MAMS
Coronavirus – COVID-19 (SARS-CoV-2)
Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus – Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) – which was first recognised in Wuhan, Hubei Province, China, in December 2019. Genetic sequencing of the virus suggests that SARS-CoV-2 is a betacoronavirus closely linked to SARS coronavirus 1.
The virus is transmitted from human to human by breathing in aerosols from the nose or mouth of an infected person or by touching the infected droplets on surfaces, then touching the eyes, nose or mouth. Infectivity is now recognised to occur before the onset of symptoms and yet high titres of virus can be detected on upper airway surfaces in people who do not develop symptoms.
The majority of people with COVID-19 have uncomplicated or mild illness (81%), with non-specific symptoms such as fever, fatigue, cough (with or without sputum production), anorexia, malaise, muscle pain, sore throat, dyspnea, nasal congestion, or headache. Rarely, patients may also present with diarrhoea, nausea and vomiting. Loss of taste and smell has been reported early in the infection.
A relatively small proportion of people, particularly but by no means exclusively in those aged >70 years, will develop severe illness requiring oxygen therapy (14%) and approximately 5% will require intensive care unit treatment. Time from the onset of the infection to hospitalisation can be up to ~13 days. Of those critically ill, most will require mechanical ventilation. The most common diagnosis in severe COVID-19 patients is severe pneumonia; this can progress to acute respiratory distress syndrome, and life-threatening multi-organ dysfunction and death. Mortality has been estimated at between 1 and 2% of those infected, the higher figure in men.
Current evidence also shows that there is a higher risk of infection and of severe disease in Black, Asian and Minority Ethnic (BAME) groups in the UK. The reasons for this are currently unclear.
Travel
Travellers should check the UK Foreign, Commonwealth & Development Office travel advice and their country-specific pages for the latest COVID-19 travel advice, which may include information on travel restrictions, quarantine or COVID-19 testing requirements. This includes considering the recommendations and requirements for any transit countries.
Testing
There are currently two types of clinical COVID-19 tests available.
The antibody test checks if you have had the coronavirus before and the antigen test, known as the PCR test, is a swab test that determines if you are currently infected with Coronavirus.
Accessing Private Testing
If you are concerned about coronavirus (COVID-19) and would like to be tested privately, we are able to offer the latest approved tests from a fully approved DHSC & UKAS Approved Laboratory.
If you need a COVID-19 (SARS-CoV-2) PCR test or COVID-19 (SARS-CoV-2) IgG Antibody test, please call or email by using the contact information on the Contact Us page.
PCR and Fit-to-fly Test |
|
Test to Release |
Confirms Positive or Negative Current Infection Greater than 99% accuracy Throat & Nasal Swab Results within 48 Hours Laboratory report and email certificate provided |
Test on Day 5 after return to UK from a country not on the UK Travel corridor list Throat or Nasal Swab Laboratory report and email certificate provided |
|
£150 |
|
£150 |
Antibody Test |
||
Test for Past infection |
|
If you would like to discuss the test options please call. |
£75 |
|
|
COVID-19 (SARS-CoV-2) PCR assay
Molecular testing (PCR Swab) will identify people with the virus.
The self-sample kit includes everything needed to take a swab sample and post it to the laboratory. The enclosed instructions must be followed to ensure that you take the swab sample accurately. Test results are usually returned in less than 72 hours to return, but often within 48hours. This time can be reduced to less than 24 hours if hand delivered to the laboratory. You will be notified immediately by text of your test result and the laboratory report will be emailed to you. This is suitable for UK exit and foreign country entry requirements.
Specimens
-
Nasal/Throat swabs collected using BD dry swabs/Remel M4RT/Copan 321C UTM or Copan 147C.
-
Samples are taken from symptomatic patients between days 1-5 from onset of symptoms.
-
Specimens are sent to the laboratory at ambient temperature in Category B packaging and labelled as containing HIGH RISK specimen.
-
For best results, please send samples on the day they are taken. However, samples are stable at ambient temperature for 3 days for wet swabs, and up to 6 days for dry swabs.
The assay
Infection with SARS-CoV-2, an RNA virus, is diagnosed using reverse-transcriptase real-time PCR. The assays used at TDL show a minimum sensitivity of 98% and a specificity of 100%, with no cross-reactivity with other viruses.
COVID-19 (SARS-CoV-2) IgG Antibody
Antibody testing can tell whether a person has been previously infected. Most patients who recover from coronavirus have been found to produce antibodies, but it is not yet known if an individual with a positive result showing presence of IgG levels following being infected with SARS-CoV-2 will be protected, either fully or partially from future infection, or for how long protective immunity may last.
Testing should be undertaken 14 days or more following exposure or onset of symptoms. The incubation period of COVID-19 ranges from between 1 to 14 days, with the majority of cases manifesting with symptoms at 3 – 5 days. The most common symptoms of COVID-19 are fever, tiredness, dry cough and difficulty breathing. These symptoms have the potential to develop into a very severe acute respiratory illness.
Evidence shows that fatality rates increase with age, gender, body weight, ethnicity and comorbidities.
The host immune system reacts to the infection by SARS-CoV-2 by producing antibodies from a few days to 2 weeks and beyond. Specific IgG antibodies are produced in the later stages of infection to SARS-CoV-2, and are detectable after RNA is no longer detectable.
Specimens
- SST/Serum
- Testing should be undertaken 14 days or more following exposure or onset of symptoms.
The assay
The persistence of IgG antibodies allows identification of people who have been infected by SARS-CoV-2.
COVID-19 (SARS-CoV-2) ‘rapid antigen test’
The ‘rapid test’ is a lateral flow chromatographic immunoassay for the qualitative detection of the nucleocapsid protein antigen from SARS-CoV-2 in nasal swab specimens directly from individuals who are suspected of an active COVID-19 infection by their healthcare provider within the first seven days of the onset of symptoms.
This test is not a reliable method of detection of COVID-19 and should only be used as an indicative sample for continual monitoring in the work place, education, care homes or other such venues of high population or density. IT IS NOT SUITABLE AS A TRAVEL TEST and a positive result would require a PCR test to verify accuracy.
References
- Department of Health (DoH) Coronavirus (COVID-19) Guidance: what you need to do.
Available at: https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public Updated daily - Department of Health (DoH) Coronavirus (COVID-19) Guidance: Test to Release.
Available at: https://www.gov.uk/government/publications/testing-to-release-for-international-travel-minimum-standards-for-testing/minimum-standards-for-private-sector-providers-of-covid-19-testing-for-testing-to-release-for-international-travel - National Health Service (England): Available at: https://www.nhs.uk/conditions/coronavirus-covid-19/#overview
- The Lancet. Covid-19 Resource Centre. Available at: https://www.thelancet.com/coronavirus-19/dgcid=kr_pop-up_tlcoronavirus20
- National Institute for Health and Care Excellence (NICE). NICE Guideline (NG) 159. COVID-19 rapid guideline: critical care. March 2020. Available at: https://www.nice.org.uk/covid-19
- WHO: Coronavirus disease (COVID-19) Pandemic. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
- WHO: Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. 13 March 2020. Available at: https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected
- The Doctors Laboratory: COVID-19 (SARS-CoV-2) testing options by PCR and IgG Antibody. Available at: https://www.tdlpathology.com/covid-19/
This email address is being protected from spambots. You need JavaScript enabled to view it.