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COVID-19 Swab Test

How fast can I get the COVID-19 results?

COVID-19 Swab Test is available. We provide the fastest PCR COVID-19 Swab Test within 24 hours from the time of collection (cut-off time 3 pm daily). We have an even faster PCR test for COVID, which can generate results within 6 hours from the time of collection.

 

If you require an RTK test, results are reported in 20 minutes from sampling time.

 

Make a booking with us for your fast COVID-19 Swab Test.

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How many types of COVID-19 swab test is available?

There are four types of COVID-19 swab test available:

  1. PCR (Polymerase Chain Reaction)

  2. RTK (Rapid Test Kit)

  3. Deep Throat Saliva Test

  4. Blood Antibody Test for Covid-19

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Which test will be the best to detect COVID-19?

PCR or Polymerase Chain Reaction will the best test for COVID-19. This test is considered the Golden Standard of care. PCR is able to detect the genetic sequence of the COVID-19 proteins. This test is highly specific and will only detect the COVID-19 protein sequence. Each species has different sequences of genetic proteins.

For example, COVID-19 has a protein sequence A-U-T-G-C. The person is swabbed and the sample is sent for PCR and the PCR test detects A-U-T-G-C proteins in the same sequence then it is definitely confirmed that it is COVID-19. If there are other protein sequence combinations like U-A-T-G-C, even a single shift of one protein will indicate that it is not COVID-19 rather it is some other organism besides COVID-19. This makes PCR highly specific. 

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What is the difference between COVID-19 Swab for PCR versus RTK?

COVID-19 PCR is the golden standard to detect and diagnose COVID-19. There are conditions when the RTK swab test may be negative for COVID-19 but can be positive on PCR testing due to the sensitivity of PCR is much higher as compared to RTK. 

Example: A patient came to me with prolonged cough and he was convinced that he was negative for COVID-19 due to his negative RTK test. However, with his history of contact with multiple people in his line of work, I decided to convince him to get a PCR test and the PCR test showed positivity.

RTK is used as a screening tool whereas PCR is used as a definitive testing tool to confirm COVID-19 infections. RTK can give a false positive test (meaning the test show positive but the person is not infected with COVID-19). There are many viruses that can mimic COVID-19 and this causes false positivity on the RTK test.

Example: A patient came with body ache without any history of travel, works from home, and has a low risk to acquire COVID-19 but his RTK was positive. I decided that we should proceed with the PCR test to confirm the diagnosis of COVID-19. After the PCR test results came out, the patient's test results were negative for COVID-19. There are many instances that people can get a positive test on RTK but a negative test on PCR because of RTK cross-reactivity with other viruses (influenza, MERS-CoV) in the oral-nasal cavity is higher and PCR is specific to the protein sequence of COVID-19. 

In short, if you get a negative test on RTK means:

  • You are negative for COVID-19.

  • You are infected with COVID-19 but the levels are very low that the RTK test results in a negative test. 

If you get a positive test of RTK means:

  • You are positive for COVID-19 or

  • You are probably infected with COVID-19 and require a PCR test to confirm the diagnosis.

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PCR is expensive and requires about 1 day to process the sample whereas RTK is cheap and fast. Until now the ministry advocates to get PCR test done as a screening tool but due to the overburden and cost; RTK is a substitute for screening in emergency conditions



Read more about COVID-19 guideline in Malaysia: http://covid-19.moh.gov.my/garis-panduan/garis-panduan-kkm

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What is the Cyclic Threshold Level (CT-level) in PCR?

The cycle threshold (Ct) value of a reaction is defined as the cycle number when the fluorescence of a PCR product can be detected above the background signal. PCR runs multiple amplification processes in order to detect the viral proteins.

 

This means that the lesser processes or CT-Level run in order to detect the viral proteins equal a high concentration of viral load in the oral-nasal cavity and vice versa.

Example: Two persons Mr. A and Mr. Z did a PCR. Mr. A has a CT level of 18 and Mr. Z has a CT level of 32. Mr. A is considered a superspreader because his CT level is <20 and this means that he has a high concentration of viruses in his oral-nasal cavity. A single sneeze will results in the spreading of viral particles into the air at a very high concentration, therefore, resulting in high dispersion and high infectivity.

Mr. Z, on the other hand, may sneeze but dispersion is low due to his high CT level (>30) and this means that he has very low concentration of viruses in his oral-nasal cavity.

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Have you had a PCR test done but the PCR is negative for COVID-19 with a positive N-Protein? 

A negative COVID-19 PCR test with a positive N-Protein. Does this mean I am infected with COVID-19? Actually COVID-19 negative means that you are infected with COVID-19 but the presence of N-Protein indicated that the person has a Nucleocapsid Protein.

Nucleocapsid protein is found in many other viruses (Influenza-like virus, SARs, MERSCOV) besides the COVID-19 virus. Therefore a positive N-Protein does not mean that you are infected with COVID-19 but rather the test was able to pick up other viruses which have similar nucleocapsid protein on the surface of the virus. 

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What is the minimal CT Level on PCR which can result in a positive RTK test for COVID-19? 

Usually, the COVID-19 RTK test can be positive if the CT Level is less than 30. If you remember the initial part about CT level in this article: the lower the CT level (less than 30) will indicate a higher concentration of the virus and higher infective rates. 

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Is the Deep Throat Saliva test accurate for COVID-19? 

Deep Throat Saliva test (oral fluid)  qualitatively detects the SARS-CoV2 nucleocapsid protein antigen in human oral fluid specimen following membrane-based immunoassay.

 

The specimen reacts with the SASR-CoV2 nucleocapsid protein antibody-coating particles in the test line region of the test cassette during the testing. Driven by capillary action, the mixture migrates upward on the membrane chromatographically to react with the SARS-CoV2 nucleocapsid protein antibody in the test line region.

 

When the specimen contains SARS-CoV2 antigens, a coloured line will be present in the test line region. In the absence of antigens to SAR-CoV2, there will be no coloured line in the test region to indicate a negative result. A coloured line will appear at the control reagent to serve as a procedure control as an indicator that the test has been performed correctly.

 

The Deep Throat Saliva test was developed in USA in Yale University and boast an accuracy of 96.9%. The study is a small study involving 160 participants only. Samples were collected by the use of the deep throat antigen rapid test kit and compared against the PCR test. The Sensitivity 93.3% and Specificity 99% for the Deep Throat Saliva test (oral fluid).

Currently, in Malaysia, Penang is starting to manufacture these test kits and has been approved for use. There is no need for unpleasant swabs in the nostril and throat. This also reduces the risk of transmission from patient to healthcare workers doing the swabs. 

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AMD CLINIC is providing this COVID-19 saliva test. Proceed to book your appointment with us.

Read more: https://www.thestar.com.my/news/nation/2021/02/18/covid-19-health-ministry-approves-deep-throat-saliva-method-as-alternative-to-swab-test

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What is the difference between the Antigen versus Antibody test for COVID-19? 

Many people ask for antigen test and say "I want the Antigen test but not the PCR test". First, we need to get the basics right. Antigen is the virus or parts of the virus and antibody is the host immune response to the antigen (virus) or parts of the virus. PCR, RTK and Deep Throat Saliva test are all used to detect the antigen. 

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When to do PCR or RTK or Throat Saliva Test for COVID-19? 

Upon infection, the earliest test to detect COVID-19 will be PCR, RTK and Deep Throat Saliva Test. These antigen test can be able to detect the antigen (virus) as early as 48 hours from the time of infection.

 

Antibody test uses blood and can be able to detect infection as early as 7 days from the time of infection as the human body needs about 7 days to generate antibodies from the time of infection. 

A NEGATIVE TEST does not mean you should have a false sense of security if your history of close contact with people who are COVID-19 positive or any situation which is considered high risk. You should retest about 48 hours later to be sure. 

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Can COVD-19 antibody test positive if I have been vaccinated against COVID-19? 

Yes. You can get a false-positive antibody test for COVID-19 if you recently been vaccinated against COVID-19. Therefore, tell your doctor about the history of COVID-19 vaccination. If you suspect you have been infected with COVID-19 and have already received your vaccination, do not do a COVID-19 antibody test as it will show a false-positive result.  

Your body will produce antibodies against the COVID-19 vaccine and the antibodies will last about 6 months or more according to most of the studies conducted. Make sure you get an antigen test either a PCR, RTK or deep throat saliva test.

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