RT-PCR vs Antigen Testing

A lot of our clients ask us about what kind of testing is available, so we wanted to take some time to discuss the difference between two major forms of testing available.

For diagnostic testing for COVID-19 there are two major forms of testing available. Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) and Antigen Testing.

RT-PCR is the standard of care for testing for the SARS-CoV-2 virus that causes COVID-19 as it is the most accurate with the least amount of false negatives and positive results. This is because RT-PCR testing uses a technique called reverse transcriptase to take viral RNA and turn it into DNA. This complicated process allows for the detection of even a small amount of viral load. It is also highly specific to the SARS-CoV-2 virus so there are less possibilities of a “false positive” result. There are now hundreds of different ways to perform RT-PCR testing but it is limited to highly complex laboratories and turnaround times vary from four hours to twelve hours for results. Even at four hours of testing time, there is a lot of time preparing specimens and delivering results. This is the reason for the lag time in result delivery which generally ranges from 24-72 hours even with full automation using robotic assistance.

Another major type of testing is Antigen Testing. There are a few different platforms that a laboratory or medical practice with a CLIA WAIVER can perform this test. An antigen is the part of the virus that creates an immune response. Antigen testing helps identify proteins on the surface of the virus. Coronaviruses have a specific protein called a “spike protein” that these antigen tests are often searching for. These antigens can be present in the body far before symptoms occur. Antigen testing has been used for many years for testing influenza, streptococcus and even HIV testing. It is generally accepted that the sensitivity of these tests is much lower (higher false negative rate) and can be as low as 84% (16% of tests are false negative). This is why antigen testing is often reserved for symptomatic individuals. With that said, antigen testing may have a place in screening as it is much more accessible and results can be delivered in 5-25 minutes depending on the platform.

With all of that said, there is still the question of which platform is best for testing. The answer is both simple and complex. No test is “perfect” for any given situation. At Total Testing Solutions we understand how complex this is and that no person or business is the same. We use our clinical experience and work with each individual to figure out which of these platforms best suits your specific needs.

Author Top Los Angeles ENT Specialist, Dr Geoffrey Trenkle, D.O. Dr. Geoffrey B. Trenkle, D.O. LACENTA C.E.O.

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Los Angeles
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