Covid 19 1gm Lgg

Covid 19 1gm Lgg

Covid 19 1gm LgG – Interpretation of IgG And IgM Rapid Test Results For COVID-19.

Knowledge regarding the interpretation of rapid test results of IgG and IgM antibodies for COVID-19 is extremely important to be understood by every clinician. This examination has several advantages like easy, cheap, fast results, and doesn’t need to be wiped out a laboratory with biosecurity level II. [1,2]

 

Covid 19 1gm Lgg
Covid 19 1gm Lgg

The COVID-19 rapid test was initially used for screening high-risk populations before being followed by more accurate screening methods, like reverse transcription-polymerase chain reaction (RT-PCR). However, rapid tests of those antibodies are reported to possess high false-positive results, additionally, there are many studies that provide low sensitivity and specificity of the test. [3,4]

IgG and IgM COVID-19 Rapid Test Working Principles

IgG and IgM rapid test or antibody examination (serology) features a working rule to assess the body’s protection system by using protective proteins that naturally recognize foreign bodies within the body. The specimens used are in accordance with the instructions of the reagent kits used, like blood, serum or plasma, or capillary blood. [5,6]

The antibodies examined include total antibodies or separate antibodies, namely IgM, IgA, and IgG. immunoglobulin M (IgM) is an antibody that forms within the youth of an individual infected with the virus, which is around the third day and may continue the blood for up to 3−4 months after infection. While immunoglobulin G (IgG) is an antibody that’s formed supported the body’s memory of the virus that when infected. IgG appears slower than IgM, which is about 7−10 days after infection and may last longer than IgM. [7,8]

Interpretation of IgG and IgM COVID-19 Rapid Test Results – Covid 19 1gm Lgg

IgG and IgM COVID-19 rapid test results are interpreted with negative results, positive IgM, positive IgG, IgG, and IgM positive, or invalid results. Ideally, a positive result indicates the body is actively forming antibodies against the SARS-Cov-2 virus, while negative results indicate that the body has not yet formed antibodies. [3,9]

Negative or Nonreactive

Discoloration from blue to red on the control line (C), and not found lines in regio M (IgM) or G (IgG), give negative or nonreactive results. The negatively interpreted results indicate that the patient is presumably not infected or because the antibody has not been formed. The results are often written as follows “anti-SARS-CoV-2 IgM and IgG non-reactive or anti-SARS-CoV-2 Total nonreactive antibodies”. confine mind that non-reactive results don’t rule out the likelihood of being infected with SARS-Cov-2, so it still requires self-isolation and repeated examination within 7 days. [10,11]

Corona Virus (Covid 19)
Corona Virus (Covid 19) (klikdokter.com

IgM Positive

There is a change in color from blue to red on the control line (C), colored lines appear in regio M, and no lines are found in regio G. These results indicate the presence of IgM antibodies from SARS-Cov-2. The results are often written as follows “anti-SARS-CoV-2 IgM reactive, anti-SARS-CoV-2 IgG non-reactive”. [10,11]

These positive IgM results are often interpreted as being infected with COVID-19 if amid symptoms of acute virus infection. However, many cases are false positives where cross-reactions occur to antibodies from other coronaviruses, or there also are inaccurate results. Therefore, in patients with symptoms or who have a risk of other reasons the test should be continued with the RT-PCR test.

IgM Positive

There is a change in color from blue to red on the control line (C), colored lines appear in regio M, and no lines are found in regio G. These results indicate the presence of IgM antibodies from SARS-Cov-2. The results are often written as follows “anti-SARS-CoV-2 IgM reactive, anti-SARS-CoV-2 IgG non-reactive”. [10,11]

These positive IgM results are often interpreted as being infected with COVID-19 if amid symptoms of acute virus infection. However, many cases are false positives where cross-reactions occur to antibodies from other coronaviruses, or there also are inaccurate results. Therefore, in patients with symptoms or who have a risk of other reasons the test should be continued with the RT-PCR test.

IgG Positive

There is a change in color from blue to red on the control line (C), a colored line appears within the regio G, and no lines are found on the regio M. These results indicate the presence of IgG antibodies from SARS-Cov-2. The results are often written as follows “anti-SARS-CoV-2 IgM non-reactive, anti-SARS-CoV-2 IgG reactive”. [10,11]

Positive IgG results indicate Sars-Cov-2 infection occurred within the past and has formed immunity, but doesn’t indicate the patient has not transmitted the virus again. Positive IgG results also can give false-positive results thanks to cross-reactions with other coronaviruses. [10,11]

IgG and IgM Positive

Visible discoloration from blue to red on the control line (C), also as colored lines appear in both regio G and M. Results are often written as follows “anti-SARS-CoV-2 IgM and IgG reactive or anti-SARS-CoV-2 total reactive antibodies”. [10,11]

These results may ideally indicate the presence of IgG and IgM antibodies from SARS-Cov-2. However, like positive IgM results, this condition may indicate the patient is correctly infected with COVID-19, false positive, or inaccurate. Patients with symptoms or risks should be continued with an RT-PCR diagnostic examination. [10,11]

Invalid or Inaccurate

The check is said invalid if the control line (C) fails to completely change from blue to red. this will be caused by insufficient specimen volume or incorrect procedural techniques. Although there are colored lines in regio G or M, if the C line doesn’t change color perfectly then the result remains invalid. it is a good idea to repeat the check. [10,11]

Sensitivity and Specificity of Rapid Test IgG and IgM COVID-19

Prospective observational studies by Prazuck et al illustrate that the sensitivity of rapid test tools can vary. this relies on the day of the examination, where the sooner it’s performed the lower the sensitivity. Prazuck et al tried to look at the sensitivity and specificity of the 2 IgG and IgM rapid tests for COVID-19, namely THE COVID-PRESTO® and COVID-DUO® brands. The sensitivity of covid-presto rapid test® conducted since the onset of symptoms appear is about 10% on the first to 5th day, 58.14% on the 6th to 10th day, 69.23% on the 11th to 15th day, and 100% when it’s quite 15 days. The sensitivity of the COVID-DUO rapid test® calculated from the onset of symptoms appeared was about 35.71% on the 0th to 5th day, 54.76% on the 6th to 10th day, 81.82% on the 11th to 15th day, and 100% when it had been over 15 days. The specificity of the 2 tools tested is 100% respectively. [12]

Meanwhile, the Cassaniti et al study reported poor performance of igg and IgM rapid test tests for COVID-19, with a sensitivity of only 18.4%. Out of a complete of 38 positive RT-PCR samples, only 7 samples gave positive results from the igg and IgM rapid test for COVID-19. supported these results, Cassaniti et al concluded that rapid tests of IgG and IgM COVID-19 aren’t recommended for triage patients with suspected COVID-19 especially in emergency units. Nevertheless, the rapid test specificity reported is sort of high which is about 91.7%. just one false negative result was among the 12 tests on the RT-PCR negative sample. While the rapid test negative prediction value of this study is 26.2% and therefore the positive predictive value is 87.5%. [13]

Limitations of Rapid Test IgG and IgM COVID-19

Given the low sensitivity of the IgG and IgM COVID-19 rapid tests, this test isn’t recommended to be used as a screening tool. Especially for triage patients who enter the hospital or for travelers. However, this examination can still be used when there are limitations of tools and facilities, also on strengthen contact tracking in prisons, nursing homes, rehabilitation centers, dormitories, boarding schools, and other vulnerable groups. [4,14]

Based on the evidence so far, who recommends the utilization of rapid tests of IgG and IgM COVID-19 just for research, not for clinical deciding, until evidence supporting use surely indications is out there. [15]

Based on the Decree of the Minister of Health of the Republic of Indonesia number HK.01.07/MENKES/413/2020 concerning Guidelines for Prevention and Control of Coronavirus Disease 2019 (COVID-19), a rapid test of antibodies isn’t used for COVID-19 diagnostics. The rapid test is merely used for screening when there are limitations of RT-PCR inspection capacity. [14]

 

 

 

 

 

 

 

 

Conclusion

The low sensitivity of IgG and IgM COVID-19 rapid tests causes this test to not be recommended as a screening tool. Especially for triage patients who enter the hospital or for travelers. However, this check can still be used when there are limitations of other proofing tools, like RT-PCR. supported recent studies, WHO recommends the utilization of rapid tests of IgG and IgM COVID-19 just for research, not for clinical deciding, until evidence supporting use for specific indications is out there.

Interpretation of rapid test results of antibodies is often written negative/nonreactive results, positive IgG, positive IgM, positive IgG and IgM, and invalid. Ideally, negative results indicate that antibodies aren’t yet formed within the body, while positive results indicate the body actively forms antibodies against the SARS-Cov-2 virus. However, thanks to low sensitivity it’s a high risk to offer false positive results so it can’t be wont to diagnose COVID-19. Patients with positive results of IgG, IgM, and both should conduct RT-PCR tests for the precise diagnostic of COVID-19. Meanwhile, patients with negative results should still apply self-isolation if they need a contact history, or conduct an RT-PCR test if symptoms and signs of infection appear.

Source:
https://www.alomedika.com/interpretasi-hasil-rapid-test-igg-igm-covid19

 

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