Examining and Explaining Antibody Testing

May 21, 2020

Sparrow Health System recently launched a drive-through coronavirus testing program at the former Sears site in Lansing's Frandor Shopping Center. People can get tested for either the virus, or for COVID-19 antibodies. People with coronavirus antibodies have been looked at as a source for plasma, which may be used to help fight the disease.

To learn more, WKAR’s Mary Ellen Pitney spoke with Dr. Jim Richard, Medical Director at Sparrow Laboratories.


What Happens

“What it requires is blood or serum. That's usually obtained via a blood draw, although there are some methods out currently that use a finger stick method”

Sparrow’s protocol uses a blood draw from upper forearm. Richard explained that the blood is then sent off-site to be tested in the lab. He says people should have a order from their primary care provider to get tested. If they do not, he says there is medical staff on site who can assess people and then write them an order for the test. Test results usually become available on an online portal within 5 days.

A Crucial Difference

“The antibody test can identify people that have had COVID virus in the past, sometimes even in the recent past, but it is not a method of identifying those that are acutely ill with the disease.”

The antibody test is not the appropriate test for somebody actively experiencing COVID-19 symptoms. The Center for Disease Control says this is due to timing. Because the body needs time to produce antibodies, few to none would be detected in a sample from a person with an acute infection. The rapid tests that are currently available to confirm the coronavirus in an acutely ill patient is viral RNA sequencing from a sample obtained through the nose or throat. This method is both expensive and requires appropriate and more complex methods.

No Clear Answers Yet

“It does need to be analyzed. It's one of these settings where it doesn't infer immunity that we know of today. We may find out in the future that it does, but we just don't know today. There's not enough information.”

Antibody testing often raises questions about immunological memory where the immune system can recognize antigens from a virus or bacteria it had been previously been exposed to and is able to neutralize a recurrent exposure. Immunological memory is why people who have had the chicken pox often, but not always, only get it once. Immunological memory is what helps prevent recurrence of infections, like the varicella virus which causes chicken pox. However, this kind of immunity can wane over time, and it is still unknown if people even develop this kind of long term immunity to SARS-CoV-2, which is the specific stain of novel coronavirus that has caused the COVID-19 pandemic.

Dr. Jim Richard, Medical Director at Sparrow Laboratories.
Credit courtesy / Dr. Jim Richard

A Promising Treatment

“What we are seeing with our preliminary work right now is about three and a half percent of the population are testing positive. I think the most important thing right now as it pertains to antibody testing is identifying possible plasma donations for the Red Cross”

It is still early in Sparrow’s testing effort, but so far approximately 3.5% of people tested are positive for COVID-19 antibodies. Richard says that people who test positive can contact the red cross and be screened to become a potential plasma donor. This plasma can then be given to patients who are acutely ill with coronavirus. This treatment has been anecdotally shown to be an effective treatment for patients who are actively fighting the disease. While promising, it is too early to determine if it is a proven treatment for COVID-19 patients. Patients are already being treated with this antibody rich plasma, including at least one at Sparrow.

TRANSCRIPT:

RICHARD: Antibody testing. Obviously, it starts with a patient. And what it requires is blood or serum. That's usually obtained via a blood draw, although there are some methods out currently that use a finger stick method, and then it's applied to the platform in order to do the testing.

Mary Ellen Pitney: How does this differ from the viral test?

RICHARD: Well, the viral test is a DNA test, which identifies the virus DNA within the epithelium of the patient. And so it detects the virus, it's at least the DNA of the virus itself. That requires a lot of extra work in order to obtain that and then portions of that viral particles that are there are identified through a rather complex mechanism. The PCR test is the test that will tell you if you are infected with the virus.

MEP: So, the antibody test says whether or not yes or no antibodies are there, the virus test actually looks at the DNA and the composition of the sample?

RICHARD: Correct; the DNA is--or the PCR test is basically used to identify patients who are acutely ill with the COVID virus. The antibody test does not detect that at all. The antibody test can identify people that have had COVID virus in the past, sometimes even in the recent past, but it is not a method of identifying those that are acutely ill with the disease.

MEP: So I drive up to the test site and I say I want an antibody test. What happens next?

RICHARD: Okay. One is if you have an order from your primary care doctor, then they will be able to draw. If you don't, we actually have primary care practitioners at the site who would be more than able to write that for you to be able to have your blood drawn and that test performed and you can readily identify, you know, see your results from that Sparrow account. It's a web based portal.

MEP: So how long does it take to get results back?

RICHARD: No, right now, it's like everything in COVID. There are allocations. But right now, we're saying that we can get the test back usually within five days. Usually it's significantly shorter than that.

MEP: This is WKAR. We are speaking with Dr. Jim Richard about expanding antibody testing efforts in Michigan. If antibodies are found, does that automatically indicate that people retain immunity to COVID-19? Or is it not that simple?

RICHARD: That's a great question; onet everybody wants to answer to.

MEP: Right. 

RICHARD: It's not that simple. 

MEP: Okay. 

RICHARD: However, what it does say is that we need more research more time with this disorder to identify whether or not antibodies mean immunity, but that also means We need a lot more testing to be able to determine whether or not that's actually the case.

MEP: So this is kind of like a preliminary data collection that then needs to be analyzed?

RICHARD: You know, that's a really good point. It does need to be analyzed. It's one of these settings where it doesn't infer immunity that we know of today. We may find out in the future that it does, but we just don't know today. There's not enough information.

MEP: It is still early in this anybody testing effort. But are there any patterns that are starting to emerge yet?

RICHARD: You know, not really patterns. What we are seeing with our preliminary work right now is about three and a half percent of the population are testing positive. I think the most important thing right now as it pertains to antibody testing is identifying possible plasma donations for the Red Cross for people to donate their plasma that may be helpful. Someone who's acutely ill with the COVID-19

MEP: Is Sparrow at all working with the Red Cross to do that plasma donation effort.

RICHARD: Absolutely. The Red Cross and Sparrow work very closely together. We talk pretty regularly on the phone. The key issue is that it identifies people that may be eligible to donate their plasma and once they are identified and contact the Red Cross, then the Red Cross handles the screening mechanism. We have had a patient here at Sparrow who was able to get what we call antibody rich plasma as an effort to try and treat them.

MEP: Dr. Jim Richard, thank you so much for speaking with me this morning.