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Your Coronavirus Test Questions Answered

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Published on June 2, 2020

Can I get a coronavirus test at my doctor’s office? Or do I go to a nearby lab? Will my current treatments help or hinder me when it comes to COVID-19?

In Part 2 of this Answers Now program, host Andrew Schorr talks to noted laboratory science experts Dr. Susan Leclair and Dr. Jim Griffith, from the UMass Center for Molecular Diagnostics. They discuss whether or not you can get an antibody test done at the same time as your other blood work, if treatments like IVIG, inhibitors or convalescent plasma can help, vaccine possibilities, and more. Watch now to learn the latest information. 

In case you missed Part 1 of this conversation, watch What’s the Latest on Coronavirus Antibody Tests?

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Transcript | Your Coronavirus Test Questions Answered

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Recorded on May 27, 2020

Andrew Schorr:

How will our system affect the antibody test? So, I have chronic lymphocytic leukemia, somebody else may have been hit hard with chemo for prostate cancer or whatever, and their immune system got affected, so the antibody test result.

Dr. Leclair:

I think you also have to add in a few more things. There are those of you who are on chemo now. There are those of you who stopped the actual taking of the chemo, taking is the global word right now, but are still feeling the effects of the chemo. Those who are using rituximab (Rituxan), for example, can experience a reaction from it up to about six months or maybe longer. And then there are those who did it, done it, so far things are looking fine. So, you have to kind of separate those out. You also have to put in some thought of what type of malignancy you had. If you do have somebody who's an elderly man, and he had a relatively low grade cancer, so he had the standard dosages of drugs, went through it relatively comfortably, that was a year-and-a-half ago, I would probably think that he is going to have testing that looks remarkably like a man of his age who didn't have prostate cancer.          

On the other hand, if I have a woman who is actively involved that's either taking it or recovering from the medication for breast cancer, well then, she's still under the influence of those medications. And since many of those medications now end with MAB or MIB, because that's telling you it's some kind of immunologic agent, then what you may be getting is some suppression of their ability to make and respond to an antigen.

Andrew Schorr:

Okay, Jim, so we're getting a lot of questions in on where to get tests, right? So you talked about the questions that people should ask about the quality of the test, the sensitivity, the specificity. Now there are some national labs, you know them well, Quest and LabCorp, and you can go in and get a test there. So how do you feel about those guys, these national organizations where you can get a reliable test there?

Dr. Griffith:

They're perfectly fine. They do good work. They try to abide by all of the clinical laboratory standards, and most of the time you don't need to ask about the methodology or the specific test protocol that they're using. So my advice would be whether it's in a physician's office or a clinic or a hospital, or an independent draw station for one of these big national labs, you should still ask the same questions that I suggested earlier. And if you can't get the answers, meaning whoever it is, whether it's a physician's office or Quest, if they can't tell you the answers to those questions, then you should be concerned about that, because it will make your answers whenever they come, difficult to rely on or understand. Or, what does it mean for me? Can I do this? Can I do that?

Andrew Schorr:

Susan, I don't know if you are aware of what's going around in the country or maybe what's happening in Massachusetts there, so many of us go for regular blood tests for our CBC and other things like that. So, can this be done at the same time? And do you know if that's happening now, where you can get your snapshot test or your antibody test at the same time?

Dr. Leclair:

Sure. What you're talking about is for the antibody test, the blood-based test, they would just be taking either an additional red stopper tube, or maybe it can be combined with some other red stopper tube test that you're taking. The biggest issues to deal with are the quality of the swab testing, the do you have it now testing? Because the object of that is to find out do you have the virus present? Well, if I stick a Q-Tip up just into the lip of my nose, it's not where the virus is. And no matter how well I did that, I'm not going to get a correct answer, because I didn't swab the correct area. So kind of one of the rules here is, if you don't, and this is also true for the throat, if you don't make that face that you've seen people make on TV, if you don't see them go "ugh" when the nasal swab goes up there, they didn't take it from the correct place.   

If when somebody was swabbing your throat, not your teeth, not your tongue, not your mouth, but your throat, if you didn't gag when they got there, then they didn't take the correct test. So you're going to have a test on a mouth swab, for example, well, that's not where the virus is. The virus is in the back of the throat. So you have to check that. So the patients who are kind of aware of issues, you want to have somebody who knows; back of the nose, back of the throat.

Andrew Schorr:

So my friends with CLL or some other conditions, multiple myeloma, many people get immunoglobulin. We've talked about it on other programs—pooled antibodies from blood products to help us not get infections, particularly bacterial infections but maybe viral infection as well. Not for COVID-19 at this point, okay? But does the fact that we're getting IVIG put us in a better or worse position? Does it affect any of this? The testing?

Dr. Griffith:

General immunoglobulins, and there's a whole range of things around that, there's interferon alfa, there's interleukin 6R, there are CD4 activators, there are neutralizing monoclonals. There are a whole bunch of things that are used to boost the immune status of patients who have less than functioning immune systems. As far as the coronavirus is concerned, we don't know how any of these work. We do know by one study that I saw, that drugs generally used for HIV therapy don't work. The famciclovir (Famvir), and there have been several of those. Generally, they don't work. The immunoglobulin infusions and all of those things like interleukins and CD4s and all that, we just don't know. I would think that having an enhanced immune status if you are immunocompromised is a good thing, because you will be less subject to co-morbidity.     

You wouldn't want to have a viral pneumonia that you can get from coronavirus at the same time you have a bacterial pneumonia. You wouldn't want to do that. So soft answer, yes, they're probably useful, no, they are not a panacea, because they are general antibodies to general things.

Andrew Schorr:

Oh, just one other question for you quickly, Jim. We've been hearing about convalescent plasma. So there are people—I've seen young people in New York who've have the COVID virus, and they're donating, their plasma is being taken from their blood to donate to some people really sick. Do we know anything about the benefit of that yet?

Dr. Griffith:

Okay, we're guessing that convalescent plasma, since you were seriously exposed to the virus and you survived, maybe you made antibodies. Maybe those antibodies are protective. We don't know that yet, but they might be. One of the problems with convalescent plasma is that one unit of plasma from a donor can supply three patients. So it's not like one, and you get a thousand patients, one and you get three patients. We have absolutely no way to track the possible donors to ask them, “Will you donate?” There just isn't a system to do that. So when there are volunteers, “I had coronavirus, I'd like to give some of my plasma,” that's wonderful. We can't say yet how good it is, but depending on your immune status, it might be a good thing.

Andrew Schorr:

So, Susan, some of our folks are taking various medicines, maybe an interferon, maybe a Bruton's tyrosine kinase inhibitor like for some leukemias or lymphomas, et cetera. So any information on whether that's protective? That's in clinical trials now, right? Trying to see?

Dr. Leclair:

Yeah, it is in clinical trials, and I think part of what is frustrating everybody both with our answers and with your own questions in the middle of the night. This virus didn't exist until sometime in November of last year. So it's only been around about six months. There are so many things that we don't know about this. In the general population, to take something from the general population that you're guessing about, and then try to extrapolate it into a very small specialized one is always difficult to do. Having said that, it looks like in non-immunosuppressed people, the Bruton’s kinase inhibitors and a lot of the other things that you guys are taking seem to modulate not the beginning, you're not going to not get COVID when you take those. And it's not really going to help you live through it in a sense if you have the slight to moderate presentations that people are talking about, where you can quarantine at home. But when you get into the severe forms of COVID, when you're near to or on the ventilator, when you're in that kind of extremis, it looks like that those modulators can control or at least limit the cytokine storm that everyone's talking about.

Andrew Schorr:

Okay, all right. Let's try to tie all this together. So, Jim, I'm sitting here thinking, “Well, if I can at a clinic or at one of these national labs, get these tests, I'm going to do it.: But I don't know yet how that will change my decision-making, right? And I'll try to get the most reliable sensitive and specific test as you told me, and I'm going to ask about that. But still, the benefit, I mean I can know whether I have the virus or not. But as far as immunity, the jury's out on that. And we'll have to do a whole other program with you guys about vaccines, but I think, Jim, it's safe to say, tell me if I'm right, that vaccines, there are many fortunately going to trials, but to see whether they work and are safe, that takes a while. And that isn’t going to happen anytime soon, right?

Dr. Griffith:

That's correct. We have had viruses for which we have developed vaccines that took seven years. We have other viruses that we have tried to develop vaccines for that we never have been able to do it. So, and others that, you know, the standard fast rate for developing a vaccine is 12 to 18 months. So this one may come in somewhere in there. Clearly the world’s scientific community is putting a full court press on doing that, but that would be to be reasonable sure that there's a reasonable chance that it might be useful, and we can make seven billion doses of it. You know, that's the other problem. You find something that works, you have to make an awful lot of it, because you have to give it to everybody.

Andrew Schorr:

That's what we can do. So we'll get our tests as you can get a reliable one, folks, and then you know, be savvy about it, because again there's a lot we don't know. We will do a future program. Theresa and I and the team are working on that, on these other questions about the difficult discussions about I protect you, you protect me. Okay, we're going to talk more about that. This has been very helpful, but Susan Leclair, Jim Griffith from Dartmouth, Massachusetts, laboratory science gurus in my book. We've had 100 people with us today. Many more will see the replay, but we'll have you back, okay? Because the answers continue to emerge, and Jim you said it, when you said, “We just don't know yet.” Okay, all. right.

Thank you so much for being with us. Have a great day, wear a mask, and consider getting one of these tests, but factor in what we don't know yet. Get a reliable one, okay?

I'm Andrew Schorr in Southern California. Remember, knowledge can be the best medicine of all. 

This is part 2 of this program.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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