Laboratory price list

The kit is designed for the qualitative and quantitative determination of neutralising IgG antibodies against SARS-CoV-2.

Antibodies produced against the structural proteins of the virus include spike and nucleocapsid antibodies. The spike is a transmembrane glycoprotein consisting of two regions (S1 and S2). S1 controls the recognition and binding to the host cell's viral receptor (ACE2), is largely made up of the receptor binding domain (RBD) and is highly immunogenic. S2 promotes viral membrane fusion with the host cell and entry. In most patients, antibodies appear after about 1-3 weeks from the onset of symptoms and are produced in both symptomatic and asymptomatic infections. Nearly parallel production of IgM and IgG antibodies has been observed in symptomatic patients with confirmed SARS-CoV-2 infection. IgM eventually disappears, but IgG remains detectable in the majority of patients. In symptomatic disease, the antibody titre may be higher, although further data are needed to confirm this.
As with several of the currently available vaccines, the SARS-CoV-2 Total (COV2T) and SARS-CoV-2 IgG (sCOVG) assays target the S1 RBD region of the virus, and primary data suggest that antibodies targeting this region may have a neutralising effect. The identification of specific antibodies associated with neutralization may play an important role in the detection of the immune response against SARS-CoV-2 virus.
Source: http://www.diagnosticum.hu/upload/product/COVID-19_Total___s_COVID-19_IgG_ellenanyag_vizsg__latok.pdf

The antibody test is used to test for immunisation, it is not suitable for detecting acute infection on its own!
Seropositivity can be caused by vaccination, previous illness or current infection. To exclude the latter, PCR testing of an upper respiratory tract specimen is required.
In immunosuppressed patients, the antibody response may not always be detectable.
Antibody levels may fall below detectable levels over time after the infection has passed, which does not necessarily mean that immunity disappears.
Only the values expressed in BAU/ml can be compared between the results of measurements from different laboratories.
Advia Centaur recommended cut off value: non-reactive: < 1.00 index Reactive: ≥ 1.00 index.

• Infection serology: Covid-19 infection: Siemens Healthcare SARS-COV2-IgG SCovG QC

The kit is designed for the qualitative and quantitative determination of neutralising IgM antibodies against SARS-CoV-2.

Antibodies produced against the structural proteins of the virus include spike and nucleocapsid antibodies. The spike is a transmembrane glycoprotein consisting of two regions (S1 and S2). S1 controls the recognition and binding to the host cell's viral receptor (ACE2), is largely made up of the receptor binding domain (RBD) and is highly immunogenic. S2 facilitates viral membrane fusion with the host cell and entry. In most patients, antibodies appear after about 1-3 weeks from the onset of symptoms and are produced in both symptomatic and asymptomatic infections. Nearly parallel production of IgM and IgG antibodies has been observed in symptomatic patients with confirmed SARS-CoV-2 infection. IgM eventually disappears, but IgG remains detectable in the majority of patients. In symptomatic disease, the antibody titre may be higher, although further data are needed to confirm this.
As with several of the currently available vaccines, the SARS-CoV-2 Total (COV2T) and SARS-CoV-2 IgG (sCOVG) assays target the S1 RBD region of the virus, and primary data suggest that antibodies targeting this region may have a neutralising effect. The identification of specific antibodies associated with neutralization may play an important role in the detection of the immune response against SARS-CoV-2 virus.
Source: http://www.diagnosticum.hu/upload/product/COVID-19_Total___s_COVID-19_IgG_ellenanyag_vizsg__latok.pdf

In immunosuppressed patients, the antibody response may not always be detectable.
Antibody levels (IgM and IgG) may fall below detectable levels over time after the infection has progressed, which does not necessarily mean that immunity is lost.
IgM levels rise in the first 2-3 weeks of infection, so positivity indicates a recent infection.

IgM positivity above 1.0.

• Infection serology: Covid-19 infection: Biomérieux SARS-CoV-2 IgM

The SARS-CoV-2 IgG and IgM antibody test in venous blood.

Antibodies produced against the structural proteins of the virus include spike and nucleocapsid antibodies. The spike is a transmembrane glycoprotein consisting of two regions (S1 and S2). S1 controls the recognition and binding to the host cell's viral receptor (ACE2), is largely made up of the receptor binding domain (RBD) and is highly immunogenic. S2 facilitates viral membrane fusion with the host cell and entry. In most patients, antibodies appear after about 1-3 weeks from the onset of symptoms and are produced in both symptomatic and asymptomatic infections. Nearly parallel production of IgM and IgG antibodies has been observed in symptomatic patients with confirmed SARS-CoV-2 infection. IgM eventually disappears, but IgG remains detectable in the majority of patients. In symptomatic disease, the antibody titre may be higher, although further data are needed to confirm this.
As with several of the currently available vaccines, the SARS-CoV-2 Total (COV2T) and SARS-CoV-2 IgG (sCOVG) assays target the S1 RBD region of the virus, and primary data suggest that antibodies targeting this region may have a neutralising effect. The identification of specific antibodies associated with neutralization may play an important role in the detection of the immune response against SARS-CoV-2 virus.
Source: http://www.diagnosticum.hu/upload/product/COVID-19_Total___s_COVID-19_IgG_ellenanyag_vizsg__latok.pdf

The detection of the antibody (IgG) is used to test for immunisation, it is not suitable for the detection of acute infection on its own! It is not possible to assess infectivity without a specific PCR test.
In immunosuppressed patients, the antibody response may not always be detectable.
Antibody levels (IgM and IgG) may fall below detectable levels over time after the infection has progressed, which does not necessarily mean that immunity is lost.
Only the values expressed in BAU/ml can be compared between the results of measurements from different laboratories.
Advia Centaur recommended cut off value: non-reactive: < 1.00 index Reactive: ≥ 1.00 index

IgM positivity above 1.0.
When the two antibodies are tested together:

• In the case of negative IgG and IgM, the patient has not yet had an infection or has had an infection for more than 3 months and the antibody levels are already low.
• Positive IgM, negative IgG - a patient who has been newly infected for less than 2 weeks (this result does not exclude the possibility that he/she has had the infection or vaccination but has already had a decrease in antibody levels). In this case the person tested is most likely to be infectious.
• Positive IgM and IgG - a newly infected or re-infected patient (even after vaccination) more than 2 weeks (2-4 weeks) ago. In this case, the person tested is most likely to be infectious.
• Positive IgG and negative IgM - Previously infected or vaccinated patient (more than 4 weeks). To the best of our knowledge, the person tested is no longer infectious.

• Infection serology: Covid-19 infection: Siemens Healthcare SARS-COV2-IgG SCovG QC, Biomérieux SARS-CoV-2 IgM

After covid-19 infection, many people have an increased chance of developing a blood clot.
D-dimer, one of the products of fibrin degradation, is formed in the breakdown process following clot formation. D-dimer measurement is used to determine whether the patient has a factor that has activated the body's blood clotting mechanism to a greater than normal extent.

• Inflammation factors: C-reactive protein (ultrasensitive, CRP)
• Vvascular image 22 parametersr: Blood counts: white blood cell (WBC), red blood cell (RBC), haemoglobin (HGB), haematocrit (HCT), red blood cell volume (MCV), red blood cell haemoglobin concentration (MCH), mean cell haemoglobin concentration (MCHC). Quality blood count parameters (both in % and absolute value): neutrophil granulocyte (NEUT), lymphocyte (LYMPH), monocyte (MONO), eosinophil granulocyte (EOS), basophil granulocyte (BASO), large immature cells (LUC). Trombocita parameters: platelets (PLT), mean platelet volume (MPV), platelet distribution curve width (PDW), platelet crit (PCT)
• Blood clotting: D-Dimer

The postcovid profile package is used to assess the status after Covid-19 infection.

Covid-19 infection increases the risk of myocardial damage and blood clots.
This can result in a heart attack. Symptoms may include chest pain or shortness of breath.
Covid-19 infection adversely affects liver, kidney and muscle function and increases inflammatory processes. It impairs thyroid function.

A D-dimer, i.e. one of the fibrin degradation products, is formed in the breakdown process following clot formation. The D-dimer measurement is used to determine whether the patient has any factors that have activated the body's blood clotting mechanism to a greater than normal extent.

A troponins proteins involved in muscle contraction in skeletal and cardiac muscle fibres. Types are C, T and I. Cardiac-specific troponin T and/or I are good markers of possible heart damage. After myocardial damage, blood troponin I and T levels are elevated as early as 3-4 hours after myocardial damage and can remain elevated for several weeks, making them a good marker of e.g. myocardial infarction.

• Liver function: direct bilirubin (D-Bil), total bilirubin (T-Bil), gamma GT (GGT), aspartate aminotransferase (GOT or AST), alanine aminotransferase (GPT or ALT)
• Water: urea (KARB, Urea, N, BUN), creatinine/ EGFR-el (KRE)
• Inflammation factors: alkaline phosphatase (ALP), C-reactive protein (ultrasensitive, CRP), lactate dehydrogenase (lactic dehydrogenase, LDH), red blood cell sedimentation (RBC)
• Muscle metabolism: creatine kinase (CK), creatine kinase-MB (CK-MB)
• Heart muscle function: cardiac troponin I (Tn I)
• Thyroid function: anti-thyroid peroxidase antibody (anti-TPO)
• Regulating thyroid hormones: thyroid stimulating hormone (TSH)
• How the haematopoietic system works: ferritin (FERR), D-dimer
• Vvascular image 22 parametersr: Blood counts: white blood cell (WBC), red blood cell (RBC), haemoglobin (HGB), haematocrit (HCT), red blood cell volume (MCV), red blood cell haemoglobin concentration (MCH), mean cell haemoglobin concentration (MCHC). Quality blood count parameters (both in % and absolute value): neutrophil granulocyte (NEUT), lymphocyte (LYMPH), monocyte (MONO), eosinophil granulocyte (EOS), basophil granulocyte (BASO), large immature cells (LUC). Trombocita parameters: platelets (PLT), mean platelet volume (MPV), platelet distribution curve width (PDW), platelet crit (PCT)

The postcovid profile plus package provides a comprehensive post-infection assessment of Covid-19.

Covid-19 infection increases the risk of myocardial damage and blood clots.
This can result in a heart attack. Symptoms may include chest pain or shortness of breath.
Covid-19 infection adversely affects liver, kidney and muscle function and increases inflammatory processes. It impairs thyroid function.

A D-dimer, i.e. one of the fibrin degradation products, is formed in the breakdown process following clot formation. The D-dimer measurement is used to determine whether the patient has any factors that have activated the body's blood clotting mechanism to a greater than normal extent.

A troponins proteins involved in muscle contraction in skeletal and cardiac muscle fibres. Types are C, T and I. Cardiac-specific troponin T and/or I are good markers of possible heart damage. After myocardial damage, blood troponin I and T levels are elevated as early as 3-4 hours after myocardial damage and can remain elevated for several weeks, making them a good marker of e.g. myocardial infarction.

In the case of increased tension in the heart muscle, the active B-type natriuretic peptide (BNP) and the inactive N-terminal pro B-type natriuretic peptide (NT-proBNP) production. The increased presence of these peptides in the blood means that the heart is working harder to provide an adequate blood supply, so the heart has suffered some degree of muscle damage.

• Carbohydrate metabolism: glucose (GLU, fasting)
• Liver function: direct bilirubin (D-Bil), total bilirubin (T-Bil), gamma GT (GGT), aspartate aminotransferase (GOT or AST), alanine aminotransferase (GPT or ALT)
• Water: urea (KARB, Urea, N, BUN), creatinine/ EGFR-el (KRE), uric acid (UA)
• Inflammation factors: alkaline phosphatase (ALP), C-reactive protein (ultrasensitive, CRP), lactate dehydrogenase (lactic dehydrogenase, LDH), red blood cell sedimentation (RBC)
• Muscle metabolism: creatine kinase (CK), creatine kinase-MB (CK-MB)
• Heart muscle function: cardiac troponin I (Tn I), troponin T (Tn T)
• Thyroid function: anti-thyroid peroxidase antibody (anti-TPO)
• Regulating thyroid hormones: thyroid stimulating hormone (TSH)
• Blood clotting: D-Dimer, protombrin+INR (Pt+INR), N-terminal pro B-type natriuretic peptide (NT-proBNP)
• How the haematopoietic system works: ferritin (FERR), D-dimer
• Vvascular image 22 parametersr: Blood counts: white blood cell (WBC), red blood cell (RBC), haemoglobin (HGB), haematocrit (HCT), red blood cell volume (MCV), red blood cell haemoglobin concentration (MCH), mean cell haemoglobin concentration (MCHC). Quality blood count parameters (both in % and absolute value): neutrophil granulocyte (NEUT), lymphocyte (LYMPH), monocyte (MONO), eosinophil granulocyte (EOS), basophil granulocyte (BASO), large immature cells (LUC). Trombocita parameters: platelets (PLT), mean platelet volume (MPV), platelet distribution curve width (PDW), platelet crit (PCT)
• Reticulocyte parameters: reticulocita (% RETIC), reticulocita (abs RETIC)