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Published on: Jul 09, 2020
2 minute read
By: Dr Rakesh Choudhary

COVID- 19 Tests – What Do You Need To Know?

COVID- 19 tests – What do you need to know?

Author: Dr. Rakesh Choudhary MBBS, MS, FRCS UK, FRCS Orth UK, MChOrth UK.

Dr. Choudhary is a practicing consultant surgeon in the UK.

So many of us think it is not their job to learn about COVID-19 tests and this should be left for the experts and governments to decide about these tests. But I strongly suggest the public must have a basic understanding of these tests which they may have to have themselves.

Basically there are two types of tests, one which can detect the virus in the body and the other one which tells if the person had the previous infection.

Virus test

The virus test detects an active infection. It detects the genetic material (RNA) of the virus during an active infection. It is also called a PCR (polymerase chain reaction) test or nucleic acid test and is sometimes inaccurately called an antigen test.

A swab is taken from deep in the back of your throat and deep in the nose. The swab should go deep up to 7-8 cm and is generally uncomfortable for the patient. Swabbing patients using the correct technique is paramount in ensuring an accurate result. By simply swabbing the inside of the nasal passage is not deep enough to verify that the virus is present.

What does virus testing tell you?

This test tells us if a patient is actively infected with the COVID-19 virus. Virus testing is used mainly for the diagnosis of COVID-19.

When should it be done?

The virus test works best during the first seven days of symptoms.

The coronavirus can be detected in swabs even before symptoms of illness first appear . This is why people can be infectious for a few days before the onset of symptoms, which usually appear about 5 days after the virus infects. Some people have no symptoms throughout their infection but are positive on the virus test and infectious to others. After a few days of illness, the concentration of the virus falls (as seen in swab samples) and the symptoms of the illness usually recede.

Accuracy of the test

In a person with COVID-19, the test is less likely to give a positive result late in the course of infection once the virus has been cleared by the immune system, or if an inadequate sample is taken from the nose or throat. There are concerns that the rate of ‘false negative’ test results could be as high as 30% and a significant number of people are wrongly being told they do not have the virus.

Antibody test

Antibody tests check your blood by looking for antibodies, which may tell you if you had a past infection with the virus that causes COVID-19. Antibodies are protein structures that are produced by the immune system in response to certain infections. The antibody can help fight off infections and can provide protection against getting that disease again (immunity). Antibodies are disease-specific. For example, measles antibodies will protect you from getting measles if you are exposed to it.

The antibody test detects the presence of antibodies as a marker of past infection. The antibody test (blood test) will only detect infections after the immune system has produced antibodies that recognize the virus. This happens approximately 7–10 days after symptoms develop.

Tests carried out a week after a patient develops symptoms will detect only 30% of people who had COVID-19 infection. Accuracy increases to 72% at two weeks and to 94% in the third week. Some people may take even longer to develop antibodies, and some people who are infected may not ever develop antibodies.

Interpretation of the antibody test is complex for non-medical people. Basically having antibodies to the virus that causes COVID-19 may provide protection from getting infected with the virus again. If it does, we do not know how much protection the antibodies may provide or how long this protection may last.

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Chest Pain While Breathing: Causes, Warning Signs, and When to Seek Urgent Care

Chest pain is one of the most alarming symptoms a person can experience, especially when it worsens during breathing. Chest pain while breathing, also known as pleuritic chest pain, often indicates involvement of the lungs, chest wall or surrounding structures. While some causes are mild, others can be life-threatening and require immediate medical attention.

In India, respiratory infections, air pollution, sedentary lifestyles and delayed medical care contribute significantly to chest-related symptoms.

What Does Chest Pain While Breathing Mean?

Chest pain while breathing refers to pain that:

worsens with deep inhalation or exhalation
may feel sharp, stabbing or burning
can be localized or spread across the chest

Pain intensity often increases with coughing or movement.

Common Causes of Chest Pain While Breathing

Lung Infections (Pneumonia)

Pneumonia inflames lung tissue and surrounding membranes.

Symptoms include:

chest pain while breathing
fever
cough
breathlessness

ICMR data identifies pneumonia as a major cause of respiratory illness in India.

Pleuritis (Inflammation of Lung Lining)

The pleura are thin membranes surrounding the lungs.

When inflamed:

breathing causes friction
sharp chest pain occurs

Pleuritis often follows viral infections or pneumonia.

Pulmonary Embolism

A blood clot in the lungs causes:

sudden chest pain
rapid breathing
severe breathlessness

This is a medical emergency requiring immediate care.

Chest Wall Muscle Strain

Muscle strain due to:

heavy lifting
intense coughing
poor posture

can cause pain during breathing or movement.

Costochondritis

Inflammation of rib cartilage causes:

localized chest pain
pain worsened by breathing or pressing on the chest

This condition is painful but not life-threatening.

Pneumothorax (Collapsed Lung)

Air leakage into the chest cavity causes:

sudden sharp chest pain
breathlessness

Often seen after trauma or in individuals with lung disease.

Heart-Related Causes

Though heart pain usually does not worsen with breathing, conditions such as:

pericarditis (heart lining inflammation)

can cause chest pain that changes with respiration.

Acid Reflux and Esophageal Spasm

Gastrointestinal causes may mimic chest pain.

However:

pain usually relates to meals
breathing-related pain should be evaluated carefully

Anxiety and Panic Disorders

Anxiety can cause:

chest tightness
rapid breathing
discomfort while breathing

Medical causes must be ruled out before attributing pain to anxiety.

Warning Signs That Require Emergency Attention

Seek immediate medical care if chest pain while breathing is associated with:

sudden onset
severe breathlessness
bluish lips or fingers
dizziness or fainting
sweating
coughing up blood

These may indicate life-threatening conditions.

Risk Factors for Serious Chest Pain

Higher risk occurs in people with:

smoking history
recent surgery or long travel
lung disease
heart disease
clotting disorders

Early evaluation is critical.

Diagnostic Evaluation

Doctors may recommend:

physical examination
chest X-ray
ECG
blood tests
CT scan

Timely diagnosis saves lives.

Why Chest Pain Should Not Be Ignored

Ignoring chest pain can lead to:

delayed treatment
worsening respiratory failure
preventable complications

WHO emphasises early symptom recognition for better outcomes.

Impact of Air Pollution and Lifestyle

Air pollution increases:

lung inflammation
infection risk

Sedentary habits reduce lung capacity, worsening symptoms.

Preventive Measures

Helpful preventive steps include:

avoiding smoking
staying physically active
managing respiratory infections early
maintaining good posture
staying hydrated

Preventive care reduces risk.

Role of Preventive Health Checkups

Regular health screening helps detect:

early lung disease
heart risk factors
chronic inflammation

Early intervention prevents emergencies.

When Chest Pain Is Less Likely Serious

Pain may be less concerning if:

localized
reproducible on touch
improves with rest

However, medical confirmation is still necessary.

Importance of Timely Medical Consultation

Chest pain should always be evaluated by a healthcare professional.

Delaying care can:

increase complications
raise mortality risk

Early action saves lives.

Conclusion

Chest pain while breathing is a critical symptom that should never be ignored. While causes range from muscle strain and infections to serious lung and heart conditions, only proper medical evaluation can determine the exact cause. Early diagnosis, timely treatment and preventive care are essential to protect respiratory and cardiovascular health. When it comes to chest pain, it is always safer to act early than to wait.

References

Indian Council of Medical Research (ICMR) – Respiratory and Cardiovascular Health Reports
World Health Organization (WHO) – Chest Pain and Respiratory Symptoms Guidelines
National Family Health Survey (NFHS-5) – Adult Respiratory Health Data
Lancet – Pulmonary Embolism and Chest Pain Research
NITI Aayog – Preventive Healthcare and Early Symptom Recognition

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