Intermediate Physics for Medicine and Biology: I’ve Got Covid

For three years I’ve dodged the bullet, but no more; I have covid. I’m doing fine, thank you. For me the symptoms were similar to a moderate cold. My doctor put me on a five-day regimen of the antiviral drug Paxlovid plus some supplements to support my immune system (vitamin C, vitamin D3, and zinc). I’ve been isolating in our spare bedroom, which is boring but otherwise comfortable. I think I’m over the hump.

During the last few days I’ve taken several of those at-home covid rapid antigen tests. There’s some interesting physics at work in them. The figure below illustrates how they’re constructed.

A covid rapid antigen test. From: Gupta et al. (2020) Nanotechnology-Based Approaches for the Detection of SARS-CoV-2. Frontiers in Nanotechnology, Volume 2, Article 589832.

To perform a test, you typically swab your nose, dip the swab in saline, stir, and then place a few drops of the solution onto the sample pad (A). You’re not detecting the virus itself, but instead the SARS-Cov 2 antibody. To explain what that means, I need to delve into a bit of immunology.

Our immune system produces a Y-shaped protein called an antibody, or immunoglobulin, that can selectively bind to an antigen, which is typically a protein that’s part of the coronavirus. The beauty of the antibody-antigen reaction is that it’s so specific: it lets the immune system attack a particular virus, bacteria, or other pathogen, ignoring everything else. When you get covid, your body launches an immune attack by producing SARS-Cov 2 antibodies. In the illustration above, the yellow Y is the antibody you are trying to detect. See David Goodsell’s marvelous painting of a virus being attacked by antibodies at the bottom of this post.

In the above figure, the conjugate pad (B) is where much of the physics lives. The pad contains gold nanoparticles (AuNP) that are coated with anti-human antibodies. An “anti-human antibody” is a molecule that binds selectively to a human antibody. In the figure, a red dot with a blue Y sticking out is a gold nanoparticle with an anti-human antibody bound to it.

A nitrocellulose membrane (NC membrane) is made from a mesh of nitrocellulose fibers (C). The mesh is porus and acts something like a wick, pulling the fluid from left to right by capillary action. This is why a device like that in the figure above is sometimes called a lateral flow test. The mesh also provides protected space for the nanoparticles and molecules to move around and interact in. The absorbent pad (D) acts like a sponge, soaking up the fluid as it reaches the right end of the detector, contributing to the capillary action and preventing any back flow.

As any SARS-Cov 2 antibody passes by a gold nanoparticle/anti-human antibody, it binds and the entire complex flows to the right together (in the figure, a combined red dot/blue Y/yellow Y).

Some additional molecules are bound to two spots on the nitrocellulose membrane. One, the test strip, has the SARS-cov 2 antigen. If any SARS-Cov 2 antibody passes by, it will bind to the antigen, immobilizing the gold nanoparticles. The other strip is goat anti-mouse antibody. How did a goat and mouse get involved? I don’t know. As I understand it, gold nanoparticles with antibodies that bind to the goat anti-mouse antibody are included in the conjugate pad, so regardless of if you have covid or not it serves as a control. If the nanoparticles don’t collect at the control strip, something is wrong.

Why bother with the gold nanoparticles? Their role is to transduce the signal so it becomes visible. Nanoparticles have interesting optical properties. When exposed to an electromagnetic field such as light, the electric field causes electrons to accumulate on one side of the particle creating a negative surface charge, leaving the opposite side positive from a lack of electrons. Such a distribution of charge oscillates at its own natural frequency (its plasma frequency), and when this frequency matches the driving frequency of the light there is a resonance. This “localized surface plasmon resonance” is effective at absorbing or scattering light. Scattering is particularly important because Rayleigh scattering (the scattering of light by particles with a radius much smaller than the wavelength of the light) depends on the sixth power of the particle radius. The binding of nanoparticles (which typically have a diameter of tens of nanometers) with large antibodies and antigens, and the aggregation of these complexes, can increase their effective size, accentuating scattering. In addition, the high concentration of the nanoparticles at the test and control strips enhance any optical effect. The end result is that you see a dark line if the nanoparticles are present.

So swab your nose, swish it in some saline, add a few drops to the sample pad, and wait. After about 15 minutes look at the results. If there is no control line, you’ve messed up. Throw the test away and try again. If there’s a control line but no test line, you’re negative. Be happy (but not too happy, because these tests are prone to false negatives). If there’s both a control line and a test line, you’ve got covid. The tests don’t give false positives too often, so you can be fairly confident you have the disease. Isolate yourself and talk to you doctor.

Where is the physics in all this? First, in the flow, which results from the surface tension created by the mesh of fibers, leading to capillary action. Second, in the optical properties of the nanoparticles, which provide the color that you see in the test and control strips. Unfortunately, Intermediate Physics for Medicine and Biology doesn’t discuss capillary action or surface plasmons, so you can’t learn about them there. Sorry; no book can cover everything. But there is interesting physics hidden in these tests.

Stay safe, dear reader, and may all your covid tests be negative.

This painting shows a cross section through a coronavirus surrounded by blood plasma, with neutralizing antibodies in bright yellow. The painting was commissioned for the cover of a special COVID-19 issue of Nature. From: David S. Goodsell, RCSB Protein Data Bank and Springer Nature; doi: 10.2210/rcsb_pdb/goodsell-gallery-025