Schmidt Jonas, Berghaus Sandro, Blessing Frithjof, Wenzel Folker, Herbeck Holger, Blessing Josef, Schierack Peter, Rödiger Stefan, Roggenbuck Dirk
Institute for Laboratory Medicine, Singen, Germany.
Furtwangen University, Faculty of Medical and Life Sciences, Villingen-Schwenningen, Germany.
Sci Rep. 2021 Nov 1;11(1):21385. doi: 10.1038/s41598-021-00827-0.
Shortages of reverse transcriptase (RT)-polymerase chain reaction (PCR) reagents and related equipment during the COVID-19 pandemic have demonstrated the need for alternative, high-throughput methods for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-mass screening in clinical diagnostic laboratories. A robust, SARS-CoV-2 RT-loop-mediated isothermal amplification (RT-LAMP) assay with high-throughput and short turnaround times in a clinical laboratory setting was established and compared to two conventional RT-PCR protocols using 323 samples of individuals with suspected SARS-CoV-2 infection. Limit of detection (LoD) and reproducibility of the isolation-free SARS-CoV-2 RT-LAMP test were determined. An almost perfect agreement (Cohen's kappa > 0.8) between the novel test and two classical RT-PCR protocols with no systematic difference (McNemar's test, P > 0.05) was observed. Sensitivity and specificity were in the range of 89.5 to 100% and 96.2 to 100% dependent on the reaction condition and the RT-PCR method used as reference. The isolation-free RT-LAMP assay showed high reproducibility (Tt intra-run coefficient of variation [CV] = 0.4%, Tt inter-run CV = 2.1%) with a LoD of 95 SARS-CoV-2 genome copies per reaction. The established SARS-CoV-2 RT-LAMP assay is a flexible and efficient alternative to conventional RT-PCR protocols, suitable for SARS-CoV-2 mass screening using existing laboratory infrastructure in clinical diagnostic laboratories.
在新冠疫情期间,逆转录酶(RT)-聚合酶链反应(PCR)试剂及相关设备的短缺表明,临床诊断实验室需要采用其他高通量方法对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)进行大规模筛查。我们建立了一种在临床实验室环境中具有高通量和短周转时间的、稳健的SARS-CoV-2 RT-环介导等温扩增(RT-LAMP)检测方法,并将其与两种传统RT-PCR方案进行比较,使用了323份疑似SARS-CoV-2感染个体的样本。确定了无分离的SARS-CoV-2 RT-LAMP检测的检测限(LoD)和重现性。观察到新检测方法与两种经典RT-PCR方案之间几乎完全一致(科恩kappa系数>0.8),且无系统差异(麦克尼马尔检验,P>0.05)。根据反应条件和用作参考的RT-PCR方法,敏感性和特异性在89.5%至100%和96.2%至100%的范围内。无分离的RT-LAMP检测显示出高重现性(批内变异系数[CV]=0.4%,批间CV=2.1%),每个反应的LoD为95个SARS-CoV-2基因组拷贝。所建立的SARS-CoV-2 RT-LAMP检测方法是传统RT-PCR方案的一种灵活且高效的替代方法,适用于利用临床诊断实验室现有的实验室基础设施对SARS-CoV-2进行大规模筛查。