Division of Immunobiology, Department of Medicine, Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA.
Virology Division, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA.
EMBO Mol Med. 2022 Feb 7;14(2):e15290. doi: 10.15252/emmm.202115290. Epub 2021 Dec 13.
With the COVID-19 pandemic caused by SARS-CoV-2 now in its second year, there remains an urgent need for diagnostic testing that can identify infected individuals, particularly those who harbor infectious virus. Various RT-PCR strategies have been proposed to identify specific viral RNA species that may predict the presence of infectious virus, including detection of transcriptional intermediates (e.g., subgenomic RNA [sgRNA]) and replicative intermediates (e.g., negative-strand RNA species). Using a novel primer/probe set for detection of subgenomic (sg)E transcripts, we successfully identified 100% of specimens containing culturable SARS-CoV-2 from a set of 126 clinical samples (total sgE C values ranging from 12.3 to 37.5). This assay showed superior performance compared to a previously published sgRNA assay and to a negative-strand RNA assay, both of which failed to detect target RNA in a subset of samples from which we isolated live virus. In addition, total levels of viral RNA (genome, negative-strand, and sgE) detected with the WHO/Charité primer-probe set correlated closely with levels of infectious virus. Specifically, infectious virus was not detected in samples with a C above 31.0. Clinical samples with higher levels of viral RNA also displayed cytopathic effect (CPE) more quickly than those with lower levels of viral RNA. Finally, we found that the infectivity of SARS-CoV-2 samples is significantly dependent on the cell type used for viral isolation, as Vero E6 cells expressing TMRPSS2 extended the analytical sensitivity of isolation by more than 3 C compared to parental Vero E6 cells and resulted in faster isolation. Our work shows that using a total viral RNA Ct cutoff of > 31 or specifically testing for sgRNA can serve as an effective rule-out test for the presence of culturable virus.
随着由 SARS-CoV-2 引起的 COVID-19 大流行进入第二年,仍然迫切需要能够识别感染者的诊断检测方法,尤其是那些携带传染性病毒的感染者。已经提出了各种 RT-PCR 策略来识别可能预测传染性病毒存在的特定病毒 RNA 种类,包括检测转录中间体(例如亚基因组 RNA [sgRNA])和复制中间体(例如负链 RNA 种类)。我们使用一种用于检测亚基因组 (sg)E 转录本的新型引物/探针集,成功地从 126 个临床样本中识别出了 100%含有可培养 SARS-CoV-2 的样本(总 sgE C 值范围为 12.3 至 37.5)。与先前发表的 sgRNA 检测和负链 RNA 检测相比,该检测方法表现出优越的性能,后两者未能检测到我们从分离出活病毒的一部分样本中检测到的靶 RNA。此外,用 WHO/Charité 引物-探针集检测到的病毒 RNA(基因组、负链和 sgE)的总水平与传染性病毒的水平密切相关。具体而言,在 C 值大于 31.0 的样本中未检测到传染性病毒。病毒 RNA 水平较高的临床样本比病毒 RNA 水平较低的样本更快地显示出细胞病变效应(CPE)。最后,我们发现 SARS-CoV-2 样本的感染性显著依赖于用于病毒分离的细胞类型,因为表达 TMRPSS2 的 Vero E6 细胞比亲本 Vero E6 细胞将分离的分析灵敏度提高了超过 3 C,并且导致更快的分离。我们的工作表明,使用总病毒 RNA Ct 截止值 > 31 或专门检测 sgRNA 可以作为存在可培养病毒的有效排除性检测。
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