Journal Article

Sample-to-answer, extraction-free, real-time RT-LAMP test for SARS-CoV-2 in nasopharyngeal, nasal, and saliva samples: Implications and use for surveillance testing

Chang, Megan M., Goh, Christopher, Patel, Keyur P., Ogoe, Dereq, Kundrod, Kathryn A., Price, Anthony, Paul, Sai, Smith, Chelsey A., Schmeler, Kathleen M., Richards-Kortum, Rebecca, Santhanaraj, Akshaya, Eldin, Karen W., Baker, Ellen, Natoli, Mary E.

2022

Overview

The global COVID-19 pandemic has highlighted the need for rapid, accurate and accessible nucleic acid tests to enable timely identification of infected individuals. We optimized a sample-to-answer nucleic acid test for SARS-CoV-2 that provides results in <1 hour using inexpensive and readily available reagents. The test workflow includes a simple lysis and viral inactivation protocol followed by direct isothermal amplification of viral RNA using RT-LAMP. The assay was validated using two different instruments, a portable isothermal fluorimeter and a standard thermocycler. Results of the RT-LAMP assay were compared to traditional RT-qPCR for nasopharyngeal swabs, nasal swabs, and saliva collected from a cohort of patients hospitalized due to COVID-19. For all three sample types, positive agreement with RT-LAMP performed using the isothermal fluorimeter was 100% for samples with Ct <30 and 69–91% for samples with Ct <40. Following validation, the test was successfully scaled to test the saliva of up to 400 asymptomatic individuals per day as part of the campus surveillance program at Rice University. Successful development, validation, and scaling of this sample-to-answer, extraction-free real-time RT-LAMP test for SARS-CoV-2 adds a highly adaptable tool to efforts to control the COVID-19 pandemic, and can inform test development strategies for future infectious disease threats.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Analysis / Asymptomatic / Bioengineering / Biology and Life Sciences / Cancer / Coronaviruses / COVID-19 / COVID-19 - diagnosis / COVID-19 - virology / COVID-19 Testing / Development strategies / Disease transmission / Evaluation / Fluorometers / Health surveillance / Humans / Inactivation / Infectious diseases / Lysis / Medical tests / Medicine and Health Sciences / Methods / Molecular Diagnostic Techniques - methods / Nasopharynx - virology / Nose - virology / Nucleic Acid Amplification Techniques - methods / Nucleic acids / Oncology / Pandemics / Population Surveillance - methods / Public health / Reagents / Real time / Reproductive health / Research and Analysis Methods / RNA / RNA, Viral - genetics / Saliva / Saliva - virology / SARS-CoV-2 - isolation & purification / Sensitivity and Specificity / Severe acute respiratory syndrome / Severe acute respiratory syndrome coronavirus 2 / Supply chains / Viral diseases / Workflow