Reverse Transcription Recombinase-Aided Amplification Assay With Lateral Flow Dipstick Assay for Rapid Detection of 2019 Novel Coronavirus

Front Cell Infect Microbiol. 2021 Feb 1:11:613304. doi: 10.3389/fcimb.2021.613304. eCollection 2021.

Abstract

Background: The emerging Coronavirus Disease-2019 (COVID-19) has challenged the public health globally. With the increasing requirement of detection for SARS-CoV-2 outside of the laboratory setting, a rapid and precise Point of Care Test (POCT) is urgently needed.

Methods: Targeting the nucleocapsid (N) gene of SARS-CoV-2, specific primers, and probes for reverse transcription recombinase-aided amplification coupled with lateral flow dipstick (RT-RAA/LFD) platform were designed. For specificity evaluation, it was tested with human coronaviruses, human influenza A virus, influenza B viruses, respiratory syncytial virus, and hepatitis B virus, respectively. For sensitivity assay, it was estimated by templates of recombinant plasmid and pseudovirus of SARS-CoV-2 RNA. For clinical assessment, 100 clinical samples (13 positive and 87 negatives for SARS-CoV-2) were tested via quantitative reverse transcription PCR (RT-qPCR) and RT-RAA/LFD, respectively.

Results: The limit of detection was 1 copies/μl in RT-RAA/LFD assay, which could be conducted within 30 min at 39°C, without any cross-reaction with other human coronaviruses and clinical respiratory pathogens. Compared with RT-qPCR, the established POCT assay offered 100% specificity and 100% sensitivity in the detection of clinical samples.

Conclusion: This work provides a convenient POCT tool for rapid screening, diagnosis, and monitoring of suspected patients in SARS-CoV-2 endemic areas.

Keywords: Coronavirus Disease-2019; Severe Acute Respiratory Syndrome Coronavirus 2; lateral flow dipstick; point of care test; reverse-transcription recombinase-aided amplification.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19 / diagnosis*
  • COVID-19 / virology
  • COVID-19 Nucleic Acid Testing / instrumentation
  • COVID-19 Nucleic Acid Testing / methods*
  • Coronavirus Nucleocapsid Proteins / genetics
  • DNA Primers / genetics
  • Humans
  • Phosphoproteins / genetics
  • Point-of-Care Testing
  • RNA, Viral / genetics
  • Real-Time Polymerase Chain Reaction / instrumentation
  • Real-Time Polymerase Chain Reaction / methods*
  • Recombinases / metabolism
  • Reverse Transcription
  • SARS-CoV-2 / genetics*
  • SARS-CoV-2 / isolation & purification
  • Sensitivity and Specificity

Substances

  • Coronavirus Nucleocapsid Proteins
  • DNA Primers
  • Phosphoproteins
  • RNA, Viral
  • Recombinases
  • nucleocapsid phosphoprotein, SARS-CoV-2