Analytical sensitivity and efficiency comparisons of SARS-CoV-2 RT–qPCR primer–probe sets

The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for accurate and rapid diagnostic assays to prompt clinical and public health interventions. Currently, several quantitative reverse transcription–PCR (RT–qPCR) assays are being used by cl...

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Published inNature microbiology Vol. 5; no. 10; pp. 1299 - 1305
Main Authors Vogels, Chantal B. F., Brito, Anderson F., Wyllie, Anne L., Fauver, Joseph R., Ott, Isabel M., Kalinich, Chaney C., Petrone, Mary E., Casanovas-Massana, Arnau, Catherine Muenker, M., Moore, Adam J., Klein, Jonathan, Lu, Peiwen, Lu-Culligan, Alice, Jiang, Xiaodong, Kim, Daniel J., Kudo, Eriko, Mao, Tianyang, Moriyama, Miyu, Oh, Ji Eun, Park, Annsea, Silva, Julio, Song, Eric, Takahashi, Takehiro, Taura, Manabu, Tokuyama, Maria, Venkataraman, Arvind, Weizman, Orr-El, Wong, Patrick, Yang, Yexin, Cheemarla, Nagarjuna R., White, Elizabeth B., Lapidus, Sarah, Earnest, Rebecca, Geng, Bertie, Vijayakumar, Pavithra, Odio, Camila, Fournier, John, Bermejo, Santos, Farhadian, Shelli, Dela Cruz, Charles S., Iwasaki, Akiko, Ko, Albert I., Landry, Marie L., Foxman, Ellen F., Grubaugh, Nathan D.
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 01.10.2020
Nature Publishing Group
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Abstract The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for accurate and rapid diagnostic assays to prompt clinical and public health interventions. Currently, several quantitative reverse transcription–PCR (RT–qPCR) assays are being used by clinical, research and public health laboratories. However, it is currently unclear whether results from different tests are comparable. Our goal was to make independent evaluations of primer–probe sets used in four common SARS-CoV-2 diagnostic assays. From our comparisons of RT–qPCR analytical efficiency and sensitivity, we show that all primer–probe sets can be used to detect SARS-CoV-2 at 500 viral RNA copies per reaction. The exception for this is the RdRp-SARSr (Charité) confirmatory primer–probe set which has low sensitivity, probably due to a mismatch to circulating SARS-CoV-2 in the reverse primer. We did not find evidence for background amplification with pre-COVID-19 samples or recent SARS-CoV-2 evolution decreasing sensitivity. Our recommendation for SARS-CoV-2 diagnostic testing is to select an assay with high sensitivity and that is regionally used, to ease comparability between outcomes. This is a comparative analysis of the performance of the primer–probe sets from four open-source molecular diagnostic assays for SARS-CoV-2 recommended by the World Health Organization.
AbstractList The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for accurate and rapid diagnostic assays to prompt clinical and public health interventions. Currently, several quantitative reverse transcription–PCR (RT–qPCR) assays are being used by clinical, research and public health laboratories. However, it is currently unclear whether results from different tests are comparable. Our goal was to make independent evaluations of primer–probe sets used in four common SARS-CoV-2 diagnostic assays. From our comparisons of RT–qPCR analytical efficiency and sensitivity, we show that all primer–probe sets can be used to detect SARS-CoV-2 at 500 viral RNA copies per reaction. The exception for this is the RdRp-SARSr (Charité) confirmatory primer–probe set which has low sensitivity, probably due to a mismatch to circulating SARS-CoV-2 in the reverse primer. We did not find evidence for background amplification with pre-COVID-19 samples or recent SARS-CoV-2 evolution decreasing sensitivity. Our recommendation for SARS-CoV-2 diagnostic testing is to select an assay with high sensitivity and that is regionally used, to ease comparability between outcomes. This is a comparative analysis of the performance of the primer–probe sets from four open-source molecular diagnostic assays for SARS-CoV-2 recommended by the World Health Organization.
The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for accurate and rapid diagnostic assays to prompt clinical and public health interventions. Currently, several quantitative reverse transcription-PCR (RT-qPCR) assays are being used by clinical, research and public health laboratories. However, it is currently unclear whether results from different tests are comparable. Our goal was to make independent evaluations of primer-probe sets used in four common SARS-CoV-2 diagnostic assays. From our comparisons of RT-qPCR analytical efficiency and sensitivity, we show that all primer-probe sets can be used to detect SARS-CoV-2 at 500 viral RNA copies per reaction. The exception for this is the RdRp-SARSr (Charité) confirmatory primer-probe set which has low sensitivity, probably due to a mismatch to circulating SARS-CoV-2 in the reverse primer. We did not find evidence for background amplification with pre-COVID-19 samples or recent SARS-CoV-2 evolution decreasing sensitivity. Our recommendation for SARS-CoV-2 diagnostic testing is to select an assay with high sensitivity and that is regionally used, to ease comparability between outcomes.
The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for accurate and rapid diagnostic assays to prompt clinical and public health interventions. Currently, several quantitative reverse transcription-PCR (RT-qPCR) assays are being used by clinical, research and public health laboratories. However, it is currently unclear whether results from different tests are comparable. Our goal was to make independent evaluations of primer-probe sets used in four common SARS-CoV-2 diagnostic assays. From our comparisons of RT-qPCR analytical efficiency and sensitivity, we show that all primer-probe sets can be used to detect SARS-CoV-2 at 500 viral RNA copies per reaction. The exception for this is the RdRp-SARSr (Charité) confirmatory primer-probe set which has low sensitivity, probably due to a mismatch to circulating SARS-CoV-2 in the reverse primer. We did not find evidence for background amplification with pre-COVID-19 samples or recent SARS-CoV-2 evolution decreasing sensitivity. Our recommendation for SARS-CoV-2 diagnostic testing is to select an assay with high sensitivity and that is regionally used, to ease comparability between outcomes.The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for accurate and rapid diagnostic assays to prompt clinical and public health interventions. Currently, several quantitative reverse transcription-PCR (RT-qPCR) assays are being used by clinical, research and public health laboratories. However, it is currently unclear whether results from different tests are comparable. Our goal was to make independent evaluations of primer-probe sets used in four common SARS-CoV-2 diagnostic assays. From our comparisons of RT-qPCR analytical efficiency and sensitivity, we show that all primer-probe sets can be used to detect SARS-CoV-2 at 500 viral RNA copies per reaction. The exception for this is the RdRp-SARSr (Charité) confirmatory primer-probe set which has low sensitivity, probably due to a mismatch to circulating SARS-CoV-2 in the reverse primer. We did not find evidence for background amplification with pre-COVID-19 samples or recent SARS-CoV-2 evolution decreasing sensitivity. Our recommendation for SARS-CoV-2 diagnostic testing is to select an assay with high sensitivity and that is regionally used, to ease comparability between outcomes.
The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for accurate and rapid diagnostic assays to prompt clinical and public health interventions. Currently, several quantitative reverse transcription–PCR (RT–qPCR) assays are being used by clinical, research and public health laboratories. However, it is currently unclear whether results from different tests are comparable. Our goal was to make independent evaluations of primer–probe sets used in four common SARS-CoV-2 diagnostic assays. From our comparisons of RT–qPCR analytical efficiency and sensitivity, we show that all primer–probe sets can be used to detect SARS-CoV-2 at 500 viral RNA copies per reaction. The exception for this is the RdRp-SARSr (Charité) confirmatory primer–probe set which has low sensitivity, probably due to a mismatch to circulating SARS-CoV-2 in the reverse primer. We did not find evidence for background amplification with pre-COVID-19 samples or recent SARS-CoV-2 evolution decreasing sensitivity. Our recommendation for SARS-CoV-2 diagnostic testing is to select an assay with high sensitivity and that is regionally used, to ease comparability between outcomes.This is a comparative analysis of the performance of the primer–probe sets from four open-source molecular diagnostic assays for SARS-CoV-2 recommended by the World Health Organization.
The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for accurate and rapid diagnostic assays to prompt clinical and public health interventions. Currently, several quantitative reverse-transcription polymerase chain reaction (RT-qPCR) assays are being used by clinical, research, and public health laboratories. However, it is currently unclear if results from different tests are comparable. Our goal was to make independent evaluations of primer-probe sets used in four common SARS-CoV-2 diagnostic assays. From our comparisons of RT-qPCR analytical efficiency and sensitivity, we show that all primer-probe sets can be used to detect SARS-CoV-2 at 500 viral RNA copies per reaction. The exception for this is the RdRp-SARSr (Charité) confirmatory primer-probe set which has low sensitivity, likely due to a mismatch to circulating SARS-CoV-2 in the reverse primer. We did not find evidence for background amplification with pre-COVID-19 samples or recent SARS-CoV-2 evolution decreasing sensitivity. Our recommendation for SARS-CoV-2 diagnostic testing is to select an assay with high sensitivity and that is regionally used to ease comparability between outcomes.
Author Ott, Isabel M.
Kalinich, Chaney C.
Grubaugh, Nathan D.
Oh, Ji Eun
Taura, Manabu
Wong, Patrick
Song, Eric
Moore, Adam J.
Vogels, Chantal B. F.
Weizman, Orr-El
Casanovas-Massana, Arnau
Moriyama, Miyu
Park, Annsea
Lapidus, Sarah
Farhadian, Shelli
Klein, Jonathan
Kim, Daniel J.
White, Elizabeth B.
Odio, Camila
Wyllie, Anne L.
Cheemarla, Nagarjuna R.
Lu, Peiwen
Earnest, Rebecca
Geng, Bertie
Brito, Anderson F.
Bermejo, Santos
Lu-Culligan, Alice
Mao, Tianyang
Venkataraman, Arvind
Iwasaki, Akiko
Ko, Albert I.
Jiang, Xiaodong
Yang, Yexin
Takahashi, Takehiro
Silva, Julio
Kudo, Eriko
Landry, Marie L.
Dela Cruz, Charles S.
Catherine Muenker, M.
Tokuyama, Maria
Petrone, Mary E.
Vijayakumar, Pavithra
Fournier, John
Foxman, Ellen F.
Fauver, Joseph R.
AuthorAffiliation 2 Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT 06520, USA
5 Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, 06510, USA
6 Department of Medicine, Northeast Medical Group, Yale-New Haven Health, New Haven, CT 06510, USA
3 Department of Immunobiology, Yale University School of Medicine, New Haven, CT, 06510, USA
10 Clinical Virology Laboratory, Yale-New Haven Hospital, New Haven, CT, 06510, USA
8 Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, 06510, USA
7 Department of Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, 06510, USA
1 Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA
4 Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, 06510, USA
9 Howard Hughes Medical Institut
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/32651556$$D View this record in MEDLINE/PubMed
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10.1093/clinchem/hvaa029
10.1016/j.tifs.2014.03.008
10.1101/2020.01.09.900589
10.1128/AEM.02403-07
10.1128/JCM.00557-20
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10.1038/s41586-020-2012-7
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CBFV, AFB, JRF, and NDG designed the study, NRC and EFF collected pre-COVID-19 nasopharyngeal swabs, CBFV, ALW, IMO, CCK, MEP, AC-M, MCM, AJM, JK, PL, AL-C, XJ, DJK, EEK, TM, MM, JEO, AP, JS, ES, TT, MT, MT, AV, O-EW, PW, YY, EBW, SL, RE, BG, PV, CO, JF, SB, SF, CSDC, AI, AIK, MLL, and NDG contributed to collection of clinical data, CBFV performed experiments, CBFV, AFB, and NDG analyzed the data and wrote the first draft. All authors read and approved the manuscript.
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References_xml – reference: SvecDTichopadANovosadovaVPfafflMWKubistaMHow good is a PCR efficiency estimate? Recommendations for precise and robust qPCR efficiency assessmentsBiomol. Detect. Quantif.201539161:CAS:528:DC%2BC28Xht1Shu73E10.1016/j.bdq.2015.01.005270770294822216
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– reference: Vogels, C. B. F., Fauver, J. R., Ott, I. & Grubaugh, N. D. Generation of SARS-COV-2 RNA transcript standards for qRT–PCR detection assay. protocols.iohttps://doi.org/10.17504/protocols.io.bdv6i69e (2020).
– reference: GinzingerDGGene quantification using real-time quantitative PCR: an emerging technology hits the mainstreamExp. Hematol.2002305035121:CAS:528:DC%2BD38XksFOksb8%3D10.1016/S0301-472X(02)00806-812063017
– reference: The Nextstrain team. Genomic epidemiology of novel coronavirus—global subsampling (2020); https://nextstrain.org/ncov?c=gt-ORF14_50
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– reference: Centers for Disease Control and Prevention. Research use only 2019—novel coronavirus (2019-nCoV) real-time RT–PCR primers and probes (2020); https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-panel-primer-probes.html
– reference: Harcourt, J. et al. Severe acute respiratory syndrome coronavirus 2 from patient with 2019 novel coronavirus disease, United States. Emerg. Infect. Dis. 26, 1266–1273 (2020).
– reference: WuFA new coronavirus associated with human respiratory disease in ChinaNature20205792652691:CAS:528:DC%2BB3cXksFKlsLc%3D10.1038/s41586-020-2008-3320155087094943
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Snippet The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for accurate and rapid diagnostic assays to...
The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for accurate and rapid diagnostic assays to...
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SubjectTerms 45/77
631/326/596/4130
631/337
Analysis
Betacoronavirus - genetics
Betacoronavirus - isolation & purification
Biomedical and Life Sciences
Clinical Laboratory Techniques - methods
Clinical Laboratory Techniques - statistics & numerical data
Comparative analysis
Coronavirus Infections - diagnosis
Coronavirus Infections - epidemiology
Coronavirus Infections - virology
Coronaviruses
COVID-19
COVID-19 Testing
Genetic Variation
Genome, Viral
Humans
Infectious Diseases
Life Sciences
Medical Microbiology
Microbiology
Molecular Probe Techniques - statistics & numerical data
Pandemics
Parasitology
Pneumonia, Viral - diagnosis
Pneumonia, Viral - epidemiology
Pneumonia, Viral - virology
Public health
Reverse Transcriptase Polymerase Chain Reaction - methods
Reverse Transcriptase Polymerase Chain Reaction - statistics & numerical data
Reverse transcription
Ribonucleic acid
RNA
RNA - genetics
RNA Probes - genetics
RNA, Viral - analysis
RNA, Viral - genetics
SARS-CoV-2
Sensitivity and Specificity
Severe acute respiratory syndrome coronavirus 2
Virology
Title Analytical sensitivity and efficiency comparisons of SARS-CoV-2 RT–qPCR primer–probe sets
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