Validation of a novel molecular assay to the diagnostic of COVID-19 based on real time PCR with high resolution melting

PLoS One. 2021 Nov 22;16(11):e0260087. doi: 10.1371/journal.pone.0260087. eCollection 2021.

Abstract

The emergence of the COVID-19 pandemic resulted in an unprecedented need for RT-qPCR-based molecular diagnostic testing, placing a strain on the supply chain and the availability of commercially available PCR testing kits and reagents. The effect of limited molecular diagnostics-related supplies has been felt across the globe, disproportionally impacting molecular diagnostic testing in developing countries where acquisition of supplies is limited due to availability. The increasing global demand for commercial molecular diagnostic testing kits and reagents has made standard PCR assays cost prohibitive, resulting in the development of alternative approaches to detect SARS-CoV-2 in clinical specimens, circumventing the need for commercial diagnostic testing kits while mitigating the high-demand for molecular diagnostics testing. The timely availability of the complete SARS-CoV-2 genome in the beginning of the COVID-19 pandemic facilitated the rapid development and deployment of specific primers and standardized laboratory protocols for the molecular diagnosis of COVID-19. An alternative method offering a highly specific manner of detecting and genotyping pathogens within clinical specimens is based on the melting temperature differences of PCR products. This method is based on the melting temperature differences between purine and pyrimidine bases. Here, RT-qPCR assays coupled with a High Resolution Melting analysis (HRM-RTqPCR) were developed to target different regions of the SARS-CoV-2 genome (RdRp, E and N) and an internal control (human RNAse P gene). The assays were validated using synthetic sequences from the viral genome and clinical specimens (nasopharyngeal swabs, serum and saliva) of sixty-five patients with severe or moderate COVID-19 from different states within Brazil; a larger validation group than that used in the development to the commercially available TaqMan RT-qPCR assay which is considered the gold standard for COVID-19 testing. The sensitivity of the HRM-RTqPCR assays targeting the viral N, RdRp and E genes were 94.12, 98.04 and 92.16%, with 100% specificity to the 3 SARS-CoV-2 genome targets, and a diagnostic accuracy of 95.38, 98.46 and 93.85%, respectively. Thus, HRM-RTqPCR emerges as an attractive alternative and low-cost methodology for the molecular diagnosis of COVID-19 in restricted-budget laboratories.

Publication types

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

MeSH terms

  • Adult
  • COVID-19 Nucleic Acid Testing / methods*
  • COVID-19 Nucleic Acid Testing / standards
  • Female
  • Humans
  • Male
  • Nucleic Acid Denaturation
  • Oligonucleotides / chemistry
  • Real-Time Polymerase Chain Reaction / methods*
  • Real-Time Polymerase Chain Reaction / standards
  • Respiratory Mucosa / virology
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / pathogenicity
  • Saliva / virology
  • Sensitivity and Specificity

Substances

  • Oligonucleotides

Grants and funding

This work has been founded by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES - Finance Code 001 to BISF), Fundação Oswaldo Cruz (INOVA VPPCB to OCM), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq Research Fellow 1D to OCM) and FAPERJ (JCNE to OCM and LAAL and CNE to LMV, SVAL and VSP. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.