An isothermal lab-on-phone test for easy molecular diagnosis of SARS-CoV-2 near patients and in less than 1 hour

Int J Infect Dis. 2022 Oct:123:1-8. doi: 10.1016/j.ijid.2022.07.042. Epub 2022 Jul 22.

Abstract

Objectives: The performance of a new point-of-care CE-IVD-marked isothermal lab-on-phone COVID-19 assay was assessed in comparison to a gold standard real-time reverse transcriptase-PCR method.

Methods: The study was conducted following a nonprobability sampling of ≥16-year-old volunteers from three different laboratories, using direct mouthwash (N = 24) or nasopharyngeal (N = 191) clinical samples.

Results: The assay demonstrated 95.19% sensitivity and 100% specificity for detection of SARS-CoV-2 in direct nasopharyngeal crude samples and 78.95% sensitivity and 100% specificity in direct mouthwash crude samples. It also successfully detected currently predominant SARS-CoV-2 variants of concern (Beta B.1.351, Delta B.1.617.2, and Omicron B.1.1.529) and demonstrated to be inert against potential cross-reactions of other common respiratory pathogens that cause infections that present similar symptoms to COVID-19.

Conclusion: This lab-on-phone pocket-sized assay relies on an isothermal amplification of SARS-CoV-2's N and E genes, taking just 50 minutes from sample to result, with only 2 minutes of hands-on time. It presents good performance when using direct nasopharyngeal crude samples, enabling a low-cost, real-time, rapid, and accurate identification of SARS-CoV-2 infections at the point of care, which is important for both clinical management and population screening, as a tool to break the chain of transmission of COVID-19 pandemic, especially in low-resources environments.

Keywords: COVID-19; LAMP assay; Nucleic acid amplification techniques; Point-of-care testing; Real-time PCR; SARS-CoV-2.

MeSH terms

  • Adolescent
  • COVID-19 Testing
  • COVID-19* / diagnosis
  • Humans
  • Laboratories
  • Molecular Diagnostic Techniques / methods
  • Mouthwashes
  • Nucleic Acid Amplification Techniques / methods
  • Pandemics
  • RNA, Viral / analysis
  • RNA, Viral / genetics
  • RNA-Directed DNA Polymerase / genetics
  • SARS-CoV-2* / genetics
  • Sensitivity and Specificity

Substances

  • Mouthwashes
  • RNA, Viral
  • RNA-Directed DNA Polymerase

Supplementary concepts

  • SARS-CoV-2 variants