Neglected SARS-CoV-2 variants and potential concerns for molecular diagnostics: a framework for nucleic acid amplification test target site quality assurance

Microbiol Spectr. 2023 Dec 12;11(6):e0076123. doi: 10.1128/spectrum.00761-23. Epub 2023 Oct 10.

Abstract

Molecular tests like polymerase chain reaction were widely used during the COVID-19 pandemic but as the pandemic evolved, so did SARS-CoV-2. This virus acquired mutations, prompting concerns that mutations could compromise molecular test results and be falsely negative. While some manufacturers may have in-house programs for monitoring mutations that could impact their assay performance, it is important to promptly report mutations in circulating viral strains that could adversely impact a diagnostic test result. However, commercial test target sites are proprietary, making independent monitoring difficult. In this study, SARS-CoV-2 test target sites were sequenced to monitor and assess mutations impact, and 29 novel mutations impacting SARS-CoV-2 detection were identified. This framework for molecular test target site quality assurance could be adapted to any molecular test, ensuring accurate diagnostic test results and disease diagnoses.

Keywords: COVID-19; NAAT; PCR; SARS-CoV-2; genome; mutation; quality; sequence; target; variant.

MeSH terms

  • COVID-19 Testing
  • COVID-19* / diagnosis
  • Clinical Laboratory Techniques / methods
  • Humans
  • Nucleic Acid Amplification Techniques
  • Pandemics
  • SARS-CoV-2* / genetics

Supplementary concepts

  • SARS-CoV-2 variants