Monitoring SARS-CoV-2 genetic variability: A post-market surveillance workflow for combined bioinformatic and laboratory evaluation of commercial RT-PCR assay performance

PLoS One. 2024 Jan 12;19(1):e0294271. doi: 10.1371/journal.pone.0294271. eCollection 2024.

Abstract

Objective: The speed at which Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is mutating has made it necessary to frequently assess how these genomic changes impact the performance of diagnostic real-time polymerase chain reaction (RT-PCR) assays. Herein, we describe a generic three-step workflow to assess the effect of genomic mutations on inclusivity and sensitivity of RT-PCR assays.

Methods: Sequences collected from the Global Initiative on Sharing All Influenza Data (GISAID) were mapped to a SARS-CoV-2 reference genome to evaluate the position and prevalence of mismatches in the oligonucleotide-binding sites of the QIAstat-Dx, an RT-PCR panel designed to detect SARS-CoV-2. The frequency of mutations and their impact on melting temperature were assessed, and sequences flagged by risk-based criteria were examined in vitro.

Results: Out of 8,900,393 SARS-CoV-2 genome sequences analyzed, only 173 (0.0019%) genomes contained potentially critical mutations for the QIAstat-Dx; follow-up in-vitro testing confirmed no impact on the assays' performance.

Conclusions: The current study demonstrates that SARS-CoV-2 genetic variants do not affect the performance of the QIAstat-Dx device. It is recommended that manufacturers incorporate this workflow into obligatory post-marketing surveillance activities, as this approach could potentially enhance genetic monitoring of their product.

MeSH terms

  • COVID-19 Testing
  • COVID-19* / diagnosis
  • Computational Biology
  • Humans
  • Reverse Transcriptase Polymerase Chain Reaction
  • SARS-CoV-2* / genetics
  • Sensitivity and Specificity
  • Workflow

Supplementary concepts

  • SARS-CoV-2 variants

Grants and funding

All the work reported in this manuscript was funded by QIAGEN. The funder provided support in the form of salaries for authors [BKS, JK, JP, JW, LP, BT, JP, RP, RDH, MJ, MR, DM, and AB], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.