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Kang M, Jeong E, Kim JY, Yun SA, Jang MA, Jang JH, Kim TY, Huh HJ, Lee NY. Optimization of extraction-free protocols for SARS-CoV-2 detection using a commercial rRT-PCR assay. Sci Rep 2023; 13:20364. [PMID: 37990045 PMCID: PMC10663557 DOI: 10.1038/s41598-023-47645-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/16/2023] [Indexed: 11/23/2023] Open
Abstract
In the ongoing global fight against coronavirus disease 2019 (COVID-19), the sample preparation process for real-time reverse transcription polymerase chain reaction (rRT-PCR) faces challenges due to time-consuming steps, labor-intensive procedures, contamination risks, resource demands, and environmental implications. However, optimized strategies for sample preparation have been poorly investigated, and the combination of RNase inhibitors and Proteinase K has been rarely considered. Hence, we investigated combinations of several extraction-free protocols incorporating heat treatment, sample dilution, and Proteinase K and RNase inhibitors, and validated the effectiveness using 120 SARS-CoV-2 positive and 62 negative clinical samples. Combining sample dilution and heat treatment with Proteinase K and RNase inhibitors addition exhibited the highest sensitivity (84.26%) with a mean increase in cycle threshold (Ct) value of + 3.8. Meanwhile, combined sample dilution and heat treatment exhibited a sensitivity of 79.63%, accounting for a 38% increase compared to heat treatment alone. Our findings highlight that the incorporation of Proteinase K and RNase inhibitors with sample dilution and heat treatment contributed only marginally to the improvement without yielding statistically significant differences. Sample dilution significantly impacts SARS-CoV-2 detection, and sample conditions play a crucial role in the efficiency of extraction-free methods. Our findings may provide insights for streamlining diagnostic testing, enhancing its accessibility, cost-effectiveness, and sustainability.
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Affiliation(s)
- Minhee Kang
- Smart Healthcare Research Institute, Biomedical Engineering Research Center, Samsung Medical Center, Seoul, South Korea
- Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
| | - Eunjung Jeong
- Smart Healthcare Research Institute, Biomedical Engineering Research Center, Samsung Medical Center, Seoul, South Korea
- Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
| | - Ji-Yeon Kim
- Samsung Biomedical Research Institute, Center for Clinical Medicine, Samsung Medical Center, Seoul, South Korea
| | - Sun Ae Yun
- Samsung Biomedical Research Institute, Center for Clinical Medicine, Samsung Medical Center, Seoul, South Korea
| | - Mi-Ae Jang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ja-Hyun Jang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Tae Yeul Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - Hee Jae Huh
- Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea.
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - Nam Yong Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Kim TY, Bae GE, Kim JY, Kang M, Jang JH, Huh HJ, Chung DR, Lee NY. Evaluation of the Kaira COVID-19/Flu/RSV Detection Kit for detection of SARS-CoV-2, influenza A/B, and respiratory syncytial virus: A comparative study with the PowerChek SARS-CoV-2, influenza A&B, RSV Multiplex Real-time PCR Kit. PLoS One 2022; 17:e0278530. [PMID: 36516190 PMCID: PMC9750031 DOI: 10.1371/journal.pone.0278530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/17/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Co-circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory viruses, such as influenza and respiratory syncytial virus (RSV), can be a severe threat to public health. The accurate detection and differentiation of these viruses are essential for clinical laboratories. Herein, we comparatively evaluated the performance of the Kaira COVID-19/Flu/RSV Detection Kit (Kaira; Optolane, Seongnam, Korea) for detection of SARS-CoV-2, influenza A and B, and RSV in nasopharyngeal swab (NPS) specimens with that of the PowerChek SARS-CoV-2, Influenza A&B, RSV Multiplex Real-time PCR Kit (PowerChek; Kogene Biotech, Seoul, Korea). METHODS A total of 250 archived NPS specimens collected for routine clinical testing were tested in parallel by the Kaira and PowerChek assays. RNA standards were serially diluted and tested by the Kaira assay to calculate the limit of detection (LOD). RESULTS The positive and negative percent agreements between the Kaira and PowerChek assays were as follows: 100% (49/49) and 100% (201/201) for SARS-CoV-2; 100% (50/50) and 99.0% (198/200) for influenza A; 100% (50/50) and 100% (200/200) for influenza B; and 100% (51/51) and 100% (199/199) for RSV, respectively. The LODs of the Kaira assay for SARS-CoV-2, influenza A and B, and RSV were 106.1, 717.1, 287.3, and 442.9 copies/mL, respectively. CONCLUSIONS The Kaira assay showed comparable performance to the PowerChek assay for detection of SARS-CoV-2, influenza A and B, and RSV in NPS specimens, indicating that the Kaira assay could be a useful diagnostic tool when these viruses are co-circulating.
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Affiliation(s)
- Tae Yeul Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Go Eun Bae
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Youn Kim
- Center for Clinical Medicine, Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - Minhee Kang
- Biomedical Engineering Research Center, Smart Healthcare Research Institute, Samsung Medical Center, Seoul, Korea
- Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Korea
| | - Ja-Hyun Jang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jae Huh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- * E-mail:
| | - Doo Ryeon Chung
- Center for Infection Prevention and Control, Samsung Medical Center, Seoul, Korea
- Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Nam Yong Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim H, Jeon S, Lee SH, Ri HS, Lee HJ, Hong JM, Paek SI. False-positive Xpert ® Xpress SARS-CoV-2 assay in an emergency room and trauma center: A retrospective chart review study. Saudi Med J 2022; 43:965-970. [PMID: 35964955 PMCID: PMC9749665 DOI: 10.15537/smj.2022.43.8.20220317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To review reports false-positive Xpert results in an emergency room and trauma center. METHODS Patients' data with false-positive Xpert results from November 2020 to February 2022 at Pusan National University Hospital, Busan, Republic of Korea, were extracted from the electronic medical records. RESULTS The positive predictive value of Xpert was 40%. Of the 12 patients with false-positive results, 5 (41.7%) were re-positives (such as, patients recovered from coronavirus disease-19 [COVID-19]), and 4 (33.3%) had head or facial trauma. Two out of 4 head or facial trauma cases had documented sample contamination with blood. CONCLUSION We found a high incidence of false-positive Xpert results among patients who recovered from COVID-19 and those with head or facial injury. Careful history taking for COVID-19 and physical examination of the sample collection site is essential before Xpert analysis.
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Affiliation(s)
- Hyerim Kim
- From the Department of Laboratory Medicine (Kim); from Biomedical Research Institute (Kim, Jeon, S. H. Lee, H-J. Lee, Hong); from the Department of Anesthesia and Pain Medicine (Jeon, H-J. Lee, Hong, Paek); from the Department of Internal Medicine (S. H. Lee), Division of Cardiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, and from the Department of Anesthesia and Pain Medicine (Ri), Kyungpook National University, School of Medicine, Daegu, Korea.
| | - Soeun Jeon
- From the Department of Laboratory Medicine (Kim); from Biomedical Research Institute (Kim, Jeon, S. H. Lee, H-J. Lee, Hong); from the Department of Anesthesia and Pain Medicine (Jeon, H-J. Lee, Hong, Paek); from the Department of Internal Medicine (S. H. Lee), Division of Cardiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, and from the Department of Anesthesia and Pain Medicine (Ri), Kyungpook National University, School of Medicine, Daegu, Korea.
- Address correspondence and reprints request to: Dr. Soeun Jeon, Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. E-mail: ORCID ID: https://orcid.org/0000-0002-4009-6321
| | - Sun Hack Lee
- From the Department of Laboratory Medicine (Kim); from Biomedical Research Institute (Kim, Jeon, S. H. Lee, H-J. Lee, Hong); from the Department of Anesthesia and Pain Medicine (Jeon, H-J. Lee, Hong, Paek); from the Department of Internal Medicine (S. H. Lee), Division of Cardiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, and from the Department of Anesthesia and Pain Medicine (Ri), Kyungpook National University, School of Medicine, Daegu, Korea.
| | - Hyun-Su Ri
- From the Department of Laboratory Medicine (Kim); from Biomedical Research Institute (Kim, Jeon, S. H. Lee, H-J. Lee, Hong); from the Department of Anesthesia and Pain Medicine (Jeon, H-J. Lee, Hong, Paek); from the Department of Internal Medicine (S. H. Lee), Division of Cardiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, and from the Department of Anesthesia and Pain Medicine (Ri), Kyungpook National University, School of Medicine, Daegu, Korea.
| | - Hyeon-Jeong Lee
- From the Department of Laboratory Medicine (Kim); from Biomedical Research Institute (Kim, Jeon, S. H. Lee, H-J. Lee, Hong); from the Department of Anesthesia and Pain Medicine (Jeon, H-J. Lee, Hong, Paek); from the Department of Internal Medicine (S. H. Lee), Division of Cardiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, and from the Department of Anesthesia and Pain Medicine (Ri), Kyungpook National University, School of Medicine, Daegu, Korea.
| | - Jeong-Min Hong
- From the Department of Laboratory Medicine (Kim); from Biomedical Research Institute (Kim, Jeon, S. H. Lee, H-J. Lee, Hong); from the Department of Anesthesia and Pain Medicine (Jeon, H-J. Lee, Hong, Paek); from the Department of Internal Medicine (S. H. Lee), Division of Cardiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, and from the Department of Anesthesia and Pain Medicine (Ri), Kyungpook National University, School of Medicine, Daegu, Korea.
| | - Sung In Paek
- From the Department of Laboratory Medicine (Kim); from Biomedical Research Institute (Kim, Jeon, S. H. Lee, H-J. Lee, Hong); from the Department of Anesthesia and Pain Medicine (Jeon, H-J. Lee, Hong, Paek); from the Department of Internal Medicine (S. H. Lee), Division of Cardiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, and from the Department of Anesthesia and Pain Medicine (Ri), Kyungpook National University, School of Medicine, Daegu, Korea.
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Havasi A, Visan S, Cainap C, Cainap SS, Mihaila AA, Pop LA. Influenza A, Influenza B, and SARS-CoV-2 Similarities and Differences – A Focus on Diagnosis. Front Microbiol 2022; 13:908525. [PMID: 35794916 PMCID: PMC9251468 DOI: 10.3389/fmicb.2022.908525] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/23/2022] [Indexed: 12/23/2022] Open
Abstract
In late December 2019, the first cases of viral pneumonia caused by an unidentified pathogen were reported in China. Two years later, SARS-CoV-2 was responsible for almost 450 million cases, claiming more than 6 million lives. The COVID-19 pandemic strained the limits of healthcare systems all across the world. Identifying viral RNA through real-time reverse transcription-polymerase chain reaction remains the gold standard in diagnosing SARS-CoV-2 infection. However, equipment cost, availability, and the need for trained personnel limited testing capacity. Through an unprecedented research effort, new diagnostic techniques such as rapid diagnostic testing, isothermal amplification techniques, and next-generation sequencing were developed, enabling accurate and accessible diagnosis. Influenza viruses are responsible for seasonal outbreaks infecting up to a quarter of the human population worldwide. Influenza and SARS-CoV-2 present with flu-like symptoms, making the differential diagnosis challenging solely on clinical presentation. Healthcare systems are likely to be faced with overlapping SARS-CoV-2 and Influenza outbreaks. This review aims to present the similarities and differences of both infections while focusing on the diagnosis. We discuss the clinical presentation of Influenza and SARS-CoV-2 and techniques available for diagnosis. Furthermore, we summarize available data regarding the multiplex diagnostic assay of both viral infections.
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Affiliation(s)
- Andrei Havasi
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Medical Oncology, The Oncology Institute “Prof. Dr. Ion Chiricuta”, Cluj-Napoca, Romania
| | - Simona Visan
- Department of Genetics, Genomics and Experimental Pathology, The Oncology Institute “Prof. Dr. Ion Chiricuta”, Cluj-Napoca, Romania
| | - Calin Cainap
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Medical Oncology, The Oncology Institute “Prof. Dr. Ion Chiricuta”, Cluj-Napoca, Romania
| | - Simona Sorana Cainap
- Pediatric Clinic No. 2, Department of Pediatric Cardiology, Emergency County Hospital for Children, Cluj-Napoca, Romania
- Department of Mother and Child, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- *Correspondence: Simona Sorana Cainap, ;
| | - Alin Adrian Mihaila
- Faculty of Economics and Business Administration, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Laura-Ancuta Pop
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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