Establishment of an in-house real-time RT-PCR assay for the detection of severe acute respiratory syndrome coronavirus 2 using the first World Health Organization international standard in a resource-limited country

在资源有限的国家,使用世界卫生组织第一个国际标准建立用于检测严重急性呼吸综合征冠状病毒 2 的内部实时 RT-PCR 检测方法

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作者:Linh Tung Nguyen, Phuong Minh Nguyen, Duc Viet Dinh, Hung Ngoc Pham, Lan Anh Thi Bui, Cuong Viet Vo, Ben Huu Nguyen, Hoan Duy Bui, Cuong Xuan Hoang, Nhat Minh Van Ngo, Truong Tien Dang, Anh Ngoc Do, Dung Dinh Vu, Linh Thuy Nguyen, Mai Ngoc Nguyen, Thu Hang Thi Dinh, Son Anh Ho, Luong Van Hoang, Su X

Background

The COVID-19 pandemic caused by SARS-CoV-2 remains public health burdens and many unresolved issues worldwide. Molecular assays based on real-time RT-PCR are critical for the detection of SARS-CoV-2 in clinical specimens from patients suspected of COVID-19.

Conclusion

In the present study, we established and validated an in-house real-time RT-PCR for molecular detection of SARS-CoV-2 in a resource-limited country.

Objective

We aimed to establish and validate an in-house real-time RT-PCR for the detection of SARS-CoV-2. Methodology: Primers and probes sets in our in-house real-time RT-PCR assay were designed in conserved regions of the N and E target genes. Optimized multiplex real-time RT-PCR assay was validated using the first WHO International Standard (NIBSC code: 20/146) and evaluated clinical performance.

Results

The limit of detection validated using the first WHO International Standard was 159 IU/ml for both E and N target genes. The evaluation of clinical performance on 170 clinical samples showed a positive percent agreement of 100% and the negative percent agreement of 99.08% for both target genes. The Kappa value of 0.99 was an excellent agreement, the strong correlation of Ct values observed between two tests with r2 = 0.84 for the E gene and 0.87 for the N gene. Notably, we assessed on 60 paired saliva and nasopharyngeal samples. The overall agreement was 91.66%, and Kappa value of 0.74 showed a high agreement between two types of samples. When using nasopharyngeal swabs as the reference standard, positive percent agreement, and negative percent agreement were 91.83% and 90.90%, respectively.

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