Abstract
The pandemic of coronavirus disease 2019 (COVID-19) urgently calls for more sensitive molecular diagnosis to improve sensitivity of current viral nuclear acid detection. We have developed an anchor primer (AP)-based assay to improve viral RNA stability by bioinformatics identification of RNase-binding site of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA and implementing AP dually targeting the N gene of SARS-CoV-2 RNA and RNase 1, 3, 6. The arbitrarily primed polymerase chain reaction (AP-PCR) improvement of viral RNA integrity was supported by (a) the AP increased resistance of the targeted gene (N gene) of SARS-CoV-2 RNA to RNase treatment; (b) the detection of SARS-CoV-2 RNA by AP-PCR with lower cycle threshold values (-2.7 cycles) compared to two commercially available assays; (c) improvement of the viral RNA stability of the ORF gene upon targeting of the N gene and RNase. Furthermore, the improved sensitivity by AP-PCR was demonstrated by detection of SARS-CoV-2 RNA in 70-80% of sputum, nasal, pharyngeal swabs and feces and 36% (4/11) of urine of the confirmed cases (n = 252), 7% convalescent cases (n = 54) and none of 300 negative cases. Lastly, AP-PCR analysis of 306 confirmed and convalescent cases revealed prolonged presence of viral loading for >20 days after the first positive diagnosis. Thus, the AP dually targeting SARS-CoV-2 RNA and RNase improves molecular detection by preserving SARS-CoV-2 RNA integrity and reveals the prolonged viral loading associated with older age and male gender in COVID-19 patients.
Keywords: COVID-19; RNA; SARS-CoV-2; anchor primer; bioinformatics analysis.
【저자키워드】 COVID-19, SARS-CoV-2, RNA, anchor primer, bioinformatics analysis., 【초록키워드】 coronavirus disease, Coronavirus disease 2019, coronavirus, pandemic, bioinformatics, Diagnosis, Gender, nasal, severe acute respiratory syndrome Coronavirus, sputum, polymerase chain reaction, sensitivity, stability, Molecular diagnosis, feces, male, Older age, Urine, SARS-CoV-2 RNA, Viral RNA, molecular, N gene, convalescent, Bioinformatics analysis, COVID-19 patients, RNase, Analysis, Cycle threshold value, Chain Reaction, confirmed case, Pharyngeal swab, acute respiratory syndrome, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, ORF gene, confirmed cases, primer, nuclear, first positive, polymerase chain, IMPROVE, supported, ORF, demonstrated, reveal, 【제목키워드】 COVID-19 patient, identification,