Abstract
The ability to distinguish between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) is of ongoing interest due to differences in transmissibility, responses to vaccination, clinical prognosis, and therapy. Although detailed genetic characterization requires whole-genome sequencing (WGS), targeted nucleic acid amplification tests can serve a complementary role in clinical settings, as they are more rapid and accessible than sequencing in most laboratories. We designed and analytically validated a two-reaction multiplex reverse transcription-quantitative PCR (RT-qPCR) assay targeting spike protein mutations L452R, E484K, and N501Y in reaction 1 and del69-70, K417N, and T478K in reaction 2. This assay had 95 to 100% agreement with WGS for 502 upper respiratory tract swab samples collected between 26 April 2021 and 1 August 2021, consisting of 43 Alpha, 2 Beta, 20 Gamma, 378 Delta, and 59 non-VOC infections. Validation in a separate group of 230 WGS-confirmed Omicron variant samples collected in December 2021 and January 2022 demonstrated 100% agreement. This RT-qPCR-based approach can be implemented in clinical laboratories already performing SARS-CoV-2 nucleic acid amplification tests to assist in local epidemiological surveillance and clinical decision-making.
Keywords: COVID-19; Omicron; SARS-CoV-2; variant.
【저자키워드】 COVID-19, SARS-CoV-2, omicron, Variant., 【초록키워드】 whole-genome sequencing, coronavirus, vaccination, therapy, Mutation, Sequencing, Genetic, variant, variants of concern, Delta, Local, severe acute respiratory syndrome Coronavirus, omicron, Spike protein, Laboratory, amplification, nucleic acid, RT-qPCR, infections, validation, PCR, Transmissibility, Surveillance, L452R, N501Y, K417N, response, VOCs, Gamma, Alpha, E484K, Beta, epidemiological, epidemiological surveillance, WGS, multiplex, nucleic acid amplification, nucleic acid amplification tests, upper respiratory tract, quantitative PCR, complementary, T478K, Clinical prognosis, acute respiratory syndrome, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, reaction, clinical settings, SARS-CoV-2 nucleic acid, approach, swab sample, collected, demonstrated, assist, 【제목키워드】 PCR, Rapid, concern, identification,