Abstract
We aimed to compare the differences in testing performance of extraction-based polymerase chain reaction (PCR) assays, elution-based direct PCR assay, and rapid antigen detection tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We used nasopharyngeal swab samples of patients with coronavirus disease 2019 (COVID-19). We used the MagNA Pure 24 System (Roche Diagnostics K.K.) or magLEAD 12gC (Precision System Science Co., Ltd.) for RNA extraction, mixed the concentrates with either the LightMix Modular SARS-CoV PCR mixture (Roche Diagnostics K.K.) or Takara SARS-CoV-2 direct PCR detection kit (Takara Bio Inc.), and amplified it using COBAS® z480 (Roche Diagnostics K.K.). For elution-based PCR, we directly applied clinical samples to the Takara SARS-CoV-2 direct PCR detection kit before the same amplification step. Additionally, we performed Espline SARS-CoV-2 (Fuji Rebio Co., Ltd.) for rapid diagnostic test (RDT), and used Lumipulse SARS-CoV-2 antigen (Fuji Rebio Co., Ltd.) and Elecsys SARS-CoV-2 antigen (Roche Diagnostics K.K.) for automated antigen tests (ATs). Extraction-based and elution-based PCR tests detected the virus up to 214-216 and 210 times dilution, respectively. ATs remained positive up to 24-26 times dilution, while RDT became negative after 22 dilutions. For 153 positive samples, positivity rates of the extraction-based PCR assay were 85.6% to 98.0%, while that of the elution-based PCR assay was 73.2%. Based on the RNA concentration process, extraction-based PCR assays were superior to elution-based direct PCR assays for detecting SARS-CoV-2.
Keywords: novel coronavirus disease 2019 (COVID-19); polymerase chain reaction; rapid diagnostic test; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
【저자키워드】 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)., polymerase chain reaction, Rapid diagnostic test, novel coronavirus disease 2019 (COVID-19), 【초록키워드】 COVID-19, coronavirus disease, SARS-CoV-2, Coronavirus disease 2019, coronavirus, SARS-CoV, diagnostic test, diagnostic, novel coronavirus disease, severe acute respiratory syndrome Coronavirus, virus, Novel coronavirus, Antigen, RNA, RNA extraction, Nasopharyngeal swab, polymerase chain reaction, amplification, clinical samples, PCR, RDT, Rapid diagnostic test, Patient, automated, SARS-CoV-2 antigen, PCR test, antigen detection, disease, Nasopharyngeal swab samples, Concentration, Dilution, Chain Reaction, Science, acute respiratory syndrome, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, extraction, PCR assay, positive, Roche Diagnostics, Elecsys, nasopharyngeal swab sample, elution, dilutions, System, Takara, polymerase chain, clinical sample, amplified, performed, assays, remained, applied, Elecsy, Fuji, Inc., Takara Bio, 【제목키워드】 coronavirus, Diagnosis, Antigen, automated, acute respiratory syndrome, polymerase chain,