Clinical Comparison of Three Sample-to-Answer Systems for Detecting SARS-CoV-2 in B.1.1.7 Lineage Emergence
Ming‐Jr Jian, Hsing‐Yi Chung, Chih-Kai Chang, Jung‐Chung Lin, Kuo‐Ming Yeh, Chien‐Wen Chen, Shih-Yi Li, Shan‐Shan Hsieh, Ming‐Tsan Liu, Ji‐Rong Yang, Shenghui Tang, Cherng‐Lih Perng, Feng‐Yee Chang, Hung‐Sheng Shang
Abstract
Purpose: Accurate molecular diagnostic assays for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, are needed for epidemiology studies and to support infection-control measures. We evaluated the analytical sensitivity and clinical performance of three sample-to-answer molecular-diagnostics systems for detecting SARS-CoV-2 using 325 nasopharyngeal swab clinical samples from symptomatic patients. Methods: The BioFire Respiratory Panel 2.1 (RP2.1), cobas Liat SARS-CoV-2 and Influenza A/B, and Cepheid Xpert Xpress SARS-CoV-2/Flu/RSV platforms, which have been granted emergency-use authorization by the US FDA, were tested and compared. Results: The positive percent agreement, negative percent agreement, and overall percent agreement among the three point of care testing systems were 98– 100%, including for the wild-type SARS-CoV-2 (non-B.1.1.7) and a variant of concern (B.1.1.7). Notably, the BioFire RP2.1 may fail to detect the SARS-CoV-2 S gene in the B.1.1.7 lineage because of the spike protein mutation. Conclusion: All three point of care testing platforms provided highly sensitive, robust, and almost accurate results for rapidly detecting SARS-CoV-2. These automated molecular diagnostic assays can increase the effectiveness of control and prevention measures for infectious diseases. Keywords: COVID-19, SARS-CoV-2, point of care testing, molecular diagnostics, sample to answer, variant of concern