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Yunying Zhou, Fengyan Pei, Mingyu Ji, Li Wang, Huailong Zhao, Huanjie
Li, Weihua Yang, Qingxi Wang, Qianqian Zhao, Yunshan Wang
Presented By:
SHAISTA JABEEN
Molecular Genetics
Semester Spring 2021
INTRODUCTION
RESULTS AND DISSCUSSION
MATERIALS AND METHODS
CONCLUSION
INTRODUCTION
CORONAVIRUS
• that caused the outbreak
• identified in the case of viral pneumonia in
Wuhan in 2019
• named as 2019-nCoV/SARS-CoV-2 by the
World Health Organization (WHO)
• SARS-CoV-2 belongs to the
coronavirus genus β with a single
stranded, non-segmented positive-sense
RNA genome
• which is the seventh known
coronavirus that can infect humans
INTRODUCTION
SARS-CoV-2 DETECTION TECHNIQUES
RT-PCR:
Genetic RNA material is the earliest marker to be
detected.
Pulmonary CT:
for the clinical diagnosis of COVID-19
ELISA for antibody tests: (antibodies IgM and IgG)
demonstrating previous exposure/immunity
monitoring the response to future immunization
strategies
INTRODUCTION
Real-Time PCR Detection
• In COVID-19 patients, RT-PCR was detected as positive
• one day before the onset of symptoms
• Most COVID-19 patients cannot be detected before
premorbid
• because of the low copy number of the virus
• Some discharged patients appearing “re-examination-
positive”
• could be attributed to the persistence of a
• small number and
• low copy number of the viruses.
INTRODUCTION
Real-Time PCR Detection
False-Negative Rate
Low Sensitivity Rate
INTRODUCTION
False-Negative Rate
It is about 20–40% in the highly suspicious cases due to
• Improper sample collection
• Storage
• Personnel operation
• Low sensitivity test kit
• Mutation or Deletion in the target gene
INTRODUCTION
Low Sensitivity Rate
The target genes for SARS-CoV-2 are based on the
conserved and specific
• open reading frame 1ab (ORF1ab)
• spike (S)
• RNA-dependent RNA polymerase (RdRp)
• envelope (E)
• nucleocapsid (N) genes
ORF1ab is the highest specificity confirmation target gene, it is
considered to be less sensitive than other targets in clinical application
INTRODUCTION
Mixed Sample Testing
• used in large-scale population testing
• improves the detection efficiency
• it might miss the individuals with low
viral load
• none of the approved nucleic acid test
kits mentioned whether they could be
used for mixed sample detection.
• suspicious results or single channel
positive results should be re-examined
with another manufacturer’s kit or
method.
• Selection of a specific validation kit is
yet to be elucidated.
MATERIALS AND METHODS
Patients:
10 confirmed cases
100 suspected cases
Ethics statement
Specimen Collection:
Nasopharyngeal Swabs
Oropharyngeal Swabs
Virus RNA extraction
Real-Time PCR:
• Five kits were selected.
• Each kit contained
• 25 μL of the reaction system
• 5 μL of the RNA template
• Amplification reaction according to the
instructions of the kits
• carried out on the ABI7500 Real-Time PCR
system
Kit 5
MATERIALS AND METHODS
Statistical methods:
 SPSS18.0 software was used for statistical analysis.
 The Student’s t-test was used to evaluate the differences between Ct values.
RESULTS
Sensitivity Evaluation of SARS-COV-2 Detection Kits
Strategies To Reduce False Negatives of SARS-COV-2
Sensitivity Evaluation Of SARS-COV-2 Detection Kits
Sensitivity Evaluation Of SARS-COV-2 Detection Kits
Strategies To Reduce False Negatives of SARS-COV-2
Strategies To Reduce False Negatives of SARS-COV-2
CONCLUSIONS
 Mixed sample detection challenges the sensitivity of nucleic acid
detection kits.
 Detection of mixed samples is only applicable to low-risk populations
using the high-sensitivity kits.
 Antibody and nucleic acid tests should complement each other to
improve the diagnosis,
 especially to screen the asymptomatic patients better and
 reduce the false-negative phenomenon of “false recovered patients”
or premorbid patients with low virus latency.
Research Paper Presentation: Sensitivity Evaluation of 2019 Novel Coronavirus (SARS-CoV-2) RT-PCR Detection Kits and Strategy to Reduce False Negative

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Research Paper Presentation: Sensitivity Evaluation of 2019 Novel Coronavirus (SARS-CoV-2) RT-PCR Detection Kits and Strategy to Reduce False Negative

  • 1. Yunying Zhou, Fengyan Pei, Mingyu Ji, Li Wang, Huailong Zhao, Huanjie Li, Weihua Yang, Qingxi Wang, Qianqian Zhao, Yunshan Wang Presented By: SHAISTA JABEEN Molecular Genetics Semester Spring 2021
  • 3. INTRODUCTION CORONAVIRUS • that caused the outbreak • identified in the case of viral pneumonia in Wuhan in 2019 • named as 2019-nCoV/SARS-CoV-2 by the World Health Organization (WHO) • SARS-CoV-2 belongs to the coronavirus genus β with a single stranded, non-segmented positive-sense RNA genome • which is the seventh known coronavirus that can infect humans
  • 4. INTRODUCTION SARS-CoV-2 DETECTION TECHNIQUES RT-PCR: Genetic RNA material is the earliest marker to be detected. Pulmonary CT: for the clinical diagnosis of COVID-19 ELISA for antibody tests: (antibodies IgM and IgG) demonstrating previous exposure/immunity monitoring the response to future immunization strategies
  • 5. INTRODUCTION Real-Time PCR Detection • In COVID-19 patients, RT-PCR was detected as positive • one day before the onset of symptoms • Most COVID-19 patients cannot be detected before premorbid • because of the low copy number of the virus • Some discharged patients appearing “re-examination- positive” • could be attributed to the persistence of a • small number and • low copy number of the viruses.
  • 7. INTRODUCTION False-Negative Rate It is about 20–40% in the highly suspicious cases due to • Improper sample collection • Storage • Personnel operation • Low sensitivity test kit • Mutation or Deletion in the target gene
  • 8. INTRODUCTION Low Sensitivity Rate The target genes for SARS-CoV-2 are based on the conserved and specific • open reading frame 1ab (ORF1ab) • spike (S) • RNA-dependent RNA polymerase (RdRp) • envelope (E) • nucleocapsid (N) genes ORF1ab is the highest specificity confirmation target gene, it is considered to be less sensitive than other targets in clinical application
  • 9. INTRODUCTION Mixed Sample Testing • used in large-scale population testing • improves the detection efficiency • it might miss the individuals with low viral load • none of the approved nucleic acid test kits mentioned whether they could be used for mixed sample detection. • suspicious results or single channel positive results should be re-examined with another manufacturer’s kit or method. • Selection of a specific validation kit is yet to be elucidated.
  • 10. MATERIALS AND METHODS Patients: 10 confirmed cases 100 suspected cases Ethics statement Specimen Collection: Nasopharyngeal Swabs Oropharyngeal Swabs Virus RNA extraction Real-Time PCR: • Five kits were selected. • Each kit contained • 25 μL of the reaction system • 5 μL of the RNA template • Amplification reaction according to the instructions of the kits • carried out on the ABI7500 Real-Time PCR system
  • 11.
  • 12.
  • 13. Kit 5
  • 14. MATERIALS AND METHODS Statistical methods:  SPSS18.0 software was used for statistical analysis.  The Student’s t-test was used to evaluate the differences between Ct values.
  • 15. RESULTS Sensitivity Evaluation of SARS-COV-2 Detection Kits Strategies To Reduce False Negatives of SARS-COV-2
  • 16. Sensitivity Evaluation Of SARS-COV-2 Detection Kits
  • 17. Sensitivity Evaluation Of SARS-COV-2 Detection Kits
  • 18. Strategies To Reduce False Negatives of SARS-COV-2
  • 19. Strategies To Reduce False Negatives of SARS-COV-2
  • 20. CONCLUSIONS  Mixed sample detection challenges the sensitivity of nucleic acid detection kits.  Detection of mixed samples is only applicable to low-risk populations using the high-sensitivity kits.  Antibody and nucleic acid tests should complement each other to improve the diagnosis,  especially to screen the asymptomatic patients better and  reduce the false-negative phenomenon of “false recovered patients” or premorbid patients with low virus latency.

Editor's Notes

  1. Citation: Zhou Y, Pei F, Ji M, Wang L, Zhao H, Li H, et al. (2020) Sensitivity evaluation of 2019 novel coronavirus (SARS-CoV-2) RT-PCR detection kits and strategy to reduce false negative. PLoS ONE 15(11): e0241469. https://doi.org/10.1371/journal. pone.0241469
  2. Sensitivity evaluation of SARS-CoV-2 detection kits The lowest detection concentration is a critical performance parameter to evaluate the sensitivity of the kit. Viral RNA was extracted from a patient with SARS-CoV-2 and diluted according to the following proportion gradient: 1:5, 1:10, 1:20, 1:40, 1:80, 1:160, and 1:320. Each concentration was detected three times with five kits.
  3. (A) Virus level that disappears with the increase in the dilution concentration in different kits.
  4. . (B) The Ct value of the amplification curve was positively correlated with the dilution gradient. The red asterisk represents the comparison of Ct values of N gene, while the green asterisk represents the comparison of Ct values of ORF1ab/RdRp gene between the two kits. �P < 0.05; ��P < 0.01. (C) Kit-1 has the highest sensitivity based on the verification of multiple positive samples. (D) Selection strategies of validation kit
  5. . (A) Continuous amplification of PCR products for gradient dilution samples.
  6. (B) Continuous amplification of PCR products for suspicious specimens.